San Francisco Chronicle - (Sunday)
S.F. rescues 1,000 thawed vaccine doses
Pilot, couriers, health workers race to transport Pfizer vials 300 miles
Dr. Mary Mercer was just coming off her emergency room shift at San Francisco General Hospital on Thursday night when the call came in: Humboldt County had a “pizza box” of Pfizer vaccine that it couldn’t use. Did San Francisco want it?
A pizza box is public health slang for a flat of Pfizer vials — which is about the size of a pizza box, and contains more than a thousand doses.
Mercer, who is the city’s vaccine coordinator on top of being an ER physician, said she didn’t hesitate. “Yes, we definitely want that,” Mercer said she told the caller. “Any drop we can get, we want.”
But Pfizer is a sensitive vaccine with particular storage
needs, and this box had already been moved from cold storage to a refrigerator. The clock had started: The doses would be unsafe to use after five days, and they needed to go into arms by Sunday.
That meant transporting 1,002 doses, stored in 167 thimblesize glass vials, 300 miles from Eureka to San Francisco, ideally in less than a day, keeping them safe and cool along the way.
The trip would ultimately involve a generous San Francisco International Airport employee and private pilot, two Muni operators turned vaccine couriers, and a team of nurses and doctors ready to inject arms at a San Francisco General clinic first thing Saturday morning.
“The effort was really energizing,” Mercer said late Friday, after the vials were nestled in their new refrigerated home at San Francisco General and had been checked by a pharmacist to ensure they were safe to use. “We were cheering the vaccine the whole way.”
The sudden gift arrived just when the city needed it most, Mercer and other public health officials said. Vaccine eligibility opened to everyone 16 and older Thursday, but San Francisco’s supply is lower now than it was a month ago — about 10,000 doses a week compared with 16,000. The thousand doses from Humboldt County represent a tenth of the city’s total supply for the week.
All of them went to a dropin clinic at San Francisco General for people who live in neighborhoods hardest hit in the pandemic. The clinic is typically open from 9 a.m. to 3 p.m. and is capable of delivering 2,000 shots, but it’s been closing early lately because of lack of supply. With the added doses, it ran at full capacity Saturday.
“Supply is so constrained, and there are so many people who need and want vaccine,” Mercer said. “We’ve really been scouring for any opportunities across the region to get more.”
That scouring is what turned up the Humboldt County vaccines. The San Francisco Public Health Department had assigned workers from the start of the pandemic to hunt for extra supplies the city could grab from counties that were overstocked. First it was personal protective equipment like masks and face shields. Now it’s vaccines.
Emergency operations staffs across the state are a closeknit community, and they have email lists and other channels for sharing information and requesting help. It was in one of those emails that a San Francisco public health staffer put out an urgent request for spare vaccine. The city needed help finding enough vaccine to cover firstdose appointments that had already been scheduled.
Meanwhile, up in Humboldt County, public health officials had scheduled a mass vaccination clinic every day of the week, expecting to administer about 1,000 shots a day, based on previous interest. But suddenly appointments dropped off, for reasons they don’t yet understand, and the county found itself with a flat of thawedout vaccine it couldn’t use.
The Pfizer vaccine must be stored in an ultracold freezer at temperatures between minus 112 and minus 76 degrees Fahrenheit. A couple of weeks before use, it can be moved into a freezer that is somewhat less cold, and then to a refrigerator, kept at 36 to 46 degrees, for up to five days.
A lot of careful management goes into planning when flats will be thawed. Throughout the pandemic, there have been many examples of counties and other vaccine providers suddenly needing to offload batches of vaccine before they expired. Sometimes freezers fail, or not as many people show up at a clinic as expected.
“This vaccine is the most logistically challenging vaccine of all time,” Dr. Ian Hoffman, the Humboldt County health officer, said Saturday. “But we were determined to get them out one way or the other. The bottom line is we’re super happy to help out another county. Our team was elated to see the way this went down.” When Mercer got word of the thousand doses Thursday, her first thought was transportation. A 12hour round trip seemed too big of an ask for the city’s couriers. Someone suggested looking for a pilot to fly the vaccine down. They eventually found a volunteer who’s an employee at San Francisco International Airport and a longtime private pilot. He asked to remain anonymous.
He flew Friday morning to tiny Kneeland Airport, an airstrip 14 miles out of Eureka. A Humboldt County public health worker drove the vials in a refrigerated container. The pilot flew them back down to San Carlos Airport.
San Francisco public health sent two couriers to pick up the cargo and make the 45minute drive to San Francisco General in a white city van.
”We got the word Friday morning, texting that somebody had to go up to Humboldt to pick up vaccine. And we were like Humboldt? You should have called us early this morning,” said one of the couriers, Marvin Stowe, with a laugh. He hadn’t realized at first that a pilot would be making the main trip. Stowe is a cable car operator who’s been transporting vaccine since February.
At San Francisco General on Saturday, the vaccine clinic where the Humboldt County shots ended up was bustling as usual, though the lines were shorter than the week before, staff said.
Cory Li, 31, and roommate Haitao Mao, 30, came there Saturday afternoon for their first shots of Pfizer. They hadn’t been told where the shots came from or about their urgent journey down the state. They were just happy to finally get their turn, after trying and failing all week to make appointments.
“At least the first shot is down now,” Li said, standing outside the clinic. Behind him a line was finally forming. And upstairs in Building 5, a pharmacist was opening tiny purplelidded vials and preparing the next round of shots.