How our hospital pharmacy team delivered the world’s first COVID-19 vaccine

By now, most people will know Margaret Keenan as the first person in the world to receive the COVID-19 vaccine outside of a clinical trial. This historic event happened at the University Hospitals of Coventry & Warwickshire (UHCW) and it was amazing to be a part of it.

I am the Division Clinical Director of Clinical Support Services at UHCW, a large teaching hospital with 155 staff working in the pharmacy team. I am also responsible for 20 other services, including intensive care, theaters, therapy, outpatient visits and complex discharges, which have been critical in the hospital’s COVID-19 response.

Like so many others, 2020 has been a particularly interesting year for me.

Deploying a vaccine as vital as the COVID-19 vaccine required careful planning. I have participated in numerous virtual meetings with my counterparts across the country on the logistics of transport, storage, legal framework and administration of the vaccine.

The trust was originally chosen to be a vaccine “hub” to receive and store the vaccine and distribute it throughout our health economy – the two neighboring hospitals and the mental health trust. It was in mid-October 2020 when we learned that it would be the Pfizer / BioNTech vaccine arriving at UHCWs. One of the few things we knew about the vaccine, before it was cleared by the Medicines and Health Products Regulatory Agency (MHRA), was that it was a particularly fragile product. which required storage in a highly specialized freezer, which could maintain vaccines at -70 ° C.

At the end of November 2020, it turned out that there was a limit to the number of times the frozen vaccine could be moved – only four times. This meant that the UHCW would now be a hospital center focused on vaccination rather than supply, and we had to adapt our plans.

When the MHRA cleared the vaccine on December 3, 2020 – just four days before the first one was given – we received a data sheet telling us exactly what to do with the drug. At the same time, Keith Ridge, chief pharmaceutical officer for England, made it clear that chief pharmacists should be responsible for all aspects of governance. This has been incredibly helpful given the new and fragile nature of the vaccine and the obvious need for pharmacy oversight. Together with the drug safety manager (pharmacist Nixy Samuel), the quality controller (Matt Berwick), the aseptic service manager (Steve Almond) and the aseptic technical manager (Nicole Hadland), I supervised the reception, the storage, distribution and preparation of vaccines.

The next day, I received the national protocol for the vaccine, and the team (along with the nurse responsible for the practice) spent the weekend developing standard operating procedures (SOPs) that we could use in the field. . We had to be prepared to respond to the latest information available, including changes to the priority vaccination list.

On Monday December 7, 2020, the healthcare and pharmaceutical teams visited the areas of the hospital dedicated to the vaccination center and we went through the SOPs in detail with them. At this point, due to the difficult vaccine preparation process, we agreed that during the first week of vaccination, the pharmacy team would be based in the vaccination center and would do most of the preparation of the vaccine. vaccine – a task that has now been passed on to healthcare teams.

The wait is growing on Monday. The vaccine vials arrived and the trust was then told they would administer the world’s very first COVID-19 vaccine. When I arrived at work at 5:00 a.m. on Tuesday morning, media from all over the world were starting to arrive – there were already many TV crews outside the hospital, creating the excitement and pressure that took hold. lasted for several days.

For the team, there was a mix of nerves and pressure to do this right in front of the world, and immense pride to see Margaret, our patient, receive that first dose at 6:31 am on December 8, 2020, quickly followed by the second patient, Mr William Shakespeare from Warwickshire, at 6:45 am.

This momentous occasion had such a buzz, but we immediately went to “business as usual”: we still had 100 patients to be vaccinated on this first day.

Since then, we have increased our daily vaccination capacity from 100 patients to around 900 and as the number of vaccines increases we are looking to use pharmaceutical and nursing staff, as well as allied health professionals, to manage the vaccination center. .

The lessons we learned from this whole process have been shared locally, nationally and internationally, all the way to Australia and the United States. It was particularly gratifying to share our experiences with a network of Italian hospital professionals, with whom we had been in regular contact since the start of the pandemic, and who had supported us by advising us on intensive care in these early days.

It has been a source of pride for me and my team, as well as for the pharmacy teams nationwide, regardless of their industry.

Mark Easter, Director of Pharmacy and Divisional Clinical Director of Clinical Support Services, University Hospitals Coventry & Warwickshire

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