Joanne Ruggiero, RN, MSN, clinical director for Women’s Health and Behavioral Health at Pennsylvania Hospital, administers the COVID-19 vaccine to Emergency Department nurse Eric Young, RN, BSN, on Wednesday morning.
There was a notable pause in the Pennsylvania Hospital auditorium after Emergency Department nurse Eric Young, RN, BSN, received his COVID-19 vaccine at 6:15 am on Wednesday morning. The room fell silent except for the flashing of photographers’ cameras.
That’s because, by most accounts, the two-second shot to Young’s arm was not particularly momentous. “Felt like any other vaccine,” he said.
As snow began flying outside the glass windows on the top floor of the Perelman Center for Advanced Medicine on Wednesday, the first 15 employees of the Hospital of the University of Pennsylvania lined up to get their COVID-19 vaccines. The hallway outside of the fifteenth floor conference room — which had been converted into a series of pods for vaccine delivery and a waiting room area — was filled with murmurs of excitement.
Raina Merchant, MD, MSHP, (pictured above) an associate professor of Emergency Medicine and director of the Center for Digital Health, said the vaccine represents opportunity and hope, as she waited to receive her shot.
“COVID-19 has disproportionally affected Black and Brown people. So on this day, it’s really important to stand up and get vaccinated, and to demonstrate the importance of having this vaccine that will help us with a brighter future,” Merchant said.
Occupational Medicine nurse Danielle Lutz, RN, is one of the many individuals behind the health system’s effort to vaccinate employees. In addition to administering the vaccine on Wednesday, she worked with hospital leadership to organize, set up, and staff the clinic — a carefully-orchestrated operation involving scheduling thousands of staff members in different priority groups, as well as arranging socially-distanced vaccination stations and monitoring areas. When Lutz found out that the vaccines had arrived at the hospital, she started to cry. Earlier this year, she lost a loved one to COVID-19.
“The importance of this is enormous – we’ve been living in our homes, secluded, away from loved ones,” Lutz said. “So for this project to get going, it’s been great. This moment just means the world to me.”
Then, as if coming to a collective realization about the gravity of the occasion, the 20 or so onlookers in the room broke into applause.
“Eric and I went to nursing school together!” shouted the nurse administering the vaccine, Joanne Ruggiero, RN, MSN, clinical director for Women’s Health and Behavioral Health at Pennsylvania Hospital. “We were study partners.”
“Poor Eric!” a colleague shouted back. Everyone laughed. The tension, broken.
The moment, though over in an instant, was a historic one for Penn Medicine and the 264-year-old hospital: Young was the first to receive the COVID vaccine at the health system, marking what many experts are calling the “beginning of the end” of an unprecedented health crisis that has infected close to 17 million nationwide and killed 13,000 Pennsylvanians.
Notably, it was mRNA research conducted at Penn — by Drew Weissman, MD, PhD, a professor of Infectious Diseases, and Katalin Karikó, PhD, an adjunct associate professor — that helped pave the way for the development of the Pfizer/BioNTech and Moderna COVID vaccines.
“It is fitting that the nation’s first hospital was the first to lead Penn Medicine to this new era in the fight against COVID,” said PJ Brennan, MD, chief medical officer of the University of Pennsylvania Health System. “The development and distribution of this vaccine will go down in history as one of the world’s most significant biomedical achievements, and beginning to deploy the vaccine to protect our own workforce is a thrilling milestone.”
By week’s end, the health system expects to receive about 9,275 doses of the Pfizer vaccine for its front-line teams. The vaccines have been distributed under an Emergency Use Authorization, an authority granted to the Food and Drug Administration (FDA) to supply unapproved medical products during a health crisis.
In accordance with local, state, and federal agency recommendations, Penn Medicine has developed a prioritization rubric to guide how COVID-19 vaccines will be distributed within the health system. Vaccines will be offered first to frontline staff who work directly with patients in emergency situations and to those who have a higher risk of exposure to patients whose COVID-19 status is unknown. As greater supplies of the vaccine become available following FDA approval, the health system will begin administering it to more staff, and eventually to patients outside of the Penn Medicine workforce.
At Pennsylvania Hospital, Chief Human Resources Officer Christine Tierney, RN, MSN, quickly put out a “call to duty” to administrative and other non-clinical nurses to staff the hospital’s COVID-19 vaccine clinic. Within one hour, she received over 100 responses.
Among those who answered the call was Ruggerio, who woke at 3:30 a.m. on Wednesday, feeling like it was Christmas morning.
“I almost didn’t need my alarm,” she said. “I thought there would be a lot of uncertainty and ambiguity here today, but so far, people have been asking to take selfies with them, and they’re clapping and cheering. It’s all excitement.”
The vaccines arrived at Pennsylvania Hospital at 2 p.m. on Tuesday afternoon, where CEO Theresa Larivee, MBA, and Daniel Wilson, MBA, RN, FABC, vice president for operations, were waiting to greet the truck. The vials must be kept at ultra-low temperatures (-112 to -76 degrees Fahrenheit), but can survive in a refrigerator for five days. When delivered to Penn on Tuesday, the vials were already thawed, so the clock began ticking — giving the hospital exactly five days to vaccinate 510 people.
Across Penn Medicine, similar processes were set to unfold at all five other hospital entities. The first doses of vaccine arrived at the Hospital of the University of Pennsylvania on Wednesday morning, with vaccines from that delivery then transported to Penn Presbyterian Medical Center. Chester County Hospital, Penn Medicine Lancaster General Hospital, and Penn Medicine Princeton Health are also slated to receive deliveries this week.
Pennsylvania Hospital pharmacist Shadaria Shuler, PharmD, draws up a vaccine dose. Diluted COVID-19 vaccines can only be kept at room-temperature for six hours before they expire.
Back at Pennsylvania Hospital on Wednesday morning, pharmacist Shadaria Shuler, PharmD, was also up against the clock, as she retrieved the vaccine vials from the refrigerator and began prepping them for administration. Each vial must be kept at room temperature for 30 minutes, then carefully inverted ten times, diluted with a saline solution, and inverted another 10 times before doses are drawn up into syringes. Diluted vaccines can last at room temperature for only six hours, while undiluted doses expire after two, so Shuler needed to time the process just right.
“We draw up meds all the time, so this was nothing new,” Shuler said.
As employees began lining up inside the lobby of Pennsylvania Hospital to receive their vaccine on Wednesday, the scene inside Zubrow Auditorium was energetic, but organized, as each station was manned by staff members who understood their roles in the assembly line.
A pharmacist at the Hospital of the University of Pennsylvania draws up a COVID-19 vaccine dose while snow falls outside the window beside her. As the vaccine clinic opened at HUP on Wednesday, a snow storm hit Philadelphia.
Vaccines arrived at Penn Medicine Princeton Health on Thursday morning.
Employees entered through the side of the auditorium, checked in with registration, were directed to sign a consent form, then walked on stage to receive their shot. After, they scheduled their appointment for the second vaccine dose — 21 to 28 days after the first — and were handed a timer. Then, they were instructed to sit in a chair and wait for 15 minutes, during which they were monitored by a nurse for any symptoms or poor reactions to the vaccine. Over the next three weeks, they will continue to receive text message check-ins from the health system.
“I feel great. It hurt less than the flu shot,” said Michael Ireland, RN, BSN, a nurse in the Crisis Response Center.
For most of the nurses, doctors, and other essential workers receiving the vaccine on Wednesday, the message they wanted to send to the public was simple: “If I did it, you should too.”
Chris Lee, MD, an internal medicine resident originally from Cork, Ireland, said he called his family earlier that morning to tell them the good news. He hopes that getting the vaccine will encourage his family members — and Philadelphians — to do the same.
“I think we’re ambassadors for the whole population to go ahead and get it. All the residents have genuinely been reviewing the vaccine studies, looking at the side effects, and trying to understand the data,” Lee said. “It certainly seems safe.”
For Christine Preblick, MD, the decision to get the vaccine was less clear-cut — the Emergency Department physician received a kidney transplant two years ago at the Hospital of the University of Pennsylvania, and she was unsure whether the COVID-19 vaccine would be safe for her. But earlier this week, her transplant team gave her the go-ahead.
The risk of contracting the coronavirus is greater than the risk of vaccine side effects, she believes. She’s looking forward to resuming her normal life again — and knows the vaccine is a key part of ensuring the whole world can do the same.
“For transplant patients, there’s uncertainty, for sure,” she said. “But it’s a leap of faith that you take.”