'Waste no dose': N.W.T. officials explain territory's vaccine distribution

Vaccinating 75 per cent of the Northwest Territories' adults against COVID-19 in just a few months is no easy feat, especially when the vaccine is as delicate as Moderna's.

"It's quite a fragile vaccination," said Dawn Deblieck, a nurse educator who's been training nurses and logisticians on the Moderna vaccine. 

"It doesn't like to be jostled or moved around very much, so the care involved in it, it has to be considered."

On Friday, N.W.T. government officials gave media a glimpse of the challenges and complex logistics involved in distributing the Moderna COVID-19 vaccine.  

It's not just that the vaccine doesn't like movement, explained Sean Marshall, it's also that the doses must also be kept at certain temperatures, which change depending on how near it is to injection time. 

Marshall is the chief logistician for the N.W.T. Health and Social Services Authority's COVID-19 Response Team.

Frozen is the preferred state for vaccine movement, because that's when it's most durable and has the longest shelf life, said Marshall. 

At refrigerator temperature, it can last another 30 days. In its cool state, the vaccine can be moved for a total of 12 hours (the team logs the length of time the vaccine has been in motion).  

Once it's at room temperature, the vaccine must be administered within 12 hours, or six hours after a vial has been punctured.

Handlers of the vaccine are expected to treat it as "something more delicate than an egg," said Marshall.

Each step recorded

Each step of the vaccine's journey across the Northwest Territories, from pharmacy freezer to the patient's arm, must be carefully recorded. 

"There's a record of what temperature it was at, how long it was in motion, from where to where, and the person who has been in custody, in custody during that travel," said Marshall.

Scott Robertson is a registered nurse and executive co-lead on the COVID-19 Response Team. 

"It takes a lot of planning to make sure that we move the vaccine to the right place, get all the people in the right area to immunize them so we don't waste any vaccine," said Robertson.

That's why the logistics team is a crucial part of the immunization effort. The vaccine doesn't go anywhere without a logistician, said Robertson.

The team has worked every day since Dec. 1, save Christmas Day, to get the vaccine program up and running, he said. 

"It's been non-stop," said Robertson. "We put together an entire training program in a matter of days."

The territory only got Moderna's instruction manual for how to administer the vaccine in the last few days of December, said Robertson, and the material is "very dense.

"So taking that information and translating it into knowledge for our staff to use is a complicated process."

Many obstacles

The team has overcome other obstacles, as well.

For one, there's a global shortage of syringes and needles. Robertson said the N.W.T. has acquired some from Canada's national stockpile, and that every dose of the vaccine has its own syringe and needle.

There's also a limited supply of coolers, fridges, freezers and data loggers. 

"We've had to be creative with the supplies that we're able to access," said Marshall. "The federal government's provided quite a bit."

Plus, before heading out to communities, the team has to consider where crew will eat and sleep, as there aren't a lot of options in some communities. They've sent team members out with sleeping bags and groceries, when necessary, said Robertson.

The logistics team exists to manage all of this, and any other issues that may arise. 

"As we get new information on a daily basis, we have to adjust our plan," said Robertson. 

In spite of all of the moving parts in the distribution process, Health Minister Julie Green says the roll-out is going "really well.

"I was very happy with the speed with which people were able to start administering the vaccine to the long-term care homes. That was ahead of schedule," she said.

Green said the Moderna vaccine information sheet has been translated into the territory's official languages, and interpreters are part of the distribution effort so that people understand what they're being offered and have the opportunity to ask questions.

"I am hoping that that will deal with a lot of vaccine hesitancy," she said.

For Robertson's part, he said his team has one very important goal: "Waste no dose."

If ever they find that they have leftover doses, "we'll put it in an available, eligible arm at the last minute," he said.

"We will do everything we can to not waste a single dose."