Ukiah Valley Medical Center discovers thawing vaccine vials
A refrigerator holding vials of coronavirus vaccine failed at Ukiah Valley Medical Center on Monday, prompting a frantic effort to inoculate hundreds of people in less than three hours before the medicine expired.
By the time staff discovered the problem, 830 doses of the Moderna vaccine had been thawing for more than nine hours, Ukiah Valley Medical Center chief medical officer Dr. Bessant Parker said. The medical center had little choice but to distribute the vaccine freely and rapidly, including members of the general public who heard about the emergency and lined up outside the medical center in hopes of getting a shot.
“Ultimately, it is vaccinating members of the community,” Parker said. “It doesn’t matter who. It’s an emergency situation to save vaccines.”
Unlike the Pfizer-BioNTech vaccine, which must be stored at super-cold temperatures, the Moderna version is stored in freezers not much different from what you have in your kitchen. Under CDC guidelines, a thawed, unpunctured vial can be kept for up to 12 hours between 46-77 degrees Fahrenheit after it has been thawed for one hour at room temperature or for 2½ hours in a refrigerator. Scientific American wrote that a thawed vial can be stored in a refrigerator for up to 30 days. Vials cannot be refrozen.
Medical center staff first discovered the refrigerator failure, caused by a faulty compressor, at 11:35 a.m. The alarm system designed to alert staff to any disruption of the refrigeration also malfunctioned, allowing the frozen vaccine to thaw.
Using the information logs at their disposal, hospital officials calculated vials had come to room temperature around 2 a.m., Ukiah Valley Medical Center President Judson Howe said. They gave themselves until 2 p.m. to administer the vaccine.
The hospital sent 200 doses to the County of Mendocino, which forwarded them to the county jail. The jail had recorded at least 68 cases of the virus among inmates and corrections staff in an outbreak last week.
The hospital called local nursing homes and got requests for 70 more doses, Parker said. Ukiah Valley Medical Center distributed the other 560 doses on-site. The Mendocino Voice, which first reported the story, said officials considered sending some of the vaccine to Howard Memorial Hospital in Willits, but an accident on Highway 101 was blocking northbound traffic.
By noon, the hospital had set up four vaccination stations on its campus. It sent out a plea to local health care workers such as nurses and pharmacists, many of whom volunteered their time, including some doctors who are not part of the Adventist Health system.
According to the Mendocino Voice, a line formed outside the medical center made up of “people off the street, patients, people who had heard from a friend or word-of-mouth.” The effort was complete by 2 p.m.
Not everyone was happy with how Ukiah Valley chose to distribute the doses.
“I’m not against giving them out emergently,” said a doctor who practices in Mendocino County but is not affiliated with Adventist Health; he asked for anonymity, fearing reprisal. “What I’m against is they emailed friends and family. We have police officers and firefighters. It’s not so emergent that you have to get that out in 10 minutes.”
The doctor said he contacted people “who warrant treatment” when he heard of the failed refrigerator. Some of them phoned Ukiah Valley and were told the doses had been exhausted.
“Adventist decided to exclude the rest of the county,” he said.
But Parker strongly disputed that assertion.
“We needed to get vaccines in the arms of people by 2 p.m.,” he said. “It’s 2 hours, 25 minutes from now. It’s 830 doses. And you haven’t planned anything for that. We don’t have a clinic day today. Nobody knows about it. If anybody is looking to make opinions and throw stones, that would be ridiculous.”
Parker said he phoned Mendocino County Public Health, and officials there gave their blessing to administer shots as quickly as possible. Ukiah Valley had already given the first round of the Moderna vaccine to 800 of its medical staff who are in the “top top,” as Parker put it, of California’s tiered priority system.
In an interview with MSNBC on Monday, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, echoed what CDC officials have stated previously — that health professionals should ignore the tier system when conditions make it unwieldy.
Ultimately, Parker said, that’s what transpired in Ukiah. The emergency distribution of the 830 doses won’t disrupt his hospital’s vaccination plan much, he said. Ukiah Valley was holding some doses for the county, and some in preparation for starting the second round of vaccinations among its Tier 1 staff. He credits a frenetic team effort for averting disaster.
“The CEO was helping out. I personally was helping,” Parker said. “It was all hands on deck. That’s the amazing part of this. This has been a whirlwind of a day. But we are glad we didn’t waste any resources.”
You can reach Phil Barber at 707-521-5263 or firstname.lastname@example.org. On Twitter @Skinny_Post.