‘Historic undertaking’ begins

First doses of vaccine injected into state health care workers

Shawn Hendricks, a nurse at the University of Maryland Medical Center, was home Monday for a rare day off when the call came: There was a dose of the COVID-19 vaccine waiting for her.

Hours after the vaccines arrived packaged in dry ice at the downtown Baltimore hospital, she came from her Baltimore County home, rolled up her sleeve and became one of the first in the state and the nation to be inoculated.

“Definitely been a topic of conversation in my household that we’d get the vaccine when it became available,” said Hendricks, who oversees several COVID-19 units as the nursing director of medicine, cardiac services and the tele-sitter program at hospital.

“My husband and I knew we’d be on board to get it,” said Hendricks, citing several family members, including her mother, who have been infected.

The doses were prepped for distribution immediately after the

U.S. Food and Drug Administration authorized a vaccine developed by Pfizer for emergency use Friday in a rapid-fire process. An advisory panel had spent Thursday considering the safety and efficacy of the vaccine, a messenger RNA vaccine, a kind studied but never before approved.

The University of Maryland hospital was the first hospital in the state to report receiving the

Pfizer vaccine — a tray of 975 doses — that will go to front-line health care workers in the 13-hospital system. Johns Hopkins Medicine also reported later Monday that it received initial doses.

Two dozen hospitals in Maryland are slated to receive about 50,700 doses of the Pfizer vaccine in coming days, including several

more in the university’s and Johns Hopkins systems, plus those in the MedStar and LifeBridge systems and others.

Another 104,300 doses of a Moderna vaccine will be shipped in another week or so if it, too, is authorized by the FDA as expected. Everyone vaccinated will need a second dose.

“For many months, we have been looking forward to the day when vaccines would be available to protect our healthcare workers and very soon for the community at large,” said Dr. MohanSuntha, the university hospital system’s president and CEO, in a statement. “As webegin vaccinations, and finally begin the process of ending this pandemic, I’m thankful to our UMMS and UMSchool of Medicine colleagues who have been working tirelessly to care for our community and lead in the development of innovative treatments and vaccines.”

Both the Pfizer and Moderna vaccines were tested at the University of Maryland School of Medicine.

Gov. Larry Hogan called the vaccination effort a “historic undertaking” in a statement that took a positive tone after nine months of the pandemic that has caused about 237,000 cases, more than 23,500 hospitalizations and nearly 5,000 deaths in Maryland. Restrictions remain in place for Marylanders and officials say masking and distancing will be needed for months.

“I had the opportunity to personally thank these front-line health care workers for agreeing to be the first recipients of the vaccine, and hearing some of their experiences throughout the pandemic,” Hogan said. “This is an exciting day for the state of Maryland, and hopefully one we will look back on as the beginning of the end of this pandemic.”

The doses are just a fraction of what’s needed to vaccinate everyone in the state of 6 million people. Hogan estimated that the initial 155,000 doses would cover just half Maryland’s health care workforce.

The hospitals receiving the first doses plan to follow federal and state guidance and give the vaccine first to workers in contact with COVID-19 patients. That includes doctors, nurses, respiratory therapists and others in the emergency rooms, critical and intensive care units and other areas.

The first five people vaccinated in the Maryland system were a nurse, a shock trauma physician, an emergency medicine physician, a respiratory therapist and an environmental services worker.

In coming weeks, more hospital workers, as well as residents and staff of nursing homes and long-term care facilities, are expected to be vaccinated. They will be followed by those with certain underlying health conditions and seniors, essential workers and then the general public. Hospitals are the first stop, but eventually people will be able to get vaccinated in a doctor’s office, urgent care center, pharmacy or other location. The effort is expected to take well into next year as more vaccines are authorized, manufactured and distributed.

Alex Azar, secretary of the U.S. Department of Health and Human Services, told NBC’s “Today” show Monday morning that he expected 20 million people to be vaccinated by the end of December, 50 million by the end of January and 100 million by the end of March.

Officials have said this will be a huge undertaking, as materials, supplies and manufacturing capacity remain limited.

The Pfizer vaccine also requires ultra-cold storage, at about minus 80 degrees Celsius, necessitating special freezers.

Most states are following guidance on vaccine distribution from the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, according to a review by the Kaiser Family Foundation.

The foundation estimates that there are 17.6 million health care workers and longterm care residents. The group expects non-health care essential workers to be recommendations for the next priority group, followed by people age 65 and older and those with conditions that put them at risk for severe illness from COVID-19.

The CDC estimates there are 87 million essential workers, 53 million seniors and more than 100 million people with high-risk medical conditions.

Johns Hopkins said it expects to begin vaccinating front-line health care workers Wednesday.

“Since supplies of the vaccine(s) will initially be limited, Johns Hopkins Medicine has developed a prioritization framework to help determine the order in which the vaccine will be offered and administered to our health care personnel,” the system said in an emailed statement.

Officials said the vaccine will go to “clinical and non-clinical staff essential to delivering care and support services to patients with and without COVID-19 through a random selection process. Vaccination will not be mandatory.

Hendricks at the university hospital said many health care workers will want the vaccine, but she wanted to encourage those in and outside the hospital to consider it. That includes African Americans like her. She said the community has been affected disproportionately but remains hesitant and distrustful of the health care system after mistreatment over many years.

“Even though the vaccine is not yet available to everyone, this will give everyone the opportunity to see the vaccine is safe,” she said.

Hospital systems anticipate strong demand, which means tough choices ahead.

Immediately after the FDAauthorization, an email went out to workers at Sinai Hospital and other in the LifeBridge system asking them to “opt in” for inoculation.

About 100 people responded immediately and 500 within the hour. By midday Monday, 1,700 signed up for one of the 2,900 doses the system was expecting in its first wave.

“There are 10,000 people in the system, but we think this is a tremendous response in a short period of time especially given there was a weekend in there,” said Leslie Simmons, LifeBridge Health executive vice president and chief operating officer. “Word is getting out and there is great interest. We just waiting on a delivery date and time.”

LifeBridge, like Hopkins and others, does not plan to require vaccination, as it does for the annual influenza vaccine. That vaccine has been around for years and has full FDA approval.

Eventually, everyone who wants the vaccine will get it, unlike when there are shortages of medications and equipment, which is not uncommon in a hospital, said Dr. Yoram Unguru, a pediatric oncologist at Sinai and medical ethicist at Johns Hopkins who has been serving on the LifeBridge committee considering the process.

Deciding to prioritize health care workers whocare for COVID-19 patients wasn’t a tough decision, but the LifeBridge team now faces the more daunting task of how to get the rest of the hospital workers, the patients and the community vaccinated when doses eventually become available.

“We do have to prioritize,” Unguru said. “But if you’re 66 years old and a nurse who is relatively healthy you’re a priority for your age, and you’re 36 and have diabetes and are a little overweight you are a priority for your conditions. Which one is more at risk? ... Those conversations have begun.”