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National

The Complicated Procedure That Keeps Coronavirus Vaccines Safe At Vaccination Sites

LULU GARCIA-NAVARRO, HOST:

In a repurposed science classroom at Dunbar High School in Washington, D.C., there is an unassuming white refrigerator.

JESSICA WALLACE: And that is just a regular old refrigerator.

GARCIA-NAVARRO: I was about to say it's like a minifridge.

WALLACE: It is a minifridge, yes.

GARCIA-NAVARRO: It's like a minifridge that has seen better days.

WALLACE: It's exactly what it is.

(LAUGHTER)

GARCIA-NAVARRO: It's battered and old, but it holds something remarkable inside. Jessica Wallace is a clinical pharmacist with Children's National Hospital.

WALLACE: So as you can see, our vaccines are in here. We store them in little boxes of 10.

GARCIA-NAVARRO: I feel like there should be angels singing, (singing) the Pfizer vaccine.

The Pfizer vaccine is one of two COVID-19 vaccines authorized for use in the United States right now, and it is in incredible demand as the country tries to claw its way out of the pandemic. I was recently at a mass vaccination event run by Children's National here in the capital, where I was taken through the complicated process to get these vaccines into the arms of the people who need it. It's a window into how challenging vaccinating the entire country is going to be. But let's back up. Before the Pfizer vaccine made it into that loaned minifridge...

BRIDGET CRONIN: We keep it in an ultracold storage at the hospital, and then we thaw it down in the mornings before we bring it here.

GARCIA-NAVARRO: It is moved under guard. Dr. Sean Tan is director of pharmacy operations at Children's National.

SEAN TAN: We call them liquid gold, and it really is.

GARCIA-NAVARRO: Possibly even more precious than gold at this point. And the guards are there because there are worries about vaccine theft.

TAN: We're treating it the same thing as a narcotic because it is highly sought after. So we believe if we don't have all these safeguards in place, we are vulnerable, and we open ourselves to be targets, which is why chain of custody is so crucial to us.

GARCIA-NAVARRO: By chain of custody, he means this.

UNIDENTIFIED PERSON #1: So for Kelly, we're going to give five vials to Kelly.

GARCIA-NAVARRO: A technician is now taking the vials out of the minifridge, logging the details, including who it's been given to. And from there, Dr. Tan says, the technician takes them back to their station.

TAN: We have seven stations to manage. We also have to make sure each person's output is steady.

UNIDENTIFIED PERSON #2: So one more.

GARCIA-NAVARRO: Hopefully six doses from each vial, over and over. And if the technicians aren't getting that, they are replaced by someone else who can. In the end, each dose is a potential life saved.

KELLIE NEAL: This is very time-specific, and it requires a skill set.

GARCIA-NAVARRO: That's Kellie Neal, a pharmacy technician supervisor at Children's National. She had to go through specific training to work with the Pfizer vaccine.

NEAL: What we're going to do is we are going to dilute each vial of COVID vaccine with 1.8 mL of sterile sodium chloride, preservative-free.

GARCIA-NAVARRO: Then you invert the vials 10 times, no shaking.

NEAL: One, two, three...

GARCIA-NAVARRO: And again, it's inverted another 10 times after it's been diluted. Then Kellie Neal puts it into the syringe.

NEAL: So the key to this is when drawing it up, if you draw it up too fast, it will be very bubbly and fizzy. And we don't want to inject any air bubbles, and we want to make sure they get the full dose.

GARCIA-NAVARRO: This is all very time-consuming, and Dr. Sean Tan says no drop can be left behind.

TAN: This is where technique and patience comes in. A lot of people like, oh, it's just a drop. I'll give up. I'll go to the next vial. But we literally take every drop out of each vial. So just a drop might be a third of a dose.

GARCIA-NAVARRO: Once the syringes are ready to go, they are transported to the doctors and nurses who will administer the injections. Again, at every stage, the vaccine is accounted for so that none goes missing. And there are police standing by, watching over this liquid gold.

CRAIG DEWOLFE: Are we working with your left arm or right arm?

AMELIA HUNT: Left arm.

GARCIA-NAVARRO: Elsewhere in the show, we'll take you inside the mass vaccination of teachers here in D.C. and show you what events like this could mean for ending the pandemic by getting kids and teachers back into their classrooms.

HUNT: I think the first word that I think of is relieved and excited.

GARCIA-NAVARRO: Stay with us. Transcript provided by NPR, Copyright NPR.