How does the Pfizer #COVID19 vaccine get to hospital vaccination centres? What are the implications for the #VaccineStrategy & how can we give it as fast as we get it, minimising waste & maximising coverage? National guidance here: https://www.hse.ie/eng/health/immunisation/hcpinfo/covid19vaccineinfo4hps/ Summary here

Vials are removed from -80 storage and distributed by the National cold chain system. 120 hour expiry time starts ticking. These arrive in the hospital at some stage in the morning and go into a monitored fridge in the Pharmacy Dept. Vials are checked out to clinic as required.

At the clinic varying configurations of a vaccination team prepare & administer the vaccine. One approach: Pharmaceutical Technicians, Pharmacists, Nurses/Midwives, Anaesthetists have a 2 hour window to dilute the vial. 1.8ml Sodium Chloride + 0.45ml. This gives 2.25ml

Begin drawing up 0.3ml doses. If you’re lucky and you have the right syringe/needle combination, you can consistently draw 7 x 0.3ml doses. It is possible that this might vary from batch to batch, but it is an ethical must for HCPs & @HSELive to maximise this precious gift

Lots of work ongoing right now to see how health professionals can maximise the supply leveraging the expertise of Pharmaceutical Technicians with extensive aseptic compounding experience. Work needed with procurement colleagues to ensure that you have this:

Not this:

The difference is waste with every dose. Thankfully, there seems to be good supplies of “low dead space” syringes from our procurement colleagues. Likewise with the needles - varying deadspace. The right combination yields 7 doses consistently. Just like the US. HT @Fionamw_ire

Once the doses are drawn, they go to the vaccinator for use within 6h. This could be a Medic, Nurse, Midwife, Pharmacist, Paramedic, EMT, or Physio with specific training. The vaccinator could also draw doses, but this increases variability. They confirm a 0.3ml dose and consent.

And finally.

This process involves a broad multidisciplinary team working effectively together. This team replicated in sites nationally on an optimised model will deliver vaccines as fast as they land. Significant voluntarism could run these centres extended hours 7d/week. #VaccinesSaveLives