BELTRAMI COUNTY -- Applause, smiles and tears abounded in a conference room at the Cass Lake Hospital on Monday as 10 health care workers were among the first in the state to receive initial doses of the COVID-19 vaccine.
White Earth descendant Danielle Whalen, a licensed practical nurse at Indian Health Services in Cass Lake, was one of the first to receive her vaccination.
“I’m excited, I’m thankful,” Whalen said as she wiped happy tears from her eyes. “I’m excited to see my mom. I really wanted to do this for the people in my community, my elders, my patients, my family. So I was very motivated, but I’m mostly very excited because I haven’t hugged my mom since March, so I’m looking forward to that. This makes a world of difference for me.”
More staff and frontline workers will be vaccinated throughout the week as the rollout continues. Each person vaccinated will also receive a second dose 21 days from the date of their initial dose.
IHS received 195 vials of the Pfizer vaccine, which is enough for 975 doses, early Monday morning. Facilities run by the state are required to wait until Monday, Dec. 21, to start vaccinating to allow time for staff to be trained in handling and administering the vaccine.
However, as a federal entity, IHS had the opportunity to start vaccinations right away according to Bill Fisher, the chief contracting officer and public affairs liaison for Bemidji Area Indian Health Services.
Fisher said one reason they were able to move forward without completing the week of training is that much of the education coming to the states has already gone through the federal system. He said operating on the federal level allowed them to have a bit of an “inside track” to things as they developed. He also mentioned that several members of Indian Health Services have actually been directly involved with Operation Warp Speed.
According to the U.S. Health and Human Services website, the goal Operation Warp Speed is to produce and deliver 300 million doses of safe and effective vaccines with the initial doses available by January 2021, as part of a broader strategy to accelerate the development, manufacturing, and distribution of COVID-19 vaccines, therapeutics, and diagnostics (collectively known as countermeasures).
“We feel it’s important to distribute it as quickly as possible, it’s been a long wait -- a long time coming,” Fisher said. “IHS has been preparing for many weeks training staff. Staff has been attending CDC trainings on how the vaccine works, how it’s given and so forth. So we feel prepared, and we know that our tribal partners would like it as quick as possible.”
He explained that they were chosen to be one of the main distribution sites for the region as they have the Cryogenic -- ultra cold -- freezers required to store the Pfizer vaccine.
“We purchased two of the ultra cold freezers capable of going down to -86 degrees Celsius that we had put in right here at the Cass Lake service unit, and then our vaccines will be distributed from here to Red Lake and White Earth and beyond,” Fisher said.
He explained that each tribal national had the option to choose to get their vaccines from the state or through IHS. The Bemidji Area Office of IHS provides service and support to 34 federally recognized tribes, and four urban Indian health programs located in Illinois, Indiana, Michigan, Minnesota and Wisconsin. Of those 34 tribes, only two or three opted to go through the state with everyone else going through IHS.
“We plan on distributing the vaccine to the 34 tribes and our urban health care partners in the other states tomorrow,” Fisher said. “So once they are received they can begin immediately vaccinating and then 21 days later do the follow up dose. So we will be delivering the second dose again once that has been received.”
IHS serves any enrolled member in a nationally recognized tribe throughout the United States.
Sanford Bemidji Medical Center
Earlier in the morning, staff at Sanford Bemidji Medical Center unboxed their first shipment of 195 vials -- 975 doses -- of the Pfizer vaccine as well.
They were also chosen as a distribution site primarily because of the ultra cold storage required for the vaccines.
“Sanford purchased, I believe, seven of these ultra cold freezers and distributed them around the Sanford footprint,” said Matt Webb, director of pharmacy at Sanford Bemidji. “Strategically placing them, since we mostly service rural areas, to get the vaccine out to as many people as possible.”
Webb explained that as the distribution site for the Northwest Regional Healthcare Coalition, they will distribute the vaccine out to other smaller medical centers and clinics in northwest Minnesota in the next week, including locations in: Roseau, Kittson County, Mahnomen, Warren, Ada, Fosston, Detroit Lakes, Thief River Falls, Bagley, Crookston and Baudette.
“So that is one really nice thing about having Sanford in this area, is that they were able to get the freezers, and the vaccine might not be here otherwise,” Sanford Bemidji Hospital Pharmacy Manager Alyssa Carlson said.
Webb said they will start vaccinating at Sanford next week, once proper training has been completed. The anticipated start date for state health care facilities is Monday, Dec. 21.
Colleen Swank, a pediatrician and clinic vice president at Sanford Bemidji, explained that the decision to wait a week was made by the state with recommendations from the CDC. So while Minnesota, and many other states, are waiting until next Monday -- some states may start vaccinating as early as today.
“The (Advisory Committee on Immunization Practices) arm the CDC are the ones who determine vaccine regulations and dosing and all that,” Webb said. “So they have come up with a prioritized list (of who gets vaccinated in what order) and then the state of Minnesota has basically prioritized staff in the order of who will get the vaccine first, starting with Group 1A -- health care staff and long term care facility staff and residents. So the state is working on getting as many doses as they can to those specific areas.”
Webb added that there are authorization fact sheets with details about the vaccine from the FDA to provide insight on things for those handling and receiving the vaccine. On the pharmacy side there is information about storage and reconstituting the vaccine, and then on the administration side there is information for nursing and pharmacy staff who will be administering it.
“And there is a fact sheet for patients as well,” Webb said, “with things like what to watch for as far as any adverse effects or events, how to report those -- not only to your primary care provider, but they also have a “Be Safe” program they are rolling out with this vaccine -- so it’s like an online database for patients and anyone can report their adverse events.”
Carlson said that all the items needed to administer the vaccine were sent to them last week, including the diluent solution for reconstituting the vaccine, syringes, face masks, face shields, gloves, alcohol pads and so forth. Those items will also be packaged up and sent along with the vaccine to the other locations around the region.
Special gloves that are regulated for the cold temperatures and protective glasses had to be worn by those handling the box during the vaccine unpacking process on Monday morning, due to the dry ice used to keep the vaccine cold and stable for transport.
As soon as the box was opened a “stop” button had to be pushed on the tracker and temperature monitor inside, which notified manufacturers that the shipment had been opened.
Webb said they would receive a report of total temperature readings from the time of shipment within an hour of opening the box to ensure the vaccine was stable and nothing had gone wrong.
“It’s also GPS enabled, so Pfizer -- the manufacturer -- and the CDC are able to track every shipment that went out, so they know that it’s here,” Webb said. “That’s why the first thing we do when we open it is hit ‘stop’ to stop the tracker, and that tells them it’s here and triggers them to send us the temperature reading.”
Swank explained that the added precautions and shipment details are primarily because of the vastly important role the vaccine is playing in the world today and because it’s so desperately needed.
“I also think simply because of how many vials are being shipped across the country all at once, there’s just that risk of it going to the wrong place or having a temperature issue,” Swank said. “So this way we know for sure that there haven’t been any issues.”
Pharmacy Technician Supervisor Peggy Olson said she and Pharmacy Buyer Christine Schummer will be the ones primarily handling the vaccine.
“We’ll be assisting with the transition when folks come from those outlining clinics; packing it up, getting their labels and all that,” Olson said. “For the onsite vaccine education clinics, we’ll have to be here before they start and make sure we’ve taken vaccines out of the freezer, so that they can come to refrigerator temperature so they can be used.”
Swank noted that though significant progress has been made, people still need to be patient and understand everyone is still learning about the vaccine and how it works long-term.
“With the vaccine, we’re pretty comfortable that people won’t be getting the symptoms of COVID,” Swank said. “But what we don’t know yet is if you can still carry it and transmit it, so we’ll all still be wearing masks and be doing all of the same things we have been doing until we learn a little bit more. If people are wondering, ‘If all the health care workers got vaccinated are they still wearing masks?’ that would be why.”
Pfizer vaccines were also delivered on Monday to the Olmsted Medical Center in Rochester, and the Minneapolis Veterans Affairs Medical Center, where a shipment of 2,925 doses was greeted by Gov. Tim Walz.
More statewide information is available on the Minnesota Department of Health website.