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ROCHESTER, Minnesota – While many details on upcoming COVID-19 vaccines are still unclear, the Mayo Clinic is preparing to begin administering doses by the end of December.
“We are confident that we will have at least one vaccine by the end of the year for at least a small target population, which has yet to be decided,” Dr Melanie Swift said this week.
Imagine getting ready for a party (back when such things were done), but you don’t know what day it’s going to happen, who’s coming up, or just about any other detail.
That’s a bit like the situation with the Mayo Clinic’s COVID Vaccine Allocation and Distribution Task Force, which Swift is leading as co-chair.
The task force faces many unknowns, but it is preparing for the mass vaccination project. At this point, Mayo is expected to start administering the Pfizer vaccine first, followed closely by others – including the Moderna vaccine.
“We are preparing to be able to faithfully and appropriately receive, store, handle and administer this vaccine (Pfizer) and the vaccines that will come after this,” said Swift.
This means solving many problems of logistics, training, software and public communication, among others.
Cold room
One of the first things to resolve is that the Pfizer vaccine should be stored at minus 103 degrees. While Mayo has some freezers that can get this cold, they are adding more to prepare for the vaccine.
“It’s cold, even for Minnesota. It’s an unusual handling requirement, ”said Swift. “However, as far as we know, none of the other vaccines will have such extreme cold demands.”
Since only one of the promising vaccines requires this type of storage, the Centers for Disease Control and Prevention does not recommend that every medical facility start installing sub-freezers.
The freezers are for long-term storage, she explained. Packages containing 195 vials of Pfizer vaccine, each containing five doses, may be stored in their shipping containers with dry ice for at least five days, 10 days if ice is reconstituted. After being removed from shipping containers, vaccines can be stored in a regular refrigerator for five days.
Once the vaccine is thawed, it will be diluted and divided into doses. A prepared dose of Pfizer vaccine should be used within five hours.
Swift said the process of handling the Pfizer vaccine would be similar to buying a frozen chocolate pie at the grocery store. First of all, it must be thawed. Once it’s ready and sliced, it won’t be long before it’s gone.
Which vaccines and which patients?
In the wake of the Pfizer vaccine, it is expected that up to five more vaccines could be cleared for use under emergency orders from the U.S. Food and Drug Administration in the first months of 2021.
It appears that the standard treatment for vaccines will receive two doses, with weeks in between. This adds another problem for the Mayo vaccination team.
“A patient receiving a Moderna vaccine cannot follow a Pfizer vaccine. They are not interchangeable, ”Swift said. “We have to build a system that ensures the patient gets the right mark at the right time and makes sure they get a full and complete series.”
While Mayo needs to prepare to administer the vaccine, who gets the vaccine and how much the clinic receives will depend on the Minnesota Department of Health.
The FDA will give the green light to a vaccine. The CDC will recommend details of how to distribute and administer the vaccines, as well as who should get them. The state will order the dose and distribute it to medical providers.
Then it will be up to the Mayo Clinic and the Olmsted Medical Center to do the work.
“The ultimate goal is that we want to vaccinate as much of the population as possible to establish widespread immunity to stop the spread of the virus,” Swift said.
And that will mean serving a lot of “chocolate pie”.
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