I served on one of first vaccination teams in December at a SNF with an active COVID outbreak, setting up the mobile clinic in an outdoor courtyard, on a chilly day. We took no breaks because we didn’t want to don and doff our PPE--a feat of endurance. We set up four stations: registration/counseling, vaccination tables, recovery area. I noted how smoothly my RN colleagues, all former or current ICU or ER nurses like myself, moved into action together, even though we never met till that morning. It was a familiar, no-nonsense rhythm of providing what was critically needed, and a welcomed break from the social-political obsessions I experienced most days of 2020.
When the public health official arrived with the refrigerated case of Pfizer-BioNTech COVID-19 vaccine, we gathered around to open it. Wow. We beheld the rows of tiny purple-capped vials, and a wave of emotion swept over the entire team. Maybe because these were among the first vaccines to arrive in Marin County, maybe because it was the day before Christmas Eve, and we were huddled together in a SNF courtyard strung with paper Christmas decorations, but there was no denying that we felt like something precious and rare and long sought after was in our hands. It was viewed as a very privileged and sacred moment, a chance to end this epidemic of sickness, death and loneliness. I gingerly picked up one vial with a double gloved hand and joked, “Look at us, we look like we’re gazing at baby Jesus, as if a Christmas miracle had arrived!” And true to form, we burst out laughing, a typical response of front-line health care personnel to break the tension and get back to work.
You might wonder if we were there to vaccinate the frail elderly residents. No, just the staff. California follows the CDC recommendations to first vaccinate the most at-risk which aren’t the non-ambulatory residents, but the staff—the nursing aids, orderlies, cooks, cleaners and janitors of nursing homes and SNFs. These folks are often new immigrants, people of color with higher rates of chronic disease, who work for low wages due to minimal education or lack of documentation. They work hard holding onto the only job they could get without specialized credentials, and they do their best in the poorest of conditions. They are most at-risk from an epidemiological viewpoint, taking public transit back and forth to crowded living conditions, frequenting stores or working extra shifts at essential service jobs, in contact with hundreds of people each week, and also going room to room at the SNF, sometimes in more than one facility.
But it wasn’t always easy to convince staff to get the shot. While a few gladly rolled up a sleeve, several heard about a “lack of testing” or that “it gives you the disease.” We had to listen patiently, try to dispel fears and misinformation. Once a threshold of staff started lining up, the tide was turned and we jabbed away. While most people I talk with are thrilled to know that the vaccine is available for everyone, there are still those who are fearful or hesitant, and in those cases, I offer this moment of mindful reframing. Consider transmuting that worry with the current fact-based reality, that the world is participating in a massive coordination to bring a remarkable vaccines everywhere…the culmination of the work of thousands--scientists, virologists, clinical investigators, immunologists, epidemiologists, refrigerant engineers, delivery and dissemination experts, independent medical advisory boards, government and private enterprise partners, dedicated public servants, extraordinary public health leaders—and it is amazing that it winds up in the hands of volunteers like me willing to reach out and ask you to roll up your sleeve for a healthier, safer, happier world than what we’ve experienced since the start of 2021.