EDITOR'S NOTE: This story is a collaboration between digital journalist William D'Urso and multimedia journalist Kristen Lago. To watch the video report that accompanies this story, click the arrow above.
For Orange County fire department personnel, their part in the coronavirus pandemic is simple: get a vaccine in as many people as possible.
So far, doses of the first vaccine have been limited to hospital workers like nurses, doctors, and the janitors tasked with sterilizing duties. Those doses came from Pfizer-BioNTech, a drug that demands a freezer capable of a frosty -94 degrees Fahrenheit.
Moderna’s vaccine is more forgiving, content with the freezing limitations of a typical kitchen icebox. Experts said that makes it a better candidate for broad distribution, and three Orange County firehouses have already begun receiving the vaccine, stashing hundreds of doses in portable ice chests that look like oversized footlockers.
But the road to vaccinating hundreds of millions of Americans has been fraught with a suite of planning and logistical complications.
Jeff Lopez has been at the heart of the local response. As the Battalion Chief of the Huntington Beach Fire Department, he’s been a piece of the nucleus responsible for training paramedics and nurses to administer the shot.
First, they had to get through the paperwork and application process that would allow them to act as a vaccination clinic and a second application that would enable them to order doses themselves. Once the California Department of Public Health approved them, department staff began administering vaccinations on December 26. The first batch of about 400 doses ran out on December 31, with more expected in February.
Lopez said the key has been education and a lot of communication. The department, which shares its Huntington Beach training facility with the Fountain Valley Fire Department, held a dozen outdoor collaborative meetings. And there were zoom meetings, conference calls, and texting.
The key to much of the planning has been the smartphone app known as Othena. Lopez and his staff had been part of the beta testing, directly corresponding with the developer to smooth out rough spots in the smartphone app. One snag was getting the software to correctly process all appropriate application approvals from the state department of public health. On top of that, not every location sees the same patient groups. Of the three locations currently administering the Moderna vaccine, Lopez said there are 11 patient groups, and getting Othena to accurately pair patients with the right location took some doing.
The app also reminds patients of their initial appointment and the second shot required four weeks later to fully inoculate a patient.
Clinic staff also use the app to keep track of appointments and record which patient received which medication. The Moderna and Pfizer shots are not designed to be combined.
The app is not yet available for download. Still, when it hits the public, users will see a slick interface with illustrations and hard-to-miss notifications reminding them when an appointment is fast approaching.
Timing with the coronavirus vaccinations is crucial for avoiding waste.
“Theres a dance, when we take it out of the freezer, when we open it and how many people we have to vaccinate,” Lopez said.
Each vial comes frozen but can be reconstituted into 10 doses. That’s twice as many as the Pfizer drug. That means patients need to be ready and waiting. Once a vial is open, both vaccines only last about six hours.
Another key has been training. Kristin Thompson, the EMS Division Chief for the Newport Beach Fire Department, has taken an equal share in preparing the vaccine infrastructure and training. Since each patient requires two shots, fire departments have needed to broaden the worker pool. The training takes about 45 minutes to one hour and includes a slide show followed by a multiple-choice quiz.
Hospitals and other vaccine coordinators have meticulously assembled protocols to ensure earmarked doses go only to the right recipients. So far, doses have been set aside for first responders. But Redland Community Hospital incurred the ire of some when it administered shots of the vaccine to family members of hospital employees. And concierge doctors to the stars told the Los Angeles Times they’ve been offered big paychecks to speed along vaccine delivery.
News reports have regularly painted a devastating picture of rising coronavirus infection rates, plummeting hospital capacity, and increasing death rates.
“We’re in the process of acquiring additional information from the county for who the groups to be vaccinated are next,” said Lopez. “After that we’re going to be like a tiger ready to pounce.”
CORRECTION: A previous version of this story incorrectly stated the wait time after the first shot of the Moderna vaccine. The waiting period before having the second injection administered is four weeks. The error has been corrected. (January 2, 2021).