Operation: Vaccination

I had the opportunity to take a look behind the scenes of the vaccination site at Dodger Stadium, considered the nation’s first and largest outdoor drive-thru vaccination site – it was transformed from a testing site to a vaccination site in under a week. Brian Labrie is an apparatus operator with the Los Angeles City Fire Department and oversees a lot of the logistics for the city-operated sites. He agreed to be my exclusive tour guide. I got an eyeful!

Labrie took me to a mesa overlooking the parking lot, you can also see the Los Angeles skyline and the stadium off to the left. Labrie says at Dodger Stadium there’s 13,000 cones (2.8 miles worth),199 tents and 405 parade barriers. Labrie says a special division was created within the LAFD to deal with all things Covid-19.

One of the challenges to putting the site together was figuring out how people would actually get their shots, while ensuring the safety of the volunteers and clinicians. Labrie says they came up with the ‘Vaccine Pit Crew’ – all the supplies and paperwork are on a cart and they push the cart up and down the lanes where up to 10 cars wait.

Labrie shows me the actual aerial photo of the stadium parking lot. He and his team would use this as a guide to convert the area from a testing site to vaccination site.

Members of the ground support crew are called ‘Woodchuckers’ because of their ability to build anything, saving the city time and taxpayers a bunch of money. They converted a training center into a workshop.

One example of a cost savings happened by accident. More than 500 iPads are in use to receive and transmit vital information from the sites, which means they need to be recharged. Commercial charging stations run in excess of a couple thousand dollars, but after a ‘Woodchucker’ took one look, the team was able to create their version using repurposed materials for around a couple hundred bucks.

I was escorted to a secure facility in downtown LA where the vaccines are stored, inventoried and prepped for shipment to the city-operated sites. Captain Keston Abe oversees this area and allowed me to look inside the refrigerators where the Moderna and Johnson & Johnson doses are stored, as well as the special ultra-deep freezer where the Pfizer vaccine is stored.

Abe also showed me how he keeps track of the inventory in real-time. When he updates a number, it syncs up with spreadsheets at all the other sites. This way, no doses are wasted and there’s enough supply to meet demand on a given day.

At the USC parking garage site, the ‘Woodchuckers’ had to build rooms to store supplies and to provide a safe and secure area for nurses to ‘draw’ the doses from the vials.

USC Pharmacist, Allison Chacon, told me about ‘Ghost Doses’ - these are extra, unexpected doses, that they’re able to squeeze out of a vial. On the day I was there they had 85 ‘Ghost Doses’ on site. This is great news since supply is so limited.

A huge thank you to the Los Angeles City Fire Department for the excellent and informative tour. Special thanks to Assistant Chief Wade White, Apparatus Operator Brian Labrie, and the men and women of the LAFD.

Listen to the complete special as heard on KFI-AM 640, and enjoy the bonus audio below that.

Bonus Materials: Take a look at this impressive set of data sent to me by Pfizer. It gives a great overview of the company’s efforts and challenge to deliver its vaccine.

Dose Shipment Information:

  • As of March 11, we have shipped:
    • 160 million doses worldwide
    • 68 million doses to the U.S.
    • 46 million doses to the European Union
  • Expect to deliver 300M doses of the Pfizer-BioNTech COVID-19 Vaccine to the U.S. government by the end of July, enabling the vaccination of up to 150 million Americans.
  • Expect to deliver more than ~2 billion doses of the Pfizer-BioNTech COVID-19 Vaccine worldwide by the end of 2021.

Thermal Shipper:

  • We have a 99.95% success rate in getting shippers containing our COVID-19 vaccine to their destination within all our prespecified parameters.
  • The thermal shippers can be recharged with dry ice and used for temporary storage at dosing locations.
    • Unopened: the shipper can maintain temp for 10 days
    • Once opened: at the point of use, the shipper can be used as temporary storage with daily use by the healthcare provider for up to 30 days (with adding dry ice every five days)
  • Our specialized thermal shippers are roughly the size of a carryon suitcase and can weigh up to 81 lbs. fully loaded. We utilize Pfizer-strategic transportation partners to ship by air to major hubs within a country/region and by ground transport to dosing locations.
  • The shippers are qualified to hold a minimum quantity of 195 vials and a maximum quantity of 975 vials.
  • Extensive testing is completed on the shippers including both worst case thermal and mechanical testing, which combined provide data on temperature and structural integrity of the thermal shippers during distribution. Additionally, the shippers are re-usable and additional data is being captured to establish the number of uses for the thermal shipping system within the network.
  • Point-of-Use (POU) Ultra-Low Temperature Freezers (ULTF) are commercially available from multiple suppliers. There are small (under-counter) and portable ULTFs suitable for most dosing locations that can extend shelf-life of the product up to six months.
  • At POU sites with ULTFs, vials can be transferred from shippers into ULTFs and held frozen (-70°C±10°C) for several months prior to use. 
  • The shipper can be open for three minutes at a time to allow for removal of vials as needed, up to twice a day.

Pfizer-BioNTech COVID-19 Vaccine Supply Chain Overview:

  • Saint Louis, MO (Raw material manufacturing): St. Louis site is where the plasmid DNA for the vaccine antigen is manufactured. The DNA is the template required to manufacture the mRNA vaccine. The template DNA is manufactured in a cell culture process and subsequently purified through a series of chromatographic and filtration steps. The purified template DNA is then linearized in preparation for the manufacture of the mRNA drug substance at our Andover, MA facility.
  • Andover, MA (Drug Substance): Using an enzymatic process, the Andover Manufacturing Facility is the site where the linearized template DNA is incubated with mRNA building blocks in a reaction vessel to make the mRNA drug substance. The mRNA drug substance is then purified to ensure it meets the highest level of quality and subsequently shipped to Kalamazoo.
  • Kalamazoo site (Formulation, fill and finish): The Kalamazoo site will receive the mRNA drug substance and other raw materials and combine them through a series of steps including impingement jet mixing and specialized mixing to construct the lipid nano particle followed by sterile filtration. The bulk vaccine will then be transferred to an aseptic filling line where it will be filled into a sterilized vial and capped. It will then undergo 100% inspection before it is transferred to the packaging lines where it will be labeled and packed. The packed containers will then go into blast freezers before being staged in storage freezers awaiting final packing into dry ice shipping containers.

PHOTO CREDIT: Steve Gregory and Pfizer


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