Vaccine Rodeo: How OHSU and Port of Portland created a vast inoculation machine
It's as if the people who built Disneyland reimagined a M*A*S*H unit.
The choreographed craziness of an average day at the mass vaccination site at Portland International Airport is a staggering amalgam of nearly 500 volunteers per day on 22 square acres of the airport's Red Lot, taking in around 5,200 cars filled with people wanting to receive their first or second shot of the anti-coronavirus vaccine. It's 400 orange traffic cones and massive circus tents and the constant roar of incoming aircraft, not that far overhead. It's the military precision of professionals and volunteers — many of whom wear goofy hats or wave pompoms — and, as of last Friday, the Herculean effort has put more than 85,000 doses of vaccine into the arms of Oregonians anxious for a glimpse of the light at the end of the COVID-19 tunnel.
Welcome to the vaccine rodeo at PDX.
"There's no playbook for how to do this," said Connie Amos, one of the site leaders at the Red Lot and the senior director of post-acute care strategy at Oregon Health & Science University.
It was OHSU, the Portland of Portland — which manages PDX — and the Red Cross that dreamed up the mass vaccination site.
"We debrief every week," Amos said. "We walk the site every week. We change how we do things, every week. We're constantly learning."
"You have to be ready for anything," said Dana Director, another site leader and OHSU's vice president of research administration, holding a water bottle, a radio and a clipboard, and wincing as a United Airlines flight swooped low over her troops Friday, April 2. "Last Sunday, we had hail. We had this, just, unbelievable wind, and a mini-tornado. And then a coyote." Director paused, answered a call for help from her radio, jotted notes on her pad. "And we wondered if the coyote was eligible for the vaccine."
Cars roll into the PDX Red Lot and volunteers queue them up in long lines to get them through the first tent, where their paperwork is processed and when they find out when to come back for the second "jab," in the case of the Pfizer and Moderna vaccines. (The site has had, at times, both those vaccines, as well as the one-shot Johnson & Johnson vaccine.)
From that tent, more volunteers loop the cars around the periphery of the lot, then queue them up for three enormous tents, where the vaccines are administered. From there, drivers are directed to a long, standing line, where they wait 15 minutes to make sure there are no unanticipated side effects. (Another queue is for those waiting 30 minutes after their shots; those who have had reactions to vaccinations in the past, or who have underlying medical conditions that might raise alarms.)
OHSU has plenty of practice vaccinating people, and zero experience looping a thousand cars through a process somewhat akin to a college drumline's halftime show. But moving people and things from Point A to Point B? That's just about all that ports do.
Michael Huggins, senior manager of landside operations at Portland International Airport, walked the site on Friday, looking for wind-rips in the big tents, swapping out the propane heaters, looking for kinks or bottlenecks in the traffic flow. "If you're here and your car battery dies, we can jump it. If you run out of gas, we can put a gallon in," Huggins said, his eyes moving over the traffic flow, one of his guys creating space for the Elephants Delicatessen vans to get through with sandwiches for the volunteers. "This has been a good day; only two jump-starts."
The partnership between OHSU and the Port of Portland started when two longtime friends gathered to talk. Kristen Leonard, chief public affairs officer at the Port of Portland, and Abby Tibbs, OHSU vice president for public affairs and marketing, began the conversation. One group had vaccines, the other had a huge economy lot that, thanks to the pandemic, nobody was using. Why not work together?
"Their leadership and our leadership got together," Huggins said, "and 10 days later, we were doing this."
Leaders like Amos and Director are working with greeters, people who queue the cars into ferry lanes, registration personnel, pharmacists, nurses, vaccinators, clinical and nonclinical monitors and helpers from the Federal Emergency Management Agency.
They've had to account for the usual armamentarium of a medical crisis — think needles, gowns and masks — but also things like 10,000 handwarmers, 3,000 ponchos ("not enough," Amos added), 500 meals per days, and vast quantities of suntan lotion.
Their goal is to move 125 cars through the system every 15 minutes.
"It's like a great play," Amos said. "We have had every kind of weather there at the Red Lot. Last weekend, we had such rainbows! It's something I never knew I'd do in my lifetime. But I'm so proud of it."
Mike Deam and Andrew Albanese are two of the OHSU pharmacists coordinating the vaccine tent. They've got 20 medical techs, six pharmacists and about 16 other volunteers working every shift.
For the Pfizer product — that Friday's supply — the vaccine is moved from a super-cold refrigeration area at OHSU to a standard refrigerator each night. In the morning, the vaccine is shipped out to PDX and the pharmacy tent.
Workers at one table were diluting the vaccine with 1.8 milligrams of a saline solution. At another table, those fluids were loaded into syringes. There's a quality-control table, checking to make sure everything is done according to the rules.
"We learn. Every day," Albanese said. "We're constantly saying, 'You don't wanna do that again!' Or, 'Oh wow, we definitely wanna do that again!'"
Dana Director watches it all, shakes her head. "We're a health care institution. We're an education and research institution. This, all this? This isn't what we do," she said. "But nobody questioned it. We just said, 'We all got our vaccinations. Let's get out there and do this."
"This is history," Albanese said. "I keep telling my staff this: You're part of history. And as we do this, we're writing the playbook for the next disaster."
The loaded hypodermics go to the vaccination tents, wide enough for six rows of cars, deep enough to cover three cars per lane. Olimbija Navalta was one of the registered nurses volunteering to give the jabs that Friday. "When we first started, we weren't sure how to get all the cars through. Now, it's like a 10-minute wait!" she said. "Wow. This is so amazing. Everyone's happy. And so that makes me happy."
She and her cohorts had just given a prime dose — that is, the first dose — to Pamela Stone, a city of Portland employee who specializes in after-school and summer programs for kids around the city; she currently works at Mount Tabor.
"It was easy! It didn't hurt at all," she said, parked in the 30-minute waiting line, not the 15-minute line, because she has a slight allergy to bee stings. Outside her car, volunteer Ashley Epping made the slow trek up and down the queue, looking for patients in any sort of medical distress.
"A couple of folks today felt lightheaded (after their shot)," Epping said. "I just make sure they have water, juice, whatever. I'm just keeping an eye on them."
Stone said a lot of her fellow educators have gotten their shots. "A lot of teachers are in the hybrid classes (in-school teaching blended with video conference call teaching), and so they've mostly gotten theirs. This is great," she said.
Asked what she misses most about the pandemic year, Stone said, "I just want to see my family. You know?" She sighed and glanced up through her windshield as a jetliner loomed over the Red Lot. "I want to jump on an airplane and go somewhere warm."
By the numbers
As of Friday, April 2:
Staff on site that day: 541
Doses that day: 5,250
PDX doses to date: 85,000-plus
OHSU doses, all sites, to date: 360,000-plus
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