On Wednesday, people stood in a long line outside the DoubleTree Hotel in Danvers, with the cold hitting their faces and probably one thing on their minds: Will I get the COVID-19 vaccine today?
The mad rush to the state’s mass vaccination site – created by confusion and a strong desire to receive one of the sought vaccines – was spurred on by the news that “extra” doses of the vaccine could be available to anyone. If they moved fast enough, they might be able to arrest one.
Curative, the company that operates the site, later made it clear that workers were offering these additional doses to patients who initially had appointments already scheduled at the end of the week.
However, the question remains: is there a way to get one of those extra photos? And is it worth a try?
The answer seems to depend on where you are going – and it is not that simple.
“It is a very important subject. I don’t think anyone wants to waste a dose of vaccine at a time of such shortage, ”said Dr. Karl Laskowski, associate medical director at Brigham and Women’s Hospital, who helped design vaccine clinics throughout the Mass General Brigham health system, to Boston.com on Friday.
Clinic staff are keen, even passionate, to ensure doses are not thrown away, as so many people need one or are eager to get it as quickly as possible, he said.
“We have to balance this with the goals of equitable and impartial distribution, so that we are not distributing at random,” said Laskowski. “Certainly nobody wants to give it to friends and family, it would be a disaster. You want to give it to the people who need it most. “
Hospitals and health systems have formulated their own strategies to discharge their vaccines within the state parameters of who is eligible to be vaccinated.
At the moment, a large part of this focus is on the elderly population of Massachusetts, aged 75 or older, although health professionals and first respondents are also eligible to receive their vaccines.
According to a new state policy, individuals who accompany an elderly person to their vaccination appointment at a massive state-run center can also be vaccinated if they make an appointment for the same day.
Still like The Boston Globe As noted, clinics can distribute extra doses of vials that cannot be re-frozen after they are opened (vaccines must be used within six hours after the vial is inserted by syringe) to anyone they choose.
“In the rare case that you have the COVID-19 vaccine that will expire and you have no one in the current priority groups to be vaccinated, you can use your clinical judgment to administer the vaccine to a person in another priority group that is closer that the current priority group is the target of vaccination to avoid waste of vaccine ”, informs the state website. “It is important that you also ensure that this individual is now included in your reminder recall systems for the second dose.”
Pharmacies and even different operators of state-sanctioned mass vaccination sites have their own protocols on what to do with overdoses, according to the newspaper.
Hospitals and clinics
At Tufts Medical Center in Boston, healthcare professionals begin to do the math about an hour or an hour and a half before the vaccine clinic closes.
They look for how many appointments are missing for the day and how many vaccines have already been taken, according to Dr. Gabriela Andujar Vazquez, an infectious disease physician and epidemiologist associated with the hospital.
“It worked very well for us in terms of … at that time, when we are almost closing, we are pulling bottle by bottle so that we can be sure that, in the end, we don’t waste any dose,” she said in an interview.
If no further appointments are scheduled, but extra doses remain, Tufts calls on several local organizations to try to find eligible weapons, she said. If this effort is unsuccessful, the hospital will work to vaccinate qualified inpatients before proceeding to outpatient clinics at its night clinics, said Andujar Vazquez.
Notably, the medical center limited its vaccines to its patients and staff by appointment only, although Andujar Vazquez said the hospital is working to open another location to expand vaccination for the general public.
“Hospitals are using a variety of approaches to ensure that each dose is administered at the end of each day,” said Valerie Fleishman, senior vice president and director of innovation at Massachusetts Health & Hospital Association, in a statement. “At a time when supplies are still very limited, providers have become adept at scheduling appointments that align precisely with the amount of vaccine they have on hand.”
Throughout Mass General Brigham’s clinical system, employees created specific waiting lists for clinics for employees and patients over 75 who still need the vaccine, according to Laskowski.
So far, the healthcare system has not really needed to expand its reach beyond these demographics due to demand, he said.
But there is a backup plan on how to handle extra doses, which prioritizes hospitalized patients who meet age requirements and then individuals over 65 with two or more comorbidities or who live in vulnerable communities, said Laskowski.
“We thought those were reasonable groups, where we wouldn’t be giving a healthy 23-year-old, which doesn’t seem right,” he said. “But if that’s the choice between throwing it in the trash and, you know, I think it’s a very difficult situation, one that we really didn’t want to be in because it’s almost impossible for people on the spot to make that call at A Hora.”
And so far, there is little waste. Mass general Brigham usually ends up with just one or two extra doses a day “after making thousands of vaccinations,” he said.
On Thursday, hospitals across the community indicated that the state informed them that their vaccine deliveries will be reduced so that more doses can be delivered to state-administered vaccination sites.
In light of that, Laskowski said that General Brigham has suspended scheduling new appointments for patients or staff seeking the first dose of the two-dose vaccine. Anyone who has an appointment and is waiting for the second dose will receive it, he said.
“Over time, this will limit our ability to give as many vaccines as before, and it will mean that there will be fewer extra doses as a result of that,” he said.
Meanwhile, at CareWell Urgent Care’s 16 vaccination sites in Bay State, patients who do not meet state protocols can receive one of the extra injections, the Globe reports.
“As part of efforts to ensure that each dose of the coronavirus vaccine is used, there have been some cases where we have provided surplus doses of the vaccine to consumers who would not otherwise qualify,” Shaun Ginter, executive director, told the newspaper in an announcement.
“We currently have a waiting list with consumers, listed in order of priority, to which we call whenever someone cancels or does not attend the service,” he said.
Pharmacies and mass vaccination sites
So far, there are four state-operated mass vaccination sites in Massachusetts, with two more – in Natick and Dartmouth – scheduled to open in the next two weeks.
Cambridge-based CIC Health currently manages locations in Fenway Park and Gillette Stadium and uses a system to record open bottles, appointments and missed appointments, among other factors, to ensure that the bottles are fully used, Rodrigo Martinez, director of marketing company, said Globe.
If leftovers are available, the company has found someone to administer the vaccine in these cases, whether it be a local worker or a person who accompanied a patient to their appointment, even if they do not belong to an eligible demographic, according to the newspaper.
“We haven’t wasted a single dose since we opened and have done more than 50,000 vaccinations since we opened,” in January, he said.
At CVS, which was set to start offering doses at 30 locations in Massachusetts on Friday, store employees are tasked with assessing “case by case how to more efficiently vaccinate eligible individuals with the remaining doses,” Joe Goode, a company spokesman, told the Globe.
“This can include local ‘waiting lists’ of eligible individuals, if appropriate,” he said.
Profiles of patients at each pharmacy can help identify eligible people, said Goode.
“In short, we are taking steps to help ensure that these valuable doses are used in the best way,” he said.
What Governor Charlie Baker said
On Thursday, Governor Charlie Baker said the facility must follow the state’s dose and eligibility requirements when handling extra injections, according to the WCVB.
“We don’t believe there should be, like, a cattle call at the end of the day,” he said. “People need to administer their dosage and administer their vaccine.
“Nobody wants to waste doses, let’s face it,” added Baker. “But at the same time, people have to administer the dosage they have for the appointments they have.”
A request for comment from the Massachusetts COVID-19 Command Center was not returned on Friday.
Laskowski informs that the public must be patient with the launch of the vaccine. Many doctors and doctors have received many calls about the vaccine and patient appointments, he said.
If someone is at high risk for the virus, they should talk to their doctor about what to do, he said.
For other healthy, lower-risk individuals, Laskowski has another piece of advice.
“I would say to people, they probably don’t call your doctor’s office because you can wait and they won’t be able to help you,” he said. “And if you are under 65 and healthy, don’t get in line, don’t stay at the pharmacy, don’t go there. Just don’t do that. “
Waiting a few more weeks for the vaccine “will not make a big difference in the grand scheme of things,” said Laskowski.
“I desperately want to get everyone’s vaccine as soon as possible,” he said. “But I think everyone is doing their best.”
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