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The COVID-19 Vaccine Has Arrived. Now What?

University of Maryland Medical System

The first batch of COVID-19 vaccines have arrived at hospitals in Maryland and more are expected later this week. Now those hospitals are reckoning with how to dole out the limited numbers of vaccines to tens of thousands of frontline healthcare workers.

Daisy Solares, a respiratory therapist at the University of Maryland Medical Center, was among the first Maryland residents to receive a COVID-19 vaccine on Monday. 

“It felt fine. Good. No pain,” she told reporters immediately after receiving the injection. “Honestly I barely even felt it.”

On Monday, the University of Maryland Medical System, or UMMS, and Johns Hopkins Medicine were among the first healthcare institutions in the country to receive a small number of doses of the highly anticipated vaccine from drugmaker Pfizer.

“We got what's called like a ‘pizza box’ worth, which has 195 vials,” said Gabe Kelen, chair of emergency medicine at Johns Hopkins Medicine and director of the institution’s Office of Critical Event Preparedness and Response. “Each vial once reconstituted has five doses in it, so that's 975 doses worth.”

Both Johns Hopkins and UMMS expect to receive a total of nearly 4,000 doses by the end of the week.

Kelen said allocating that relatively small number of vaccines among roughly 40,000 healthcare workers creates a significant challenge, one that has required months of planning.

First in line are workers who have the greatest risk of getting COVID-19, said Gary Tuggle, deputy incident commander at UMMS.

“That could be a doctor. It could be a nurse. It could be an environmental service worker. It could be a food service person,” Tuggle said.

Though UMMS began vaccinations on Monday, Johns Hopkins plans to start vaccinations Wednesday.

“We included people who are so vital that if they went down the operations would be hindered,” Kelen said. “That included people in the labs, people who actually clean the rooms, for example, security — people that not everybody might think of as a frontline healthcare worker.”

Neither institution will require employees to get the vaccine, and not all employees are ready to trust that it’s safe.

“Vaccines have historically had a negative connotation in some communities, particularly communities of color,” Tuggle said. “Trying to overcome that, not just within the workforce, but you know in populations — underserved populations is tough.”

That mistrust stems in part from a long history of mistreatment by medical professionals of communities of color, particularly Black Americans. Tuggle said transparency is key to building that trust.

“It's got to be clear that you're better off taking this vaccine than not taking it, and if that means, you know, having to take it myself, right, just to show people that look like I look, right, that I'm willing to do it, then I'll do that,” said Tuggle, who is Black.

Kelen said he hopes that Johns Hopkins continues to get thousands more doses each week, especially once drugmaker Moderna’s vaccine is approved by the U.S. Food and Drug Administration, which is expected later this week. After that occurs, Kelen said he expects to receive between 3,000 and 6,000 doses a week.

But that brings another “logistical nightmare,” Kelen said, as they ensure that everyone who gets a first dose also gets scheduled for a second dose a few weeks later, without becoming short-staffed due to the small number of recipients who are likely to experience mild to moderate side effects.

“Some will get a headache or a fever or just feel lousy for a day, maybe two, so we're trying to stagger out the return visits for sure,” Kelen said.

As UMMS plans out the next steps in the vaccination process, Tuggle said leaders have been considering stadiums as possible sites to conduct mass vaccinations of the broader public. However, that likely won’t occur for a few months at least.

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