Okla. Department Takes COVID Vaccines On the Road

In late December and early January, two members of Oklahoma’s Elk City Fire & EMS, Chief Medical Officer Kyle Chervenka and Assistant Chief Medical Officer Brian Pierce, began helping the Beckham County Health Department with its COVID-19 vaccine pods. We quickly turned into “shot-givers” who met with them every Wednesday in January, February, and March.

After the first day of shot-giving, we realized there was going to be a large population we couldn’t reach: the homebound and elderly who couldn’t stand in lines or maybe even figure out a computer to set up appointments. We determined Elk City Fire & EMS was set up perfectly to help this underserved population, so by mid-January we’d started the paperwork process to begin in-home vaccinations.

As with anything state-related, it wasn’t a fast process. We were met with enthusiasm but also uncertainty, since this had never been done before. Luckily for us, being so plugged in with our health department had developed some important connections. They were able to help us get the ball rolling. After a ton of paperwork and some inspections from the state, we were approved for our in-home vaccinations around the end of February and received our first allotment of vaccines the first week of March. We began giving the shots March 9th.

We used a modified ICS system to guide the effort. Chervenka took care of finances, ordering supplies, and paperwork, while Pierce handled the scheduling, planning, and public relations. We sat up a phone in the office dedicated solely to calling in for scheduling. We wanted to make this a person-to-person connection, given the difficulties the elderly can have with technology. We used a phone number that wasn’t tied to the fire station because we didn’t know when people would call or how often that phone would ring. Our IT department hooked us up with a new phone and a city number that wasn’t being used anymore. We then built an Excel spreadsheet that allowed easy day-by-day scheduling.

When citizens called Pierce plugged them into the schedule based on vaccination-day routes and scheduled a crew, typically one paramedic and one firefighter in an ERU.

Challenges

One planning challenge we faced was the time interval in which you have to use the vaccine once you puncture the vial. We received the Johnson & Johnson vaccine—since it requires only one shot, the health department realized this would benefit our logistics. This particular vaccine, once taken out of the refrigerator and punctured, has to be used in two hours. Each vial has five doses, so when scheduling you have to make sure all doses will be used (we were adamant we weren’t going to waste any) and you can drive to recipients’ houses in enough time. If you’re able to keep the vaccine between 36ºF–46ºF, you get up to six hours before you have to discard the vial.

Another factor in scheduling is the 15-minute observation time after each shot. Since these are EUA (emergency use authorizations) medications, all recipients had to be monitored for 15 minutes after their shot. All these factors made this more difficult than administering something like a flu shot.

Results

The Elk City team has served 14 different communities in four different counties during the vaccination effort so far. We gave 95 in-home vaccines over roughly the first six weeks and delivered an additional 75 to business pods.

We had great success with the in-home component, but when it started to slow down, we reached out to businesses that had employees who wanted the shot but couldn’t get away from work to get it. We saw huge support for this, and all feedback was positive. Says Pierce, “I’m sure this has directly and positively affected our fight against this pesky virus, but that’s purely speculative at this point.”

This could not have occurred without support from the health department and City Manager Tom Ivester. With his support and the efforts of our medics and firefighters, we have enjoyed helping get this important vaccine out there.

Brian Pierce, AAS, CCP-C, FP-C, is assistant medical officer and public information officer for Elk City Fire & EMS in Oklahoma.