As Vaccine Arrives at a Nursing Home: ‘I Hope Everybody Takes It’

The jab took seconds. The planning took weeks.

The approval of Pfizer’s novel coronavirus vaccine in December brought hope to the residents and staff members at Staten Island’s Clove Lakes Health Care and Rehabilitation Center. The facility was hit hard: It lost more than 40 residents to the virus last year and struggled financially as the number of new residents plummeted, along with their income.

The employees and residents had counted on the vaccine to help them return to some semblance of their old routine — including family visits — and were determined not to waste any time. Weeks before a single person got the vaccine staff had been preparing for the rollout, contacting residents and families by mail, email, robocalls and social service workers to reassure everyone about its safety and effectiveness.

On Monday, a team from Walgreens spent the day at the nursing home, administering first and second doses (some had their first dose administered on Dec. 21) of the vaccine to dozens of employees and residents. Lorri Senk, the administrator for Clove Lakes, has been pleased with the result.

“It was a great day,” Ms. Senk said. “We felt relief.”

Here’s how the day unfolded:

The team from Walgreens arrived at 8:30 a.m. and prepared vaccines and paperwork. The vaccine, which has to be kept between 36 and 46 degrees Fahrenheit, was stored on ice inside a Styrofoam cooler, whose temperature was monitored and recorded throughout the day.

The vaccine itself has to be reconstituted by injecting a sodium chloride solution into the vaccine vial, ultimately yielding 6.3 doses that need to be used within six hours.

The team filled 30 syringes at a time, keeping track of distribution and preparing more as needed.

Christopher McNamara, the pharmacy manager at the Walgreens in the Dongan Hills neighborhood, led the team of a dozen workers — all of whom had volunteered — in what he called a moment of history as well as duty.

“I do this because as a health care professional, this is a great opportunity to set a precedent and provide services,” said Mr. McNamara, 39. “This is what I went to school for. I want to serve the public and be a role model.”

One team of volunteers from Walgreens set up in the atrium, where they began vaccinating the nursing home’s employees at 9 a.m., while the rest set up in the day rooms on each floor, preparing to vaccinate the residents.

The Clove Lakes staff had ensured the day before that all residents receiving the vaccine on Monday had tested negative for Covid-19 the previous week; the employees then spent part of the morning making sure residents were ready and lined up outside their rooms.

As residents prepared to get their injections in their floor’s day room, staff members receiving the vaccine lined up outside the atrium for their own shots.

Ms. Senk, the administrator, made sure their paperwork was in order before they were allowed to enter and be vaccinated.

Covid-19 Vaccines ›

Answers to Your Vaccine Questions

While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.

Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.

Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.

The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.

No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

After staff members received their injections, they were handed written proof of vaccination, before heading back to help the residents.

Staff members guided residents to and from the vaccination sites throughout the day. Social distancing was enforced as much as possible, and staff members looked after residents who had difficulty wearing their masks properly.

The staff had discussed the procedure with residents in the days before, reassuring people about side effects and safety.

“It’s a new vaccine, so people were unsure,” Ms. Senk said. “But they asked great questions.”

Irene Lucente, a resident, was the first to get the vaccine in her unit. “It’s going to save a lot of lives,” she said. “They had a long way to go to get here, to get it perfect.”

She’s also come a long way. Born on Mulberry Street in Little Italy more than a century ago, the retired seamstress and mother of three said she had survived past pandemics, including the 1918 flu. She looked forward to receiving the vaccine, not so much for her, but for others who have not been allowed to visit the facility where she has lived for the past seven years.

“I’m 104, so I’m not worried about myself,” she said. “I’m worried about my children and grandchildren.”

And the shot itself?

“It was good,” she said. “I didn’t feel anything.”

Hospital trips have kept James Ivaliotis away from Clove Lakes for weeks on end since he moved in nearly two years ago. At 69 years old, with cirrhosis and problems walking, the retired health care finance professional knew the risks. But he has weathered the pandemic with optimism.

“I just felt confident it was going to not hit me or my family,” he said. My son works at a hospital and he was in the heart of the thing. He never caught it.”

Residents of nearby rooms on his floor have not been so lucky, losing their lives to the virus. He signed up for the vaccine as soon as it became available. He said there was a good turnout for the day, even if some people had expressed reservations about being among the first in the country.

“People are always scared the first time something new comes out,” he said. “Like, ‘Let’s see if the people that got it first grow a third eye.’ But it’s catching on more, and people are starting to see. I’m glad I got it. I hope everybody takes it.”

That kind of reaction buoyed the Walgreens team.

“There’s always doubts,” Mr. McNamara said. “But like with any type of thing, you have to educate people. With this pandemic, the benefits of the vaccine outweigh the risks.”

As 5 p.m. approached, the pharmacy technicians gathered up their supplies and paperwork. But even though the vaccinations stopped at that time, Mr. McNamara said his day was hardly done.

“At the end of the day I have to go back to the store,” he said, and “do whatever closing procedures we have to do and submit final numbers.”

If he’s lucky, he’ll finish by 8 p.m., before returning to his home on Staten Island.

“It’s all for the good,” he said. “They were all excited to get the shot. There really was no skepticism anywhere.”

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