From farmer’s bar to pharma’s bar
TWO YEARS AGO, THE MCINTOSH CENTRE AT SHEPPARTON SHOWGROUNDS WAS THE PLACE FOR PEOPLE TO CELEBRATE. THIS YEAR, IT BECAME THE EPICENTRE OF SHEPPARTON’S COVID-19 VACCINATION ROLLOUT. WE SPOKE TO THE PHARMACISTS BEHIND THE BAR WHO DRAW UP VACCINE DOSES, TO FIND OUT WHAT IT TAKES TO GO FROM IN THE VIAL TO IN PEOPLE’S ARMS
Seven months into the COVID-19 vaccination rollout and Shepparton’s Vaccination Hub is humming along, giving hundreds of vaccinations a day.
At peak times, such as during the Shepparton COVID-19 outbreak in August and September, the centre administered more than 1000 doses a day of COVID-19 vaccinations to people from a range of eligibility groups.
Throughout this time, working on a bench that used to be the bar for Shepparton‘s McIntosh Centre, the Goulburn Valley Health pharmacy team has been busily drawing up COVID-19 vaccine doses.
Despite using an esky and ice, this shot is a little more complicated than what would have been served over the counters of the McIntosh Centre in past years.
“It‘s very involved, it‘s not just pull it out of the fridge and stick it in an arm,” GV Health McIntosh Vaccination Centre pharmacy team leader Annette Neil said.
“When we train nurses, they say: ‘I had no idea there was so much involved.‘ It‘s a real eye-opener as to how much goes on behind the scenes.”
Long before the Shepparton Vaccination Hub opens for the day, staff are busily preparing needles and doses for the day‘s vaccinations.
Using an esky that has been filled with ice and refrigerated overnight, vials of AstraZeneca and Pfizer vaccines are taken from GV Health‘s main campus to the vaccination hub where they are stored in specialised vaccine fridges – one for each drug – that are being constantly monitored to ensure they maintain a consistent temperature.
“We bring in as many vaccine vials as we think we‘ll need for the day. We know that from the day before because we have spoken to the rest of the team and know the numbers that are booked,” Ms Neil said.
“We allow a little more for walk-ins and always bring slightly more than what we need — you never know what the day is going to bring.
“With the AstraZeneca, they come in their packaged boxes, with the Pfizer, they arrive in ‘pizza boxes‘, and it‘s because they do look like pizza boxes.
“We pack them down into smaller boxes which hold 49 vials, and as soon as you take them out of the freezer, they are good for a month.
“We re-label the boxes with their new expiry date after they leave the freezer.”
Staff ‘strip‘ syringes to be used for the day — a process that involves removing a new syringe from its packaging ready to draw a dose from a vial.
Once the Pfizer vial is diluted with saline, the vaccine dose can be kept for six hours in the syringe.
Each syringe is labelled to show which batch of the COVID-19 vaccine is being used, the expiry date and the saline batch and expiry date.
“Everything is on the label, exactly what we do, how we‘re doing it and the time,” Ms Neil said.
“And those labels and the paperwork are printed the day prior. So there is a lot of preparation before we even draw up.”
Pharmacy staff draw up a dose from the vial — a precise process that takes minutes per syringe.
It is then passed on to a pharmacist or nurse to check the syringe.
“They check the needle is straight, that there are no bubbles and it is at the standard and amount it should be. We then label it and send it out to the vaccinators,” Ms Neil said.
The syringes are placed into a kidney dish and delivered to a point – where the vaccination team can collect and take it to the public-facing side of the vaccination hub.
Once the Pfizer vial is diluted with saline the vaccine dose can be kept for six hours in the syringe.
With COVID-19 present in the community, the ‘front of house’ staff (vaccination, administration and support teams) must put on additional personal protective equipment (PPE) including gowns, N95 face masks and eye protection.
Since the beginning of the vaccination rollout, the pharmacy process has been gradually improved as staff have recognised areas for improvement.
“It‘s been really good, there is a lot involved, and we‘ve had some really good feedback,” Ms Neil said.
“When new staff come along, I always tell them if you think of anything we‘re not doing or we‘re overdoing, we‘re open to suggestions — because that‘s how we learn.
“It‘s nice to do something different. I haven‘t done this single-handedly; Stephanie Chan, our deputy director, has done a lot of work to set things up — she has been fantastic.”