This week’s Meet a Mom interview is with two doctors who have lead a huge vaccination effort at their CA-based hospital. At the time of press, the CDC reports almost 150 million Americans are fully vaccinated—and these two women have helped administer 25,000 of those to date. Dr. Stephanie White, D.O., FAAFP, Associate Dean of Clinical Education at WesternU College, lives in Los Angles, and is Mom to a 6-year-old son and 2-year-old daughter. Dr. Preeti Kotha, PharmD, APh, Director of Pharmacy Services/ Associate Professor at WesternU lives in Rancho Cucamonga and has two girls, 9 and 11. When vaccinations started to become available, Drs White and Kotha teamed up to make them available to their community, working for several months to gain access to doses. “WesternU is a health professions university and we were very eager to protect the students and staff from COVID exposure. We are also situated in a high risk community (Pomona, CA) and had seen devastating COVID outcomes for our patients and neighbors,” explains Dr. White.
The pair developed a partnership with the Los Angeles County Public Health department, and after several false starts they got the go-ahead. “In early February we received a call that over 1170 doses of Pfizer vaccine would be arriving in a few days’ time. Preeti and I sent out the call to the entire university asking for help in preparing a vaccine clinic. We moved into a large common space, relocated computers, crawled on the floor placing 6 foot markers, quickly ordered and designed signage and oriented the team to the electronic health record system. Preeti had run flu vaccine clinics in the past and I had given vaccines as a family doctor, but neither of us had attempted anything on this scale,” shares Dr. White.
We asked this doctor duo about going from 0 to 25,000 vaccinations in just a few weeks, combating vaccine hesitancy, being a working mom (in a high risk job) through a pandemic, their summer camp and vaccination plans for their own kids, and more.
Can you please share more about the logistics of this undertaking?
Dr. White: The vaccine arrived on a Tuesday and we carefully followed the manufacturer’s checklist. Every shipment of Pfizer vaccine arrives with a temperature monitor and when you open the box, you press and hold a button for 3 seconds that transmits a signal back to the company to let them know the vaccine is being unpacked. The sensor is then supposed to turn green. Ours went black. We frantically called Pfizer who transferred us 5 times and after 45 minutes we got the information that there had been a temperature excursion and that we should unpack the vaccine into the freezer and await instructions. Several hours later an email came stating that the vaccine had been too cold for a brief period of time. They informed us not to use the vaccine yet and more instructions would be given in 48 hours. We called the entire team to delay the start of vaccine clinic and planned for a 48 hour hold. Four hours after that we received an updated email stating the vaccine was safe to use. We hurriedly called the team to say we were back on.
On our first day of vaccinations we tested our work flow and administered 60 vaccines. We identified bottle necks, confusing signs and missing supplies. Members of operations, technical support and facilities all chipped in to suggest better throughput and more efficient processes. The following day we ramped up to 300 vaccines and by Friday we had administered the full 1170 doses with no wastage.
Over the following weeks we became increasingly efficient and maxed our daily doses to 1400 with almost no wait times. Faculty and staff from all over WesternU contributed and students volunteered to do health screenings, administer vaccines and monitor patients for side effects. Physicians, pharmacists, nurses, dentists, optometrists, physician assistants, physical therapists and even the veterinarians came to volunteer in medical and nonmedical roles. On any given day over 10 different languages were spoken, people from all different backgrounds, identities and abilities and talents collaborated to protect the community. To date we have administered over 25,000 injections.
What did it feel like to be part of keeping so many people and their families healthy?
Dr. White: The vaccine clinic was very healing for me. It was a lonely, frightening year. Even working face to face in clinic often felt isolating with the mask, face shield, glove and gowns. Team members had to eat alone in private rooms or personal cars and we didn’t get the reassuring hugs that help on hard days. All our potlucks and baby showers and community building stopped. It felt like a war zone some days.
When we started the vaccine clinic suddenly I was connected to so many people. Co-workers who had been home alone for months finally got to be in a room together. We were all vaccinated within the first month or two so the fear of infecting each other quickly dissolved. We could eat a meal and laugh and get a hug. We formed closer friendships and the sense of community returned.
The patient care experience was deeply moving. Patients would often sob in relief as the vaccine went in. I watched a teacher weep for the full 15 minute observation period after we vaccinated her. She thanked us over and over again and most of us cried with her. Vaccinating my own patients was very personal. As each one walked out the door I would take a deep breath and whisper to myself “okay, she’s safe.” I could feel the weight lifting every time another person walked out with this protection. So many people were lost. We were (are) all living with grief and trauma and finally there was a path forward.
Dr. Kotha: Providing these vaccinations was a truly humbling experience. Dr. White and I’ve have had so many people come up to us and tell us how much they appreciated us providing the vaccines at WesternU in Pomona. It’s a great feeling, keeps me going, and makes me want to do more.
What are the biggest barriers to getting enough people vaccinated for herd immunity?
Dr. White: Early on the barrier was primarily access. California, and most the US, has solved that issue. Vaccines are readily available in millions of locations with weekend and evening hours. Now we are facing vaccine hesitancy. Social media has spread false information about the vaccines and vaccines in general have become politicized. As a scientific community we are trained to be extremely precise in our language. We try to never overstate the facts or speak in absolutes. However when non-scientists are reading about the vaccines they see very persuasive language used by the anti-vaccine movement. Conspiracy theory and anti-vax language is often clear and even relatable. The marketing and graphics are more enticing than the often sterile, formal communications from the CDC or vaccine advocacy groups. There were many hard lessons in this public health effort. The medical profession has to adapt to the needs of the people we serve. Our insistence on cautious communication was interpreted as a lack of confidence in vaccines which led to reduced vaccination rates.
On a personal note, how has this school year been for you as moms?
Dr. White: My son, Lucas, really struggled with online kindergarten. My husband, Peter, worked with him as much as he could but was also trying to run his business and take care of our home while I worked long hours out of the house. Thankfully in the spring Lucas was able to attend in-person kindergarten for several months and loved every second of it. We are most focused on his social-emotional wellbeing and tried not to fret about academics at such a young age. Parker, our 2-year-old daughter, was home until February when she started an outdoor nature preschool. She has returned home filthy dirty and deliriously happy day every day since starting. We have a nanny from 8am-6pm to help, so Peter could get a little work done between meal prep, diaper changes, kindergarten classes and dog walking. The balance was really hard on everyone. Peter remained incredibly supportive of me and never once expressed resentment about being the primary caregiver for the kids all year. He cheered me on and gave me the strength to do battle each day. I watched a lot of marriages fall apart this year and I feel grateful for my partner.
Dr. Kotha: I believe the last school year was very different for them. I had to get used to it myself. My 9- and 11-year-old (then 8 and 10y) are great kids, they understood that mom and dad (also a pharmacist) must be at work and adapted to the situation. They were in distance-learning mode, and it takes a toll on children of that age to stay indoors, look at a computer to learn and not have any physical exercise or social interactions.
What strategies did you use as a working mom (and doctor) during the pandemic to keep all your balls in the air?
Dr. White: Peter and I first worked to simplify our schedules, commitments and expectations as much as possible. We cancelled basically everything. No one wanted to POD with us since I was such a high COVID risk, which meant we had to get creative in entertaining the kids and keeping them safe. Lucas and I created a “Wild Card Sunday” jar and every week he got to pick a theme. We did reptile day, alien day, fancy day, Japan day, pretend Christmas, and dozens of others. It forced me to think about the kids and make a plan during the week and I was more present on Sundays when I was home from work.
The reality is that the balls did not stay in the air. Plenty fell. But I kept my team safe at work through luck and grit and kept my family connected through small gestures and more engaged time. I did build in some time for exercise, sobbing in the car, luxurious scalding hot showers and way more homecooked meals.
Dr. Kotha: I must say, I am blessed; my husband and I were on the same page and he was supportive. During the pandemic, grades were all over the place, we needed to consistently help with course work. The only strategy is we had a timetable and followed through on it.
Dr. White: Many people thanked me for my work and taking on personal risk, but I don’t think they saw how terrified I was for my own husband and kids. Choosing to uphold my oath to medicine meant betraying many promises to my family. Working long hours, taking a pay cut, eating alone in an exam room were all hard. Coming home and stripping down naked in the yard, tip toeing to a shower and scrubbing myself before I let my kids near me – that was really traumatic. At first Parker would cry and then she just got used to it which felt worse. She knew I was dangerous when I got home. I think I’ll be unpacking those months for the rest of my life.
Dr. Kotha: We are not work-from-home. I’ve had friends say, “I am so tired of staying home, aren’t you”? I am like, I’ve been going to work this whole time. My 8-year-old would say, “why can’t you work from home like my friend’s parents?” Having no babysitter and working opposite shift than my husband’s had taken a mental toll on all of us. Not to mentions, screaming into the house ‘No-hugs till I shower’, separated laundry running a few times a day, every day. Lol those were real things we need.
Dr. White: Vaccinations are one of the most important inventions in human history. They have saved millions of lives. The COVID-19 vaccines are safe, very effective and have very few side effects. There will always be risks with vaccines and new risks tend to be much scarier than known risks. We are in far more danger getting in to a car, drinking alcohol, eating junk food, swimming in the ocean, climbing a ladder, but those risks are familiar and we accept them. Choosing to get a COVID vaccine when you are experiencing fear of the unknown takes tremendous courage. We all have courage within us. Each time someone works through their fear we are all safer. There is one less patient that pulls me from my kids and one more person who can help the community recover.
Dr. White: Lucas and Parker are both going to outdoor day camp for most of the summer. The COVID rates are low here now and the benefit of outdoor playtime with peers feels much greater than the risk of getting COVID. I am very hopeful we will be able to vaccinate young children in the fall. I intend to vaccinate both my kids as soon as the emergency use authorization extends to their age groups.
Anything else you’d like to share?
Dr. Kotha: As a person, I need to remind myself that I have a responsibility towards myself along with other responsibilities. Most moms tend to forget this. I believe it is very important to remember, you can’t pour from an empty cup. Always take care of yourself to stay full of love, empathy, and compassion. Take care Moms!!