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Marian hospital pharmacy employees prepare COVID-19 vaccine for thousands

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Sydney Asencio laboriously prepared to enter a lab that's no bigger than a prison cell, first slipping booties over her shoes, donning a hair net and gown, then washing her hands and forearms for at least 30 seconds before putting on gloves.

A pharmacy technician at Marian Regional Medical Center, Asencio was prepping for the tedious and repetitive task of mixing and filling individual syringes with COVID-19 vaccine for a three-day clinic that started on Thursday to inoculate 3,600 adults aged 65 and older. 

She wiped down equipment and nearby surfaces with disinfectant, then started the process of filling each syringe with a small amount of saline before plunging the needle into the vial and drawing a tiny amount of vaccine, “liquid gold," before capping the syringe. She's lost count of how many doses she has prepared, but the process, she said, is already like second nature. 

“It’s kind of peaceful,” Asencio said. “I don’t mind the repetitiveness of it. It’s kind of nice just getting your job done and not being interrupted."

Doctors and nurses are usually the ones depicted in photographs administering the coronavirus vaccine, but Marian pharmacy employees have worked behind the scenes in a team effort to ensure there is ample supply.

“Every day we’re doing this, it’s our way out of the pandemic,” said Marissa A., a pharmacist who has worked for Marian for nearly eight years and stepped into the role of vaccine coordinator. She preferred to not give her last name for security purposes.

Her lead in the hospital’s vaccine operation earned her employee of the month recognition and the respect of her co-workers.

Efforts to acquire the Pfizer-BioNTech vaccine began with applying for it in November, with the expectation it would receive emergency use authorization on Dec. 11. Because the vaccine requires cold storage, Marian ordered an ultra-low temperature freezer, which arrived the day before Thanksgiving, according to Jessica Beck, Marian’s pharmacy manager.

Vaccine preparation begins inside the freezer located in an undisclosed area of the hospital. Beck and Marissa don protective equipment, including thick protective gloves, just to open the freezer, which sits at -110 degrees Fahrenheit and will cause instant frostbite if bare skin touches the inside. 

The task requires two people for safety and security purposes, according to Beck.

The Pfizer vaccine, which the hospital first received in December, can be stored in the freezer for up to six months, and lasts five days once it’s pulled out and placed in refrigeration. It only lasts two hours, however, once it leaves the refrigerator. Once it’s mixed, the vaccine lasts up to six hours. Each step is time-stamped down to the minute.

The Moderna vaccine, which the hospital first received in January, isn't as volatile and doesn’t require ultra-low temperatures like Pfizer's, according to Beck.

Beginning prep

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Marissa removed 54 vaccine vials, placed them into a portable cooler and transported them with Beck through a multistory labyrinth of hallways and elevators inside the hospital before arriving at the pharmacy.

Technicians begin their vaccine preparation starting at 5 a.m. and stagger doses into the afternoon to ensure no dose is wasted. Vials hold up to six 0.3 milliliter doses each.

“It’s kind of a balancing act,” Beck said. “We don’t want to have too much and not have any arms to put [the vaccines] in.”

During Asencio’s garbing process, which occurs in a separate room connected to the lab, she has to follow a specific order, first donning the booties one at a time. A red line marks a boundary that an unsterile employee cannot cross. Asencio steps across the red line one foot at a time after donning booties. She completes the garbing process before entering the room, where a second technician is usually already working.

"It was nerve-wracking at first," Asencio said. "You definitely want to be careful not to be spilling any of the vaccine."

Once prepared, a runner collects and transports the batch to a cluster of tents in a parking lot several hundred yards away, where dozens of older adults awaited their shots.

Each day, the pharmacy must record how many doses are prepared and administered, data which are sent off to state health officials.

“It’s all numbers, all day,” Marissa said. “When I took on the role of vaccine coordinator, I didn’t know what to expect. I don’t think anyone did.”

Receving a dose

Franco Colantino, 70, is a retired software/technology business consultant in Santa Maria who received his first dose of the Pfizer vaccine on Friday. His second dose is scheduled in March. His wife isn’t vaccinated yet because she is under 65.

After the vaccine, Colantino hopes to visit his family in central Italy by summertime. In the meantime, he’s content with biking throughout the Santa Maria Valley, an activity that he does every other day. He's upbeat about the vaccine, but is taking a wait-and-see approach. 

“Life is good but a little boring. But it’s good, especially in this area,” Colantino said. 


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