Dr. Thuan Ong hunched before colleagues and cameras with hands clasped tight between his knees and his eyes trained on UW Medical Center’s gray hospital carpet.
Ong’s voice quavered with emotion amid complicated reflections as he waited to be vaccinated against the novel coronavirus.
“I feel very privileged,” said Ong, who since February has ventured into long-term care facilities where the most vulnerable have suffered — from COVID-19, the disease caused by the coronavirus, and from the lonely inhumanity that accompanies it.
And so he felt sorrow also, for colleagues who have been at times “afraid and desperate,” for patients lost, and for those whose pain is forthcoming, as cases of coronavirus surge while they wait for the vaccine.
“That’s the weight we’re all feeling; the sadness that we can’t get it to them yet,” Ong said in an interview later.
Ong was one of 13 workers in health care who were among the first in Washington state to receive the Pfizer-BioNTech vaccine Tuesday in an event at UW Medical Center. The event, which gave each worker a moment to speak, highlighted the complicated emotions of fatigued front-line workers, who experience both hope and catharsis with the vaccine’s arrival, but also deep concern over what’s to come amid a fall surge in hospitalizations.
UW Medicine had 120 patients receiving treatment for COVID-19 Tuesday, two shy of its highest point in spring, said Tim Dellit, UW Medicine’s chief medical officer.
“We anticipate we will likely peak toward the beginning of February and it’s anticipated that we could see three to four times the number of patients we saw in spring,” Dellit said of UW Medicine hospitalizations, basing his comments on forecasts from the Institute for Health Metrics and Evaluation. “It’s the fatigue, the exhaustion and burnout that is most critical.”
To exhausted front-line workers, seeing vaccinations lifted spirits.
“It’s been a long, exhausting road.” said Amy Fry, a COVID-19 ICU nurse at Harborview Medical Center and the first to be vaccinated Tuesday. Fry said she was feeling hope and she viewed the vaccination as “first step toward the end of this nightmare.”
Those vaccinated comprised a diverse group — by age, race and profession. They included doctors, nurses and environmental services technicians who clean hospital rooms. A Seattle Fire Department paramedic, a flight nurse and a medical assistant were inoculated also.
Vaccine doses shipped across the country Monday, with UW Medicine receiving some 3,900. Each of UW Medicine’s campuses, including UW Medical Center, UW Medical Center — Northwest, Valley Medical Center and Harborview Medical Center — received a tray of 975 doses of vaccine.
UW Medicine will begin vaccinating high-risk staffers en masse on Thursday. UW Medicine expects to have administered all of the first 3,900 vaccine doses by early next week and for its high-risk employees to have received their first doses by the end of December.
Dr. John Lynch, medical director of infection control at Harborview Medical Center, said more than 90% of people considered at high risk of infection had signed up to receive a dose of vaccine. About 700 people signed up to administer vaccines, Lynch added.
Washington’s first 62,400 doses have been directed to 40 facilities in 29 counties, including hospitals, one pharmacy, two tribal nations and an urban Indian health facility, according to Michele Roberts, the state Department of Health’s (DOH) acting assistant secretary.
Doses continued to flow to health care organizations across the region Tuesday. Among those receiving vaccine were the Lummi Public Health Department, which on Tuesday received some 300 doses of vaccine for distribution to front-line workers and vulnerable populations, the Seattle Cancer Care Alliance, which will vaccinate its staff to help protect vulnerable patients and also the CHI Franciscan hospital system.
Swedish in Seattle began vaccinating its first staff members Tuesday afternoon. Shortly before receiving his dose, Dr. Marc Horton, executive medical director for surgical services, compared seeing doses arrive to the moon landing. He said he was 100% confident in the vaccine and that he hoped its promise would help people resist letting their guard down over the holidays.
“The idea that we only have another three or four months, versus god only knows how long, should be the boost we need,” Horton said.
Swedish received 3,900 doses and plans to administer them all over the next four days, said Donna Jensen, chief nursing officer for Swedish Medical Group. “We’re planning for pretty long days to make sure we capture all of our shifts, making sure they have the opportunity to stagger their timing, and we should be golden,” she said.
Swedish and its partner organizations have nearly 15,000 workers, who will all be vaccinated as soon as more doses are delivered. “We will be doing this for a while,” she said.
Between the Pfizer-BioNTech vaccine, and a Moderna vaccine awaiting emergency approval, state officials expect more than 400,000 doses from the federal government by the end of 2020; they will go to hospitals for health care workers, some first responders and to residents in long-term care facilities.
A Food and Drug Administration analysis Tuesday found Moderna’s vaccine was safe and effective, and the agency could give a green light for its use later this week. Neither vaccine is made with the novel coronavirus. Instead, pieces of genetic code are introduced into the body, which can then teach the immune system how to respond to the virus.
The state has asked those administering vaccines to prioritize health care workers who are at the highest risk, including people who treat COVID-19 patients face-to-face, testing-site staffers and first responders with the most risk of exposure.
Both vaccines require two doses, with several weeks between administration.
Clinical-trial data suggests both vaccines work well across different ages, races, ethnicities, body types and preexisting medical conditions. Few serious health events were reported during the trials, but for some, the vaccine will come with a kick — side effects that indicate it’s working.
The vaccines could cause pain where injected, fatigue, headache, fevers and chills, among other reactions.
Two Seattle women who participated in the clinical trial of of the Pfizer-BioNTech vaccine said the possibility of reactions shouldn’t scare anyone off.
“People like us volunteered so we could know how safe the vaccine is and how protective it is — and what we now know from these early results is that it’s safe and effective,” said Dr. Carmen Mikacenic, an intensive care physician and researcher at Virginia Mason and Benaroya Research Institute, which coordinated the trial. “People should really get it if they can.”
Mikacenic, 40, also persuaded her mom, Karen Mikacenic, 68, to join the trial, which enrolled about 100 people in the only Western Washington study of the Pfizer-BioNTec vaccine.
“It wasn’t too different from a flu shot,” Karen said. “My arm hurt a little bit, but that’s all.”
Neither woman knows whether she got the vaccine. For participants who got a placebo, Pfizer is offering the real thing on a staggered schedule, with health care workers like Carmen Mikacenic first in line.
Study follow-ups will continue for several months.
At UW Medical Center, those vaccinated were closely watched for reactions. Nurse Kaitlyn Drew observed them for 15 or 30 minutes, saying they reported some pain at the injection site, but no other reactions.
Hospitals, many which are short-staffed as they manage a surge of COVID-19 patients, expect some employees to feel the temporary side effects for a day or two after inoculation. Since the pandemic began, hospitals have discouraged workers to come in if they are feeling unwell.
Now they must carefully manage staffers’ schedules to get units immunized while keeping enough people in place to manage care.
At UW Medicine, staffers who develop reactions that resemble symptoms of COVID-19 will remain home and receive testing as soon as possible to distinguish between a vaccine reaction and disease resulting from exposure to the coronavirus, according to Lynch.
Despite these complications, vaccinating workers at hospitals, which offer centralized distribution, ultracold technology to store the Pfizer-BioNTech vaccine and long experience managing efforts like influenza vaccination clinics, could be the smoothest portion of the initial effort.
More complicated will be reaching high-risk first responders, who will need to schedule and travel to hospital locations and also residents and workers in nursing homes.
Of Washington’s initial doses of Pfizer vaccine, some have been directed to Consonus, a pharmacy working with long-term care facilities.
Most of the state’s approximately 4,000 long-term care facilities are expected to begin receiving vaccines after Dec. 28 under a federal partnership with CVS and Walgreens. The state hopes to administer first doses to workers and residents in long-term care facilities by January’s end, according to Roberts, of the DOH.
Vaccines could be available more broadly in the spring and summer, and state officials are working out who should receive priority, based on clinical trial data and guidance from independent advisers to the federal Centers for Disease Control and Prevention.
Jules Mack, a clinical specialist in respiratory care at Harborview Medical Center, who was vaccinated Tuesday, said it was “monumental” for family members across the country to see her receive the vaccine. Mack said family members, including her son, have expressed reservations.
“I’m going to stand up, as a woman of color, to share: This is safe,” Mack said just before she was inoculated. Her son texted to say he was proud of her, Mack said.
“By him seeing and knowing I’m here and that I’m making that step to keep myself safe and my family at home, he’s looking at it differently,” Mack said, adding that she hoped to persuade people of color to do research on the vaccine if they had concerns.
After health care workers and long-term-care residents, the next waves of vaccination are likely to include some essential workers, seniors and people with significant health issues that place them at risk of severe illness from the coronavirus.