Journal of Pharmacy Management - Jan 2022

Journal of Pharmacy Management • Volume 38 • Issue 1 • January 2022 AFTERWORD Heraclitus once famously said, “The only constant in life Is change“, my, has that been the case during 2020-21. From the changes to Covid 19 vaccination dose intervals, through to the updates and changes from the JCVI to reflect the emerging evidence. Meanwhile, the ‘day’ job of patient consultations, medicines management, medicines reviews, drug safety reviews and so on continues unabated. Just as 2020 was coming to a close and the practice was in the middle of winter pressures, I was called to a meeting with the Practice Director and the PCN Business Manager. “We’re going to turn the unused side of the branch surgery into a Covid Vaccination centre, we need you take ownership of the vaccines and reconstitution… - the pharmacy bit …..” We eagerly awaited our first delivery of the defrosted Pfizer vaccine ‘pizza box’. Despite our enthusiasm, [wide eyed child on Christmas day looks] as the first delivery of vaccine and consumables arrived, the delivery driver was very nonchalant andmatter of fact. To him this was just another vaccine centre with another delivery: this was a momentous day for me, the Practice and the PCN, but he couldn’t understand what all the fuss was about. As per the SOP and recommendations, the pizza box was dutifully transferred to the vaccine fridge to ensure cold chain continuity. Later that morning, with anticipation I opened the outer carton – 195 purple lidded Pfizer vials all huddled together like penguins on an Antarctic ice floe sheltering from the cold. With special care I removed 10 vials from the box to allow them to come up to room temperature, only to find that the space this generated led to the rest of the ‘penguins’ toppling over…… Anxious that the lipid coating on the vaccine would be damaged I carefully righted them and returned the pizza box to the cold chain. Later that day talking with a nurse colleague, it became apparent the simple way to avoid this toppling of the vials was to ‘decant’ or count off 20 vials (the equivalent of 100 then 120 doses) into a disposable kidney bowl. In this way doses could be removed safely and effectively from the fridge without disturbing the main flock. The initial take up for the early cohorts of patients 2 and 3 (elderly and clinically vulnerable) was amazing. It was mid-winter, cold, icy and with a bitter wind blowing across North Northampton but still they came along. Talking to the 80+ years old was such a privilege, stoic, hardy, determined, but so grateful for the opportunity to receive their vaccination. Many of them felt this was their civic duty and had to be done for the sake of the country. I remember clearly vaccinating one lovely couple whose combined age was 204 years ! Charming, friendly and enthusiastic they had their Pfizer vaccinations and left waving. During January 2021 the Pfizer dose interval was increased from 3 weeks to 8 weeks as per the JCVI Penguins and Passports – a year in the life of a PCN Clinical Pharmacist Chris Grahame, Senior Clinical Pharmacist 43