An inside look at the strict procedures followed before a person receives COVID-19 vaccination

Posted at 12:13 PM, Dec 18, 2020

CHICAGO — Millions of frontline healthcare workers are rolling up their sleeves for the first of a two-dose COVID-19 vaccine. First out is Pfizer’s vaccine, and now, an FDA panel has recommended Moderna’s vaccine for emergency use authorization.

The available Pfizer shot requires a complex and precise procedure for it to work.

Before the needle even breaks the skin, a strict protocol must be followed precisely.

“We're going to put it take it from the negative 80 ultra-low storage and we're gonna defrost it to refrigerator temperatures,” explained Erin Shaughnessy, director of pharmacy at Rush University Medical Center in Chicago. “That's gonna give us five days of stability for the vaccine.”

It’s like something out of Mission Impossible.

“We installed additional security cameras and we have additional security protocols,” said Shaughnessy.

She’s charged with ensuring the vaccine is securely handled and properly prepped before it’s injected.

“We don't want to risk wasting any of the drugs,” she said. “The stuff is liquid gold right now.”

That liquid gold must be stored at 80 below zero, in a secure location that only a few pharmacists have access to.

“We have to take it out of the ultra-low freezer and move it to a refrigerator just to thaw for three hours.”

Once thawed, it cannot be re-stored.

“You can't put the medication back into the freezer,” said Shaughnessy. “Once inside, you have to use it or you're going to lose it. It's gonna have a five-day refrigerated expiration.”

Pfizer’s vaccine protocol also requires the vaccine to be protected from UV light and the dilution must be gently inverted exactly 10 times. Shaken too hard, says Shaughnessy, and it could go bad.

“It's very, very specific," she explained.

That’s when the clock starts ticking.

“Once they're thawed and reconstituted, basically diluted down to make the actual doses, then that's when we have six hours on the clock going from that dilution point into someone's arm,” said Luke Hvass, a clinical pharmacist at Rush.

Each dose is recorded and logged. It’s a symphony of procedures that must come together like clockwork.

“It's a lift for a lot of hospitals, a lot of organizations, but I think it's a challenge everybody is ready to rise to because everyone is so excited about getting this vaccine process started,” said Shaughnessy.

The Department of Health and Human Services has expanded the scope of who can act as vaccinators. In addition to pharmacists, interns, pharmacy students and pharmacy technicians who complete 20 hours of training will be added to the vaccination workforce to help handle the massive undertaking.