COURT HOUSE – With a sharp jab to her upper left arm late Thursday afternoon, Dec. 17, registered nurse Gina McNeal became the first person at Cape Regional Medical Center (CRMC) to receive a newly approved vaccine against Covid. She will be far from the last.
The Pfizer vaccine against the coronavirus became the first to receive federal approval Dec. 11. Hospital staff said they eagerly awaited its arrival.
It was off the truck late in the morning Dec. 17, and by 4 p.m., it was being administered to frontline staff, including doctors and nurses who work in the emergency room and the Covid ward.
Dr. Andrea McCoy, chief medical officer, CRMC, and Dr. Richard Artymowicz, director of pharmacy services, CRMC, Dec. 18 said the mood in the hallways was noticeably different since the vaccine’s arrival. With the new vaccines came a renewed sense of hope at the close of a brutal year.
Since the novel coronavirus arrived, in Cape May County, in spring, medical experts and hospital staff learned a lot about the virus and found effective ways to treat it.
However, according to McCoy, staff members feel like there is a way for them to help put an end to a pandemic that caused more than 18,000 deaths in New Jersey and more than 300,000 nationally.
“I think that has really buoyed the morale,” said McCoy.
The staff in the hospital’s Covid ward must keep their layers of protective gear on throughout 12-hour shifts, Artymowicz said. It is hot and uncomfortable and makes it difficult for team members to communicate.
Until recently, it was also the only armor available for health care workers. He said staff handled the difficulties with grace and good humor, but there’s no denying it was a challenge.
For others in the hospital, outside the Covid ward, there has also been an increased sense of urgency and more intense stress.
“Through all this, we’re very proud of our staff,” he said.
Harder still for staff members, the doctors said, has been watching patients struggle and even die, separated from family and loved ones, kept in isolation to prevent further spread of the virus.
“That’s why the vaccine has been so great. People come in and get the vaccine and are smiling,” Artymowicz said.
Shipped Carefully
The vaccines arrived in a temperature-controlled box, fitted with a GPS system that tracked it through the route. Once Artymowicz opened it, he pressed a button that sent a signal that the package arrived, then he awaited the response that it was safe to use before he started preparing the first doses.
The doses must be kept extremely cold throughout the shipping process. Pfizer’s website recommends about -70 degrees Celsius for shipping, which is 94 degrees below zero in Fahrenheit.
Hospital staff members are used to keeping medicines cold, Artymowicz said, but do not usually need ultra-cold freezers. There is additional paperwork with each dose and other logistical issues. There was also some uncertainty about what day the first batch of vaccines would arrive.
“All in all, it’s gone pretty smoothly, I think,” Artymowicz said.
The federal government supplied the vaccine.
“It’s all part of Operation Warp Speed, so the supplies to administer the vaccine, as well as the vaccine, were provided to us free of charge,” Artymowicz said.
The multibillion-dollar Trump administration initiative seeks to rapidly deliver 300 million doses, with the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, U.S. Department of Defense, and other agencies working to accelerate the development and delivery of an effective vaccine.
“This is a national effort. This was an international effort to deliver this vaccine,” said McCoy.
Hundreds of Doses
The hospital has 975 doses, each in small vials that hold a few milliliters of the vaccine, less than a teaspoon’s worth. A standard vaccine needle is used to inject the vaccine into the deltoid muscle.
Common side effects, as listed by the U.S. Food and Drug Administration (FDA), include tiredness, headaches, muscle pain, fever, and more, as well as soreness at the injection site.
McCoy received an injection Dec. 17. She said it was a little sore the next day, but she did not report other problems. Artymowicz received his earlier. He participated in the vaccine’s clinical trials. He said he was not nervous to be among the first to receive the new vaccine.
In addition to the other logistical issues, once a vial of the vaccine is opened, every dose must be administered within a short window of time, or it can’t be used at all. That meant some coordination. Most staff members are eager for a turn, they said, but not all are.
“There are others who are hesitant. They literally needed handholding through it. They knew they wanted it, but were still tentative,” said McCoy. “There are still others saying ‘no, no, no, no.’ We’re working to understand why they’re saying it, so we can help to respond to their concerns.”
Possible Turning Point
Like the winter solstice, the vaccine’s arrival marks a turning point, but winter is still ahead. McCoy urged people to remain careful, saying they should keep wearing masks in public, wash their hands regularly, keep practicing social distancing, and take other precautions as the vaccine rollout continues.
“I think the most important thing we can do is to not let our guard down,” McCoy said. It will take time before enough people receive a vaccination to prevent the virus from spreading through the community.
With case numbers climbing, restrictions on gatherings and much else remain in place in New Jersey.
As of Dec. 18, a quarter of the people admitted to CRMC were diagnosed with Covid. In spring, the hospital saw many senior patients. In December, the hospital has many patients in their 20s, 30s, and 40s.
Beyond the vaccine, hospital staff knows more about how to treat the disease than they did in spring, with new medicines and therapies available.
“They’re sick enough to be in the hospital, but they’re doing better,” said Artymowicz. “I think that’s because of the things that we learned early on, and we do have some more interventions that we know work.”
The hospital has seen fewer deaths from the disease than they did in the spring, according to McCoy.
The next step will be to bring the vaccine to the general population, and the other vaccines created by Moderna and AstraZeneca. This will take place at urgent care centers, doctors’ offices, or at the hospital.
“We’re still sorting out how that’s going to look. Right now, we’re focusing on getting the health care workers vaccinated in phase 1A,” Artymowicz said. The process will not be immediate.
“I think we’re looking at several more months of this if not a year before we have enough of the population immunized,” McCoy said.
To contact Bill Barlow, email bbarlow@cmcherald.com.
