A Very Special Delivery:
COVID-19 vaccines come to Lebanon

by MainGate Staff
Fall 2021

It was in December that AUBMC first became aware of Lebanon’s intention to sign a deal to secure millions of COVID-19 vaccines, starting with the Pfizer-BioNTech product which would start arriving in February. Dr. Umayya Musharrafieh, interim chair of the Department of Family Medicine, urgently drew up names for a multidisciplinary task force. Occupational medicine specialists, administrators, nurses, pharmacists, IT experts, communication staff, and quality and infection control staff would begin planning to receive the vaccine while Musharrafieh would act as the point person for contact with the Ministry of Public Health (MOPH).

The task force had to set up a new workflow and devise a plan from scratch. “This vaccine is pretty complex in terms of handling and for its thermal requirements. It’s not just a refrigerated flu shot,” said Dr. Carine Sakr, employee health director and assistant professor of clinical specialty at the Faculty of Medicine. For this reason, formal training was administered by the Pfizer team in Lebanon and was attended by the multidisciplinary task force. Additionally, multiple mock sessions at the vaccination site were conducted to identify potential challenges.

The difficulties involved in running a nationwide vaccination program are well-documented. New Yorkers, for example, had difficulty securing vaccine appointments due to supply shortages and a poorly designed, decentralized scheduling system. Musharrafieh foresaw that Lebanon, with its well-documented infrastructure and organizational challenges, would also struggle. “I recall very well that in order to launch [the electronic healthcare records system] EPIC, we had to hire many people and receive lots of training, and even after implementation we still faced occasional glitches. So I expected that there would be issues,” she said.

AUBMC created a backup registration system on EPIC should the MOPH registration platform hit a snag—a wise decision as it turned out. “We setup an internal pre-vaccination form and vaccine registration, mostly taken from CDC, Pfizer, and MOPH. We did not reinvent the wheel.”

The first batch of the Pfizer-BioNTech vaccine arrived at the Beirut-Rafic Hariri International Airport in the twilight hours of Saturday, February 13, on a Middle East Airlines Airbus A321. The precious cargo was met on the tarmac by an array of officials filming the event on their phones. From
there it was transported to a MOPH warehouse attached to Rafic Hariri University Hospital (RHUH), where it was stored overnight. AUBMC would be one of three launch sites, along with RHUH and Saint George Hospital, to begin administering vaccinations on February 14, Valentine’s Day.

A few days before Valentine’s Day, the MOPH told AUBMC it would receive 180 doses for the pilot. Then word came that AUBMC would receive additional vials, and the immunization team sprang into action to register additional frontline healthcare workers. “Even within category 1, there is priority. These were people working in the COVID-19 units, in the Emergency Department,” Musharrafieh said. The actual number of doses that arrived was more than 500, necessitating a frantic last-minute push to ensure as many frontline staff as possible would benefit from the vaccine at this first opportunity.

On the morning of February 14, the shipment was delivered in sealed boxes stacked inside refrigerated trucks. Pharmacists unsealed, counted, and checked each vial against its batch number while ensuring temperature logs were verified. At the vaccination site, the pharmacy team handled vaccine preparation, then distributed the trays of vaccines ready to be administered to the nurses staffing the 10 stations inside the vaccination room. Smiling eyes shone through masked faces in the vaccination line, which wrapped around the glass facade of the Halim and Aida Daniel Academic and Clinical Center. “It was an extremely positive vibe,” noted Sakr. Nurses and doctors struggling on the frontlines against COVID-19 were eager finally to have some protection in addition to PPE [Personal Protective Equipment].

The operation went very smoothly and AUBMC vaccinated 536 of its frontliners that Sunday. A small number of doses, about 20, that had been prepared and would have gone to waste otherwise were administered to members of staff in category 2 who had registered on the MOPH, including protection officers. Attempts to turn this into a “scandal” about vaccine prioritization were quickly dismissed; AUBMC has acted with utmost transparency and compliance with the MOPH rules throughout the immunization campaign.

After 11 days, 6,765 people had been vaccinated at AUBMC. Many of these were people over 75 and were included as category 1 recipients; for them it was a rare respite from the compounding miseries of isolation and anxiety. One 90-year-old woman described her experience: “It’s been very good. People should register.

If one is going to die, let them die not from this virus, but with God’s will.” The vaccination campaign has ramped up in recent months. In addition to vaccinating Lebanese from all backgrounds, the “AUBe Vaccinated” campaign has—at time of printing—vaccinated over 97% of AUB faculty, staff, and students.

For instructions on how to get vaccinated at AUBMC, visit this link: www.aub.edu.lb/emergency/AVC/Pages/Logistics.aspx”