Shane Anderson, pharmacy clinical manager at St. Vincent Healthcare in Billings, prepares to open a box of Pfizer vaccines on Monday, Dec. 14, 2020. Credit: Courtesy of St. Vincent Healthcare

HELENA — At St. Peter’s Health in Helena, many doctors and medical staff spent the beginning of this week eagerly preparing for a pivotal moment. On Wednesday and Thursday, the hospital said, frontline employees will begin receiving the first of two doses of a COVID-19 vaccine developed by Pfizer and BioNTech, marking what many health experts consider a seismic step in the fight against the coronavirus afflicting Montana and the country.

The past several months of vaccine development have been “just historic in terms of the rapidity and the completeness of the vaccine trials,” said Dr. Anne Anglim, a member of the hospital’s COVID-19 Incident Response Team and one of the first medical providers at St. Peter’s scheduled to receive the vaccine Wednesday.

State officials tapped St. Peter’s and nine other Montana hospitals to receive one box each of the Pfizer vaccine, each containing 975 doses, to be administered to high-risk employees. St. Vincent Healthcare in Billings was the first to receive its allocation, on Monday, and began distributing inoculations to priority employees on Tuesday afternoon. 

“We’re expecting that this week we can get completely through our tier 1 group, which are people that are taking care of COVID patients in some fashion or form, and well into our tier 2 group,” said Dr. Michael Bush, chief medical officer at St. Vincent. “It’s basically just ranking risk and trying to get the vaccine to people.”

Distribution of the Pfizer vaccine comes with a slew of logistical hurdles. All participants must receive a second shot three weeks after the initial dose. The vials must be stored at an ultra-cold temperature until they are ready to be used. Once thawed in a refrigerator, the vaccine remains viable for up to five days, requiring careful strategizing by hospital administrators to ensure no doses go to waste. St. Vincent has a large enough staff that it plans to use all of its 975 doses within five days, Bush said. St. Peter’s, alternatively, plans to thaw smaller portions of the vaccine to administer to employees on a staggered schedule. 

A box of Pfizer vaccines delivered to St. Vincent Healthcare in Billings on Monday, Dec. 14, 2020. Courtesy of St. Vincent Healthcare.

“Obviously if we could kind of get it done all in a day or two, that would be ideal,” said  Tom Richardson, clinical pharmacy manager and another member of the COVID-19 response team at St. Peter’s. “I think logistically, we kind of settled on, you know, we need to have a few options to be able to give employees flexibility.”

The Food and Drug Administration greenlit the Pfizer vaccine on Friday for emergency use as the number of positive cases and COVID-19 deaths continue to rise nationwide. After testing the vaccine in a late-stage clinical trial involving more than 43,000 people, Pfizer found the product to have an efficacy rate of 95%. The results were later evaluated and validated by the FDA.

Despite the vaccine’s resounding success in trials, many health care workers have not yet signalled that they are ready and willing to receive the vaccine. An October survey of registered nurses found that only a third said they would voluntarily be vaccinated against COVID-19, with another 36% responding that they would not, and 31% saying they were unsure. Bush, as well as Anglim and Richardson, estimate that between 65% and 70% of their medical staffs are prepared to receive the vaccine, with the remaining 30% to 35% harboring reservations, based on the hospitals’ internal surveys. 

“I think before [the emergency use authorization] we kind of had a lot of theoretical questions,” Richardson said. “But now it’s out there, we know there’s ample amounts of evidence and data, and just about every major medical community has endorsed this vaccine based off of the totality of this evidence and science.” 

Over the past week, since more data about the Pfizer vaccine has become publicly available, Richardson said, he and other St. Peter’s staff members involved in the COVID-19 response have been trying to answer as many questions and concerns from hospital employees as possible. 

Medical providers at Bozeman Health Deaconess after receiving vaccinations on Monday, Dec. 14, 2020. From left to right: Dr. Eric Lowe, ED; Miranda Morin, RN; Ben Hinkle, RN; Traci Glushko, RN; Dr. Sullivan, pulmonologist; and Dr. David Crites, hospitalist. Courtesy of Bozeman Health.

State and local health officials, as well as Montana’s congressional delegation, are aware of the critical role of public messaging as access to vaccines becomes more widely available. The Department of Public Health and Human Services has created a web page with updated information about the distribution plan and answers to frequently asked questions about the vaccines. Democratic Gov. Steve Bullock and Republican Gov.-elect Greg Gianforte both praised the state’s initial rollout of vaccinations, as well as the health care workers who will receive them. Senators Steve Daines and Jon Tester have also celebrated the distribution, issuing statements of support for hospital employees and encouraging Montanans to participate in the vaccination effort when more doses become available.  

“I look forward to that day when we can just hug and shake hands, and we’re getting there,” Bullock said at a press conference Tuesday at St. Vincent. “Today really does mark that first step toward getting back to normalcy that we need in our communities, our state and our country.”

Montana expects to receive additional shipments of the Pfizer vaccine in the coming weeks, in addition to doses of the vaccine developed by Moderna, which is getting an emergency use review by the FDA this week. State health officials have said that Moderna’s product, which doesn’t require ultra-cold storage and can be shipped in smaller amounts, is a more feasible option for vaccine distribution in rural areas.

Among the general public, roughly a quarter of Americans remain hesitant about receiving a COVID-19 vaccine, according to a new survey from the Kaiser Family Foundation. The poll found that skepticism is highest among Republicans, rural residents and Black adults, many of whom expressed reservations about the vaccine because of possible side effects and lack of trust in the government institutions responsible for ensuring the product’s safety and efficacy. 

Health care officials remain one of the most trusted sources of information about vaccines, according to survey respondents. Richardson said that puts an increased responsibility on hospital employees receiving the vaccine in Montana to field questions and address concerns from the general public.

“Hopefully the community can continue to educate themselves and trust the medical professionals who are reading and interpreting the science and telling people that it’s safe and effective,” he said. “And we can continue to provide that education and build that confidence in our community.”

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Mara writes about health and human services stories happening in local communities, the Montana statehouse and the court system. She also produces the Shared State podcast in collaboration with MTPR and YPR. Before joining Montana Free Press, Mara worked in podcast and radio production at Slate and WNYC. She was born and raised in Helena, MT and graduated from Seattle University in 2016.