AS VIALS SPOILED, A RACE AGAINST TIME
When a freezer broke, a small Ukiah hospital dropped everything to inoculate hundreds.
SACRAMENTO — About the time Gov. Gavin Newsom took to Facebook on Monday to lament the pace of vaccine distribution statewide, one Northern California hospital was injecting local residents at a furious pace — providing an unintentional road map for how a mass inoculation program could work.
At 11: 35 on Monday morning, senior staff at Adventist Health Ukiah Valley Medical Center in Mendocino County were holding their f irst 2021 executive meeting when the hospital pharmacist interrupted: The compressor on a freezer storing 830 doses of the Moderna COVID- 19 vaccine had stopped working hours earlier, and the alarm meant to guard against such failure had failed.
The doses were quickly thawing.
“It was not how my day was planned,” said Adventist spokeswoman Cici Winiger, who was in the executive meeting. “At that point it was all hands on deck, drop everything.”
The Moderna vaccine is shipped and stored at frozen
temperatures, and stays stable up to 8 degrees Celsius in a regular refrigerator for up to 30 days. But once it reaches room temperature, as it did in the Adventist freezer, it must be used within 12 hours. By the time the freezer problem was discovered, the vials had been creeping toward warm for some time.
Medical staff estimated they had two hours to use them before they would no longer be viable.
With the minutes ticking down, the medical team made the decision that the goal would be to inject every dose, regardless of state guidelines. The medical team believed that “the more people we vaccinate just brings us closer to herd immunity,” Winiger said.
Winiger got on the phone, trying to give the shots f irst to those on the priority lists. One local elder care facility took 40 doses for staff, and the hospital’s chief medical officer drove them to the facility himself.
About 200 doses belong to the county and were being stored by the hospital. Winiger said those doses were returned to the county. The county in turn gave 100 doses to the city of Ukiah, county Chief Executive Carmel J. Angelo said.
Lt. John Bednar, who helps run the county jail, said his facility received 97 of those county doses about 1 p. m. The jail has been experiencing an outbreak, with about three dozen inmates out of 250 currently positive, he said. About a dozen staff have also fallen ill with the virus.
Faced with only an hour to use the shots, sheriff ’s officials decided to administer them to staff and front- line personnel because they didn’t think there was enough time to gain consent and organize a safe protocol for inmates.
Four county medical staff began giving the shots, Bednar said.
“I was like, ‘ Oh, boy, let’s get going,’ ” Bednar said, when the shots first arrived. “I think it went as well as it could.”
An additional 100 doses hit the f ire department about 12: 15 p. m., Fire Chief Doug Hutchison said. At first, garbled information he received through phone calls left him fearing all 800 doses were coming his way, leaving him thinking, “There is no way,” he said. His fulltime staff of 16 had already been promised to help with other clinics.
Hutchison headed to a city conference center, and his remaining crew “began giving shots as fast as we could sit people down and roll up their sleeve,” he said. Their syringes went into the arms of police, essential city staff and f irefighters — including Hutchison, who had declined earlier offerings of the vaccine to make sure his staff got it first.
“I was trying to make sure all my people got shots before I did,” he said.
Ukiah is hardly the only community nationwide that has encountered temperature problems in distributing a COVID- 19 vaccine. Last month, New Mexico reported it had lost 75 doses of Pfizer’s vaccine because of potential overheating during delivery to a hospital, and Texas reported that a “temperature excursion” forced it to set aside 4,300 doses of the Moderna vaccine, later replaced by the federal government.
On Christmas Day in Connecticut, a power outage caused by a winter storm forced medical providers to launch their own Operation Warp Speed to distribute hundreds of doses of the Moderna vaccine before they became useless.
Despite such incidents, the main challenges in mass inoculations have to do with logistical and bureaucratic complications, lack of a centralized state or federal system for distributing the vaccine, and public uncertainty about the safety of the vaccines, despite successful clinical trials last year.
In Mendocino County, Bednar, the sheriff ’s lieutenant, was one of those who received the initial dose Monday, though he isn’t yet sure how he feels about it.
“It’s one of those things where I was a little hesitant at f irst because it’s a new vaccine,” he said. “But I have family that is older, and it’s better that I get it than possibly risk their safety.”
Even as the shots were being delivered to the jail, a big- rig accident on one of the main highways cut the hospital off from its sister facility about 20 minutes away, Winiger said, making it impossible to reach. Ukiah, a town of about 20,000 surrounded by state and national forest, has a population spread through its rural and often difficult- to- navigate territory, creating a daunting challenge to quickly deliver the doses to remote areas.
The Adventist staff turned instead to the local community, with about 600 shots remaining.
First, they sent a text asking every available medical professional to turn out at one of four sites to give the vaccines and monitor those who took them.
“We had nurses, pharmacists, physicians, even those that are not part of the hospital, coming to help,” said Judson Howe, president for Adventist Health in Mendocino County.
“It was all hands on deck and a true community effort.”
Then hospital staff blasted out a text to employees letting people know that anyone who showed up could have the shot. “We just wanted to make sure none of this goes to waste,” Winiger said.
By noon, within 15 minutes after learning of the freezer failure, shots were being administered at all four sites.
Lines began to form as word spread and some staff was siphoned off for crowd control. At the site Winiger ran, about 30 people were turned away after the doses ran out. At the main site near the hospital, she estimates about 120 people left without the shot.
But by the two- hour deadline, every dose had found a patient, Winiger said.
Winiger described the effort as “heroic,” with dozens of medical staff turning out to volunteer within minutes and a quick decision to split into four clinics that kept crowds at controllable numbers.
In his briefing Monday, Newsom also mentioned the need not to waste doses.
“We have plenty of people that want to take that shot,” he said, “and the key is to make sure that, while we are enforcing the rules of the road, we’re aren’t enforcing against just common sense and the energy of someone who says: ‘ Look, I don’t want to waste this dose. Why don’t I get it to someone?’ ”