Vaccination against covid-19: a process “with the efficiency of a Russian ballet” | Report

The São João Hospital Center, in Porto, is preparing to have one of the most unusual Sundays in its history. The first doses of the covid-19 vaccine arrived at the hospital in mid-afternoon on Saturday and, immediately, the countdown began so that nothing is wasted and the goal can be met: vaccinate more than 2000 professionals of the hospital unit between 10am and 8pm. Vaccinate 2,125 people, to be precise. If for some reason it is not possible to administer all the doses this Sunday, the process should be completed in the following days. “The product expires on Wednesday”, explains the director of pharmaceutical services of the hospital, Pedro Soares.

It is because of his services that the first part of the vaccination operation is carried out in S. João and the responsibility is great. “It is a logistical operation that is scary because of its size, but we hope to be able to execute with the efficiency of a ballet Russian ”, said the official, at the door of the service where two pharmacists and their senior diagnostic and therapeutic technicians will work, starting at 8 am this Sunday and throughout the day, in the preparation of the vaccines that later they will be transported by an assistant. operating spaces in the outpatient area where they will be administered.

Pedro Soares does not expect problems in the preparation of the vaccines, which will consist of 0.3 milliliters of the BioNTech-Pfizer product and physiological serum. “It is a process of technical manipulation to which we are already used,” he told reporters on Saturday who came to see the logistics operation installed in the hospital. What needs to be carefully structured is time. And there are many times to tell in this process.

From the beginning, the very durability of the vaccine, which began to count from the moment it was thawed, in Coimbra. At this time, the vaccine is already stored at the normal temperature found in the refrigerator in a home (between 2 and 8 degrees Celsius), but its shelf life, once thawed, is only five days, so must be used until Wednesday. Then you have to take into account the time allocated to its preparation from when it comes out of the fridge: two hours. And finally, there is another deadline in the work accounts of those who will be sitting in a small chamber in the pharmacy area preparing the vaccine – from dilution to administration, at room temperature, no more than six hours can pass.

Pedro Soares is confident that the process will continue as at the time of the arrival and reception of the vaccine: “Everything went smoothly, since it was organized, planned and executed to perfection.” But there are many details to take into account. For example, in the chamber where each vial of BioNTech-Pfizer preparation is transformed into five doses of vaccines, only the products necessary for what is being prepared at that moment enter. “It is also a form of control, because if something is left behind, we know that something is not right,” he explains.

And then you have to transport the vaccines ready for the aging corridors and with some holes in the siding of S. João, down a flight of stairs. For this reason, the five-minute journey will be made by stairs and without the use of an elevator that the operational assistant crosses on the way – “something will not happen to the elevators”, says the head of the pharmacy – and the vaccinations In hand, in thermal cases, and not in trolleys to avoid any vibration as much as possible.

The expectation is that almost 200 units per hour will be prepared, allowing all the product that arrived in three boxes – two with 195 bottles and one with 135, in a total of 525 bottles – to be prepared and administered throughout the day. “In the history of the hospital, we have never had a Sunday like this,” says Pedro Soares.

The rest of the operation will be carried out in the area that is usually crowded for outpatient clinics, but which is much quieter on Sunday. It is there, in the K5 zone, where the first vaccine will be administered in Portugal, in the presence of the Minister of Health, Marta Temido, shortly after 10 a.m. on Sunday. The chair with the poster next to it announcing the Covid-19 Vaccination Plan is ready and awaiting the symbolic moment that will mark the beginning of the process in the five hospitals in the country that will receive the first doses of the vaccine. – São João, Porto, Coimbra, Lisbon north and downtown Lisbon.

But the actual operation occurs a little further to the side, in the K2 and K3 zones. This is where 25 doctor’s offices were equipped with all the necessary material for the nurses to administer the vaccines. Xavier Barreto, director of the Outpatient Center, explained that around a hundred professionals (including about 40 nurses) were mobilized for this operation, which also involves the use of a waiting room so that, after taking the vaccine, the patients Professionals from the inoculated São João can wait the obligatory half hour to avoid any adverse effects that may arise.

The doctors, operational nursing assistants and senior diagnostic and therapeutic technicians selected for this first phase of vaccination must attend at the previously indicated time and, after taking the vaccine and after half an hour of control, they will receive a telephone number with the that they will be able to contact if, in the following days, they can have a reaction. Although Nelson Pereira, director of the Emergency Management and Intensive Care Unit, does not expect anything different from what happened in other countries – I mean, nothing serious. “Vaccination is a fundamental act of citizenship at this stage in which we find ourselves. By getting vaccinated we are protecting others ”, he defended.

In São João, where more than 90% of professionals were available to get vaccinated, the message was understood. Now the process will begin.