For the past ten years I've been volunteering with the Medical Reserve Corps, which is part of the Lake County General Health District in Ohio. And for the past two months, I've been administering the COVID-19 vaccines. With major retail pharmacies joining this effort, here are four priorities care administrators need to focus on now.
1. Remove as much second-guessing as possible from clinical decision-making
Many of us are feeling overwhelmed by the volume of new information on the vaccines. We're still learning a lot on safety, efficacy, and allergic reactions. On top of that, public health officials need to know the details regarding the next vaccines expected to receive emergency use authorization as fast as possible so they can adapt their plans stat. My recommendation is a no-brainer: have access to the latest information in one central location with real-time updates, curation and assessment of references and data. You need to trust that source and make sure that the editors still practice in some fashion, so they know what it's like to make decisions at the point of care and that means better guidance.
2. Plan for more staff and volunteers who can vaccinate now!
There's no time to lose. During the holiday break, school nurses represented the bulk of the staff in our clinics. Since then, more nurses, pharmacists, and other professionals certified to administer vaccines have been signing up to volunteer. That's allowed us to keep up with current vaccine supply. As supply increases going forward, personnel needs will likely increase too. I see some difficulties with keeping enough medical volunteers and personnel over the long haul.
3. Have a clear plan for socially distant monitoring
Social distancing needs to be factored into your plan from initial triage to monitoring for immediate adverse reactions after administration. One of our clinic sites is set up in what can be described as a giant garage. Immediately following vaccine administration, people drive back out to be monitored in a parking lot by volunteer EMS organized in squads. We're monitoring for immediate allergic reactions and vasovagal reactions. If there is a history of any sort of severe allergic reaction, we mark the cars so they can be monitored for at least 30 minutes. That's the plan at this clinic. What's your plan?
4. Encourage everyone to participate in the new CDC V-safe mobile app
The CDC is collecting information to get a better understanding of reactions as well as immunity and symptoms with questions like "How are you feeling today?" or "Do you have any symptoms?". Questions first come daily, then three, six, and twelve months after. I imagine we're going to start seeing some robust data on adverse reactions among other soon. For us data nerds, it's very interesting because we've never seen something like this on that scale before.
For the latest drug and vaccine guidance on COVID-19, visit our Lexicomp resources page.
