ROCHESTER, Minn. — While many details about the coming COVID-19 vaccines are still uncertain, Mayo Clinic is preparing to start administering doses by late December.
“We’re very confident that we will have at least one vaccine by the end of the year for at least a small, targeted population, which hasn’t been decided yet,” Dr. Melanie Swift said this week.
Imagine preparing for a party (back when such things were done), but you don’t know what day it will happen, who is coming or almost any other details.
That’s kind of the situation of Mayo Clinic’s COVID Vaccine Allocation and Distribution Work Group, which Swift leads as a co-chair.
The work group faces many unknowns, but it is preparing for the massive vaccination project. At this point, the expectation is that Mayo will start administering the Pfizer vaccine first, with more — including the Moderna vaccine — following closely.
“We’re preparing to be able to faithfully and appropriately receive and store and handle and administer this (Pfizer) vaccine and the vaccines that will come after this one,” Swift said.
That means working out a lot of logistical, training, software and public communication issues, among others.
One of the first things to address is that the Pfizer vaccine needs to be stored at minus 103 degrees. While Mayo does have some freezers that can get that cold, they are adding more to prepare for the vaccine.
“That’s cold, even for Minnesota. This is an unusual handling requirement,” Swift said. “However, as far we know, none of the other vaccines will have such extreme ultra-cold requirements.”
Given that only one of the promising vaccines requires this type of storage, the Centers for Disease Control and Prevention is not recommending that every medical facility start installing the subfreezers.
The freezers are for long-term storage, she explained. The packages containing 195 vials of Pfizer's vaccine, each holding five doses, can be stored in their shipping containers with dry ice for at least five days, 10 days if the ice is replenished. After being removed from the shipping containers, the vaccines can be stored in a regular refrigerator for five days.
Once the vaccine is thawed, it will be diluted and divided into doses. A prepared dose of the Pfizer vaccine will need to be used within five hours.
Swift said the process for handling the Pfizer vaccine would be similar to buying a frozen chocolate pie from the grocery store. First, it needs to be thawed out. Once it is ready and sliced up, it won’t sit around very long before it’s gone.
Which vaccines, and which patients?
On the heels of the Pfizer vaccine, it is anticipated that up to five more vaccines could be cleared for use under emergency orders from the U.S. Food and Drug Administration in the early months of 2021.
It looks like the standard treatment for the vaccines will be receiving two doses, with weeks in between. That adds another issue for Mayo’s vaccine team.
“A patient getting a Moderna vaccine can’t follow up with a Pfizer vaccine. They aren’t interchangeable,” Swift said. “We need to build a system that ensures that the patient gets the correct brand at the correct time and make sure they get a full and complete series.”
While Mayo needs to prepare for administering the vaccine, who will get the vaccine and how many the clinic will receive is up to the Minnesota Department of Health.
The FDA will give the green light to a vaccine. The CDC will recommend details of how to distribute and administer the vaccines, as well as who should get them. The state will order the dose and distribute them to medical providers.
Then it will be up to Mayo Clinic and Olmsted Medical Center to do the work.
“The ultimate goal is that we want to vaccinate as much of the population as we can to establish widespread immunity to stop the spread of the virus,” Swift said.
And that will mean serving up a lot of “chocolate pie.”