Einstein Ready to Inoculate Employees When COVID-19 Vaccine Available
It was late September when Einstein Healthcare Network began preparing to dispense a COVID vaccine – long before any drug company had one to offer. Now, on the eve of the expected emergency approval of the Pfizer and Moderna vaccines, Einstein is ready to go.
“We knew pharmaceutical companies were working on it and we hoped for good news, which we’ve received in the past couple of weeks,” says Steven Sivak, MD. Dr. Sivak is President of Einstein Physicians Philadelphia and chairs the Vaccine Task Force.
The network has two freezers to keep the vaccine super cooled. A priority list of employee categories is being created in the likelihood that there aren’t enough doses to go around. Task force members have determined where and to whom the injections will be administered. They’ve decided the vaccine will not be mandatory for Einstein employees, at least not right away.
The task force has been nimble and flexible, adapting to new guidelines that the Centers for Disease Control and Prevention (CDC) has been releasing as rapidly as baseballs from a pitching machine.
“We have a big committee with a lot of smart, talented people,” Dr. Sivak says. “We’ve been able to engage people from all of our campuses in many different departments,” including nursing, pharmacy, administration, finance, human resources, ethics, government relations, marketing, information technology, physicians and facilities.
More than two dozen people are on the Vaccine Task Force. “We have different experts looking into all areas relevant to their expertise,” he says.
Who Gets the Vaccine, and When?
The most delicate and difficult question the committee had to address was: who would get the vaccine?
Since the CDC was expected to limit the first phase to healthcare workers, the committee had to decide: who would be first? “We had to design a prioritization methodology,” Dr. Sivak says. “With a limited supply, who’s going to get it and in what order?”
The committee discussed a few options – including first come, first served. Then they agreed to provide the vaccine first to “those at greatest professional risk and those at highest personal risk.”
Healthcare workers who are most likely to work directly with COVID patients – those who work in the Emergency Department, for instance – would receive priority. So would those who are at highest risk of serious complications if they get the virus because of either age or compromised health problems.
Since privacy concerns prohibit inquiries about age or medical issues, the process of prioritization asks whether a recipient wants to be included in a high-risk category, based on medical condition or age.
“Since we can’t know what people’s medical conditions are, they’ll have to self-disclose,” Dr. Sivak says. Disclosure is not mandatory.
If there’s not enough vaccine to go around for all healthcare workers who qualify, Dr. Sivak says, “we’ll randomize at each level of the list so that no one can say there was favoritism.”
Vaccination Will Be Voluntary
Another tricky question the committee faced was whether to make the inoculation mandatory for those who were qualified to receive it. The hospital requires employees to get an annual flu shot, so why not a COVID vaccine? The decision was to make it voluntary for now.
“Our decision may change, but keep in mind that the vaccine is being released under FDA Emergency Use Authorization, not FDA approval,” Sivak says. “There are still many unanswered questions about the vaccine – we don’t know the long-term effects. We feel there’s a good safety profile with the vaccine, but it’s based on only two months of experience.
“Given that a drug is usually tested for six months before receiving emergency approval, we agreed we should not require the vaccine and leave it up to the individual. If the FDA ultimately approves it [through the normal process], we may change our position.” Anyone who opts out of getting the vaccine can opt back in at any time.
Dr. Sivak says he has never seen anything of this magnitude in his career. Nor has anyone else, of course, but he’s perhaps more qualified than most to oversee mass vaccinations of the Einstein workforce.
In 2008, only 25% of Einstein employees were getting the annual flu vaccine, and hospital leadership asked Dr. Sivak to improve that participation rate. “The rate went from 25 to 99% over five years,” Dr. Sivak says, “and that rate has been sustained.”
That’s how Dr. Sivak got his nickname, “Flu Man.” And that’s why he was asked again to facilitate the COVID vaccine. Thanks to him and the agile task force, Einstein is ready for the vaccine, just in time.
And, yes, Dr. Sivak says, if he’s eligible to get the vaccine, he will.