At a high school in Washington, D.C., this past week, Bridget Cronin looked on as public school workers shuffled through the two dozen vaccination stations that lined the building's atrium.
Volunteers alternated waving green placards to usher in the next patient. Red placards were on hand to signal the need for more vaccine doses.
The mass vaccination event to immunize teachers and other public school workers in the district, held at Dunbar High School, was the culmination of weeks of planning.
"We've got a cool flow going, where people can quickly come, get assessed by a doctor or nurse, pharmacist at the table," said Cronin, vice president of operations integration at nearby Children's National Hospital, who was in charge of setting up and overseeing the vaccine drive. "It's all one-way traffic all the way through the site to keep everything moving."
By the day's end, more than 1,750 D.C. Public Schools employees got their second shot of the Pfizer-BioNTech vaccine, out of about 7,600 DCPS workers in all.
The event relied on the support of Children's National medical staff — who volunteered their unpaid time to help with the effort. Many of the volunteers and those in line to receive the vaccine see the effort as a promising route to get teachers and kids back in the classroom. Since the pandemic forced schools to close nearly a year ago, mental health professionals have noted a spike in levels of anxiety and depression in children.
And re-opening schools is critical for the working parents reliant on child care who are needed to revive the economy.
In a CNN town hall last week, President Biden said teachers and other school workers should be "on the list of preferred" to get a COVID-19 vaccine.
Yet the vaccination campaign at Dunbar High offers just a glimpse of some of the enormous challenges ahead to pull off the biggest vaccination campaign in U.S. history, geared toward lifting the country out of the coronavirus pandemic.
Accountability at every step
At Dunbar, volunteer staff set up a pop-up laboratory in a repurposed science laboratory where the reserve Pfizer vaccines had been stored in a loaned-out fridge. But even before the vaccines reached volunteer hands, a fragile process was at work to transport the precious commodity.
The morning of the vaccine drive, hospital staff retrieved the vials from ultra-cold storage at Children's National for dethawing.
Due to fears of vaccine theft, the vaccine supply was then moved to the high school under the vigilant watch of security personnel.
"We're treating it the same thing as a narcotic because it is highly sought after," said Dr. Sean Tan, the director of pharmacy operations at Children's National. "We believe if we don't have all these safeguards in place we are vulnerable and we open ourselves to be targets."
Back at the high school, technicians prepared the vaccine-filled syringes in a time-consuming — and time-sensitive — procedure. Each vial had to be diluted and pulled into the syringe with certain steadiness.
Kellie Neal, a pharmacy technician supervisor at Children's National, had to go through special training to work with the Pfizer vaccine.
"We don't want to inject any air bubbles and we want to make sure they get the full dose," Neal said.
Dr. Tan said no drop can be spared.
"This is where technique and patience comes in," he said. "A lot of people are like, 'Oh, it's just a drop, I'll give up, I go to the next vial.' But we literally take every drop out of each vial," he said, because "just a drop might be a third of a dose."
The prepared syringes were then delivered to the doctors and nurses who administered the injections.
"We're in this together"
Cronin said a total of 125 volunteers from the hospital participated in the vaccine event. They held another round later in the week to vaccinate additional school workers.
"We created a gigantic sign-up sheet," she said. "The vaccine is free through the Department of Health, and then it's through the goodness of people's hearts that they're here today to get our city and everyone out of this pandemic."
But Washington's dependence on that generosity is also a symptom of a piecemeal, disjointed process in which Americans are getting vaccinated.
It took about a 2-hour wait for some of the school workers to make it to one of 24 tables where they were able to get the shot. Still, Cronin said mass vaccinations like this are more efficient than small-scale supermarket and pharmacy signups when it comes to inoculating large groups.
"We see 24 patients every 5 minutes," she said.
Back at the one of the stations, Dr. Craig DeWolfe, a pediatric hospitalist whose child attends a D.C. school, asked principal Amelia Hunt a series of medical questions before administering her second shot of the Pfizer vaccine.
"It means so much to me to be able to give back to these teachers and the principals and all the staff who have given so much to my son, our family. We're in this together for sure," DeWolfe told Hunt.
Hunt returned the gratitude.
"I appreciate you tremendously," she said. "I can't imagine what your job has been like and what the experience has been like being on the front lines of all this, so thank you for volunteering your time to come in and do this."
It will take many months to get teachers across the country vaccinated. And questions remain about the threats of new coronavirus variants and potential infection surges that could leave teachers exposed.
The D.C. Teachers' Union has said that opening schools safely requires more than vaccines. It has stipulated that community transmission must be low and that there needs to be measures in place, like good ventilation and cleaning protocols.
Another challenge: vaccine hesitancy
Logistics aside, there are also still many teachers who are reluctant to get vaccinated. According to DCPS, only 64% of teachers who were invited to be part of the vaccination clinic signed up. That number dropped to 45% when accounting for other support staff. And even after showing up at the site ready to be vaccinated, people have questions.
"I think the first and most important thing we can do as medical professionals when dealing and talking with people about their own potential hesitancy is acknowledge our own hesitancy," said Dr. Nathaniel Beers, a pediatrician at Children's National.
"Six months ago, I, too, was hesitant to think about potentially getting the vaccine," he said, "but taking the time to understand the science behind it, to understand that, while the vaccine itself is new, the technology that they use to develop the vaccine has been in development for many years. "
"A positive step forward"
But for principal Hunt, the vaccination drive felt like the start of a new chapter.
"I'm so excited because it means that we are taking that step forward, that positive step forward," she said.
The day she got her second coronavirus vaccine dose, she said, her school was marking a "Random Acts of Kindness Week."
"If there's something that I could do to be kind to someone else, it's getting this vaccine — because it means I'm keeping myself safe but I'm keeping my neighbors safe as well," she said.
Hiba Ahmad and Melissa Gray produced and edited the broadcast versions of this story.
LULU GARCIA-NAVARRO, HOST:
It's one of the puzzles of this pandemic. The economy can't come back online without working parents. Working parents cannot fully focus on their jobs without their kids being back in school. And their kids can't get back into school without teachers returning to the classroom. There is now a big tool to help that happen - vaccines. Here is President Biden speaking at a CNN town hall this past week.
(SOUNDBITE OF ARCHIVED RECORDING)
PRESIDENT JOE BIDEN: I think that teachers and the folks who work in the school, the cafeteria workers and others, should be on the list of preferred to get a vaccination.
GARCIA-NAVARRO: Of course, this isn't only an economic issue, right? Kids need school for all sorts of reasons. And for many children across the country, they've been almost a year out of the classroom, hurting their mental health, their grades. Today on the program, we're going to take you to a mass vaccination event of public school workers here in Washington, D.C., to understand the enormous national undertaking underway.
BRIDGET CRONIN: We see 24 patients every five minutes.
CRONIN: And so to keep up with that kind of pace, they have a whole production line going in the back room.
GARCIA-NAVARRO: This really does feel like a wartime effort.
GARCIA-NAVARRO: That's Bridget Cronin from Children's National Hospital in Washington, D.C. She's in charge of setting up and overseeing this operation at Dunbar High School. By day's end, some 1,700 D.C. public school system employees will have their second shot of the Pfizer vaccine. There are around 7,600 DCPS workers in total in the system.
CRONIN: We've established a pharmacy in one of the back - laboratories of the high school. And so we bring the vaccine from the hospital, where we keep it in the ultracold freezers. And we thaw it, and we bring it here and keep it in a small freezer here. And we have a team of people that's in the back room preparing the doses. But those logistics are really considerable.
GARCIA-NAVARRO: Elsewhere in the show, we will take you inside that pop-up pharmacy. But here's one thing you should know about today's event if you want to understand some of the challenges of the biggest vaccination campaign in U.S. history. This event took weeks of planning. And the medical staff from Children's National, who have already done so much during this pandemic, are volunteering their time, unpaid.
CRONIN: We created a gigantic sign-up sheet. We have hundreds and hundreds of volunteers that have signed up. It takes about 125 or 150 people a day to support this event. And so we had to call everyone - calling all hands, please come help us.
GARCIA-NAVARRO: Yes, it's wonderful that the staff of this hospital has been able to help in this way, but it's also a symptom of the piecemeal and fragmented way Americans are getting vaccinated writ large. Still, mass vaccinations like this are more efficient when inoculating large groups, says Bridget Cronin, than the small-scale supermarket and pharmacy sign-ups.
UNIDENTIFIED PERSON #1: So you're going to actually go straight down. Stay towards the left.
UNIDENTIFIED PERSON #2: OK.
UNIDENTIFIED PERSON #1: And they'll help you...
GARCIA-NAVARRO: It took about a two-hour wait for some of the school workers to make it to one of the 24 tables where they were able to get their shot. Among them was Jose Roberto Reconco, a cheerful 70-year-old DCPS custodial worker.
JOSE ROBERTO RECONCO: (Speaking Spanish).
GARCIA-NAVARRO: He tells me that he and his wife got COVID in November. They didn't have health insurance, and so it was a scary time. He was in and out of the hospital. So getting the vaccine should have been a top priority. But he tells me...
RECONCO: (Speaking Spanish).
GARCIA-NAVARRO: "My wife is still so scared," he says. "She didn't want me to get the vaccine." She told him about her fears, fears fed by some misinformation. But he decided that if the world was fighting to get the vaccine, it made sense for him to get the shots, too. He jokes, she said to him as he was headed out the door today...
RECONCO: (Speaking Spanish).
GARCIA-NAVARRO: "Do whatever you want. Just make sure your papers are in order," he said she said. "Where do you want to be buried? What do you want your coffin to look like? That way I won't be in a rush, and you can go into your hole in the ground as you would wish," he recounts, laughing. He is funny, but vaccine hesitancy is a real problem, especially among communities of color. According to DCPS, only 64% of teachers who were invited to be part of this vaccination clinic signed up. That dropped to only 45% when including other support staff. And even after they've shown up at the site, ready to be vaccinated, people have questions.
I see you've got a badge there saying, ask me about the vaccine. Do people ask you about the vaccine? And what do they want to know?
NATHANIEL BEERS: I think the first and most important thing we can do as medical professionals when dealing and talking with people about their own potential hesitancy is acknowledge our own hesitancy.
GARCIA-NAVARRO: That's Dr. Nathaniel Beers, a pediatrician at Children's National Hospital.
BEERS: So the first thing I do is acknowledge that six months ago, I, too, was hesitant to think about potentially getting the vaccine - but taking the time to understand the science behind it, to understand that while the vaccine itself is new, the technology that they used to develop the vaccine has been in development for many years. This is the first time that we're using it - doesn't mean it hasn't been tested many times in lots of different settings before it was used.
GARCIA-NAVARRO: It's a message he's been repeating to those who are worried. Suddenly, at around mid-afternoon, another doctor stands on the steps of the large atrium where the vaccines are being administered.
UNIDENTIFIED PERSON #3: Everyone, please stop vaccinating. Vaccine count commences now.
GARCIA-NAVARRO: It's one of the many protocols in place to make sure all the vaccines are accounted for and that the pace is on target. Back at one of the tables, Dr. Craig DeWolfe, whose child is in a D.C. public school, is about to administer the second shot of the Pfizer vaccine to principal Amelia Hunt. And it's gratitude all around.
CRAIG DEWOLFE: It means so much to me to be able to give back to this - teachers and the principals and all the staff who have given so much to my son, our family. So we're in this together for sure.
AMELIA HUNT: I appreciate you tremendously. It's - I can't imagine what your job has been like.
GARCIA-NAVARRO: And then it's on to the medical questions.
DEWOLFE: Did you have any reaction to the previous vaccine?
HUNT: I did not.
DEWOLFE: Fantastic. And any other...
GARCIA-NAVARRO: It will take many months to get teachers across this country vaccinated. And there are questions about the variants and other possible surges that could leave teachers exposed. The Washington, D.C., Teachers' Union has said that opening schools safely requires more than vaccines. It has stipulated that community transmission must be low, and there have to be measures in place, like good ventilation and cleaning protocols. Still, for her part, Amelia Hunt says this feels like a new chapter.
HUNT: I'm so excited because it means that we are taking that step forward, that positive step forward. I'm excited for all of my children at my school to be able to just see our building. This week is Random Acts of Kindness Week. That there's something that I can do to be kind to someone else is getting this vaccine because it means I'm keeping myself safe, but I'm keeping my neighbors safe as well. Transcript provided by NPR, Copyright NPR.