En español | When Lena Napolitano was picked to be one of the first recipients of the COVID-19 vaccine at University of Michigan Medicine in Ann Arbor, she felt like she'd won the lottery. The room erupted in cheers as the 63-year-old surgeon and critical care physician gave two thumbs up.
Amid the jubilation, her thoughts quickly turned to her ICU patients struggling to survive and her colleagues still fighting to save them. Napolitano and high-risk health care workers across the country made history last week when they received the first round of Pfizer's COVID vaccine, with many more scheduled to get that shot or the newly authorized vaccine from Moderna in the coming days. The development comes as coronavirus cases soar in the United States, with deaths rising far above 300,000.
Most older Americans in generally good health may not get the vaccine for months. A CDC advisory board has recommended that adults 75 and older be prioritized for vaccination next, after the initial rounds are allotted to certain health care workers, along with nursing home residents and staff. But many of those getting the first vaccinations are older health care workers. After more than nine months of battling the virus, the significance of this turning point isn't lost on them.
"I just felt a sense of relief, and I felt honored,” said Linda Lawson, 59, the associate vice president of nursing at University of Florida Health in Jacksonville, after she got her first shot. “This is the beginning of the end of this horrible, horrible pandemic. And I'm so proud to be part of it.”
For health care workers, the year has been fraught with loss, sick colleagues and emotional fatigue, unforgiving hours and stress and an upending of their and their families’ lives. Adding to the horror for many has been the insertion of politics in public health and science.
Luis Angel, a pulmonary medicine specialist at New York University Langone Health, watched as his hospital became paralyzed by a “completely unprecedented” deluge of patients in March, April and May — of which, he said, nearly 35 percent died. In history books, he suspects, 2020 will be remembered in medicine for two things: the “biggest failure in public health” as COVID spread to nearly 20 million Americans, “followed by the biggest achievement” in the swift development of vaccines.
Angel, 55, was one of the first four vaccination recipients at his hospital. He said he got the vaccine so that he can continue caring for his regular patients, many of whom are immunosuppressed, but also because he sees being vaccinated as an act of patriotism.
That sense of duty also drove Les McKinney, 61, who as director of environmental services oversees housekeeping, laundry and maintenance at Good Samaritan Society – Sioux Falls Village, a nursing home in South Dakota. Yes, he still needs a haircut and misses seeing his grandchildren, but this moment in the war against COVID was bigger than him.
"All I could think of was this is step one in getting rid of it, and I'm doing my part to help eradicate this crap,” he said. “We need everybody to get on board to get this stopped.”
Striving to lead by example
The task of prioritizing who'd get the vaccine first fell on multidisciplinary hospital committees and state and local leaders, with recommendations from the Centers for Disease Control and Prevention (CDC). On top of wanting to target those with the greatest risk of exposure — people working in COVID units, ICUs or emergency rooms, for example — was the calculation that media coverage could help drive positive vaccine messaging. That meant being intentional about including people from different racial and community backgrounds, job descriptions and age groups.
Stephen Hartsell, an emergency physician at University of Utah Health in Salt Lake City, was among the first to get the vaccine. He felt some guilt about it.
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"I felt a little bit bad in that here I was a white male in a leadership position, and I was up there getting my vaccine first,” said Hartsell, 67. But to other employees and to the disenfranchised community members who often flock to the emergency department as a safety net for care, “we also wanted to make sure that we showed that we weren't asking people to do things that we would not do ourselves.”
The vaccine is administered in two rounds, 21 days apart in the case of Pfizer's, 28 for Moderna's. Before these first recipients received the first shot, they had already scheduled the second.
Some spoke of after-the-fact soreness in the arm but said it was no worse than a flu shot and better than a tetanus shot. Randi Schaeffer, 66, couldn't say whether the vaccination made her tired, since as interim vice president of nursing at North Dakota's Sanford Bismarck Medical Center she is exhausted from working up to 12 hours a day.
Luti Kashimawo, 57, the section head and medical director of the pediatric intensive care unit at Ochsner Hospital for Children in New Orleans, woke up the next morning with a slight headache and minor body aches but “took a Tylenol, took my warm shower, and I was good to go.”
And James Allen, a 62-year-old pulmonary care critical doctor at Ohio State University Wexner Medical Center in Columbus, actually wished he'd had more side effects beyond his sore arm. Side effects result from an activated immune system, he explained, and “are a sign that the vaccine is doing what it's supposed to do.” Allen wants to alleviate concerns about the COVID vaccines being distributed across the nation, and he's not alone.
"There's a lot of really smart, thoughtful, rigorous work that was done to move these vaccines forward,” said Trish Kritek, 50, a pulmonary and critical care physician at University of Washington Medical Center in Seattle, where she's been working in the COVID intensive care unit. “I know that people are anxious about it feeling fast, but the science that is being used for these vaccines has been something that people have been working on for decades.”
At the same time, many health care workers who got the first shots warn that the end of COVID isn't here yet. First, enough people need to get vaccinated for it to make a significant difference, which will take time. And it's not yet clear if someone who receives the vaccine will be immune from contracting an asymptomatic case that could be transmitted to others.
For all of these reasons, the CDC and the vaccine recipients say it's still important to mask up, wash your hands, social distance and maintain caution, especially as the numbers of cases, hospitalizations and deaths continue to grow. “I'm going to be very black-and-white here: We are still in a very dangerous life-threatening pandemic.… Why would we let up on anything?” said Napolitano, of the University of Michigan.
Her medical center sees “the sickest of the sick,” getting referrals from across the state and elsewhere, like Ohio and Indiana, she said. She sees ICU beds full of COVID patients who are “right on the edge of death” and knows there's still a long way to go.