Unboxing the coronavirus vaccine in Seattle: A glimmer of hope

The box looked like no big deal. White, cardboard, and a pink sticker that read, “priority boarding.”

But it was a big deal. Precious cargo that held hope for a future of employment and being with loved ones in celebration and death — for life, and life resumed. (And hugs and drinking in bars! And recess, and wearing lipstick in public!)

This box held 195 vials of the Covid-19 vaccine from Pfizer-BioNTech, which had been authorized over the weekend. Scientists in Germany developed the vaccine at breakneck speed, and thank goodness: In the U.S., one person was dying every 30 seconds from the virus.

FedEx delivered this white box to UW Medical Center in Seattle around 7:30 a.m. on Monday. The box found a spot on a cart in the bowels of the hospital, where it would be rather unceremoniously unboxed.

“Happy vaccine day,” said Steve Fijalka, the chief pharmacy officer at UW, to a small group of journalists. There was no time for pomp and circumstance. Every second mattered; if the vaccine vials were out for too long, the entire batch could be in peril.

Earlier that morning, across the country, a critical care nurse named Sandra Lindsey at Long Island Jewish Medical Center had received the vaccine. She was the first person in the U.S. to get the shot.

Lindsey wanted to be an example, she told The New York Times, not just as the first American to get the vaccine, but “as a Black woman who understands the legacy of unequal and racist medical treatment and experimentation on people of color.”

As other boxes with the vaccine landed in cities across America, the Electoral College handed Joe Biden and Kamala Harris their official victory. The vaccine and a change in administration – Monday promised two new tomorrows.

And then another headline flashed, a reminder that we are still in this thing: The coronavirus had claimed its 300,000th victim.

In Washington state, the hospitals were filling up but not as quickly as predicted after Thanksgiving. The number of people hospitalized for coronavirus hovered above 1,000 – a striking number to hospital leaders.

On a call with reporters on Monday, those leaders said they could not handle a surge from people gathering over Christmas and New Years.

“Our concern is that people think, ‘Okay, the crisis is past, and we can relax,’” said June Altaras, a nurse and senior vice president with MultiCare. “The vaccine does bring light at the end of the tunnel, but not with these first few waves of doses.”

The hospital leaders sounded alternately happy about the vaccine, and worn down by the virus.

“We get calls, ‘Can I send a pizza to the ICU?” said Cassie Sauer, president of the Washington Hospital Association. Her voice had a slight edge. “If you’re going to do anything to support health care workers, don’t get sick.”

Stay home, she said. No football party. No playdates.

“It is physically and emotionally exhausting to take care of patients with Covid,” Sauer said. “To watch people essentially suffocate to death from a disease that's preventable is really challenging."

A reporter asked about rural communities pummeled by the virus.

Sauer said many rural areas couldn’t afford the ultra-cold storage required of the Pfizer vaccine. These are ultracold freezers that can maintain negative-94 degrees Fahrenheit. Some cost $16,000, others $25,000.

Pete Rutherford, CEO of Confluence Health, said they would make it work, regardless.

“It will take coolers and dry ice and so on for the last five miles, or the last fifty miles,” he said.

This temperature requirement makes it a finicky vaccine.

The vials are packed in the white box with dry ice pellets. That’s key – can’t be slabs.

The dry ice must be replaced every five days; a temperature gauge turns red if the box is too warm.

It must be thawed to be injected, and then diluted with saline. Each vial contains five doses.

“It’s such a precious resource; there is a lot of concern about doing it wrong,” Sauer said. “Thawing it wrong. Diluting it wrong.”

Back at UW Medical Center, Steve Fijalka, the chief pharmacy officer, wore a pressed dress shirt and tie, as though to honor the moment.

Wearing thick, blue gloves to prevent the dry ice from burning his hands, Fijalka cut open the box and pulled up the top. A plume of dry ice poured out.

Fijalka fumbled slightly as he grasped the tray. He handed it to Christine Meyer, the pharmacy purchasing operations manager.

Someone unlatched the ultracold freezer, and Meyer slid it in. It looked like a dance, almost.

They turned to the box and the remaining three trays, scooping up dry ice pellets and pouring them in. These vaccine vials would go to the other UW hospitals.

“That was quick,” someone said off camera, when the white box had been resealed.

“The way we wanted it,” Fijalka said. He sounded relieved.

It had taken under three minutes – much longer, and the vaccine vials might not have been cold enough.

Fijalka and the pharmacy team walked the box to a black Honda CR-V waiting outside, where Fijalka would drive the remaining trays to Harborview, Valley Medical, and Northwest hospitals.

On KIRO TV, the morning show hosts watched the livestream of the box opening.

“Never has a cardboard box, Styrofoam and dry ice been so meaningful,” said host Matt Smith. “What he just held in his hands, and put in that sub-zero freezer, will save lives.”