Injecting vaccines in the Harbor Area
By Hunter Chase, Community News Reporter
Most people have spent the pandemic trying to avoid people infected with COVID-19, which has killed more than 532,000 in the United States alone. The 60 people on the staff of the Harbor Community Health Centers have done the opposite — they have been treating people with COVID-19, and as a result, 10 of them have been infected at different times.
Now, they are no longer putting themselves in as much risk. They have been vaccinated with the Moderna vaccine, which is 94.1% effective. They have just begun vaccinating other people.
“We’re going to essentially follow the tier groups,” said Jennifer Chen, a nurse practitioner and director of clinical operations at the Harbor Community Health Centers in San Pedro.
While the centers have three locations, only the location at 6th Street offers vaccinations.
“We have this outdoor area that we’re setting up, because [patients] have to be monitored for 15 to 30 minutes post-vaccination,” Chen said. “So you want to make sure we have enough social distancing room to accommodate that.”
Vaccinations for patients 65 and older began on March 3, and will move to the next tier as each group is completed.
The centers requested 300 doses of the Moderna vaccine, but will only receive 100, said Tamra King, CEO of the centers. The centers now receive 100 doses every week.
Prior to receiving the vaccine, the 60 staffers at the centers were just as susceptible to infection as the rest of the public. Because of the cases of infection among the staff, further preventive measures were put in place.
“We did weekly testing for all staff until we had … no negatives for a few weeks,” Chen said. “Any employee essentially who says they don’t feel well, have a fever or anything like that, we test them right away.”
King said the staff has had no COVID-19 cases for six or seven weeks.
“It’s definitely calming down amongst the staff,” King said.
When administered, the vaccine feels like a standard flu shot; it only stings a bit, Chen said. Most people don’t feel any immediate effects, but later that day or evening some people have reported sore arms, fevers, chills or fatigue, and some get headaches or nausea.
Not everyone that gets the vaccine has side effects, but among those who do, those side effects tend to be stronger after the second dose. If a person experiences a strong allergic reaction to the first dose, said person should not get the second dose. This has already happened to one of the people that received the vaccine at the centers.
Unfortunately, there are few treatments for COVID-19 that are scientifically proven. One uses monoclonal antibodies, which can act as substitute antibodies to restore, enhance or mimic the immune system’s attack on cells’ infusion centers. Chen has been in communication with the county of Los Angeles about how to refer patients to infusion centers for these antibodies.
“Other than that, we do very symptomatic treatment,” Chen said. “We treat the cough and cold with over-the-counters; if they need inhalers, we’ll give those.”
The staff monitor infected patients, especially if their oxygen saturation is fluctuating. If necessary, they administer supplemental oxygen.
“We don’t have good, solid therapies for … the moderate to more severe disease,” Chen said.
Patients who need treatment for severe symptoms are referred to a hospital.
As vaccinations have become the focus of the fight against COVID-19, the role of testing is evolving. The centers have been doing “COVID clinics” in the afternoons for four days a week, where they offer testing and treatment.
“When we started, [the clinics were] filling up pretty quickly,” Chen said. “If we tested 10 people, maybe one to two would be positive. Recently, in the last couple weeks, we haven’t really had that much demand for testing anymore.”
King said they are only testing patients who have had prolonged, direct exposure to someone who was infected, or are showing symptoms of COVID-19.
“We’re not really doing like the big drive-through testings, [we’re not] doing the general public,” King said. “We just don’t have enough supplies.”
Before they allow patients to enter the building, they ask screening questions, such as if they have had any symptoms or exposures. The staff also checks patients’ temperatures.
“We are able to handle most of our visits through telehealth, which really decreases the foot traffic coming through the clinic,” Chen said.
The staff at the centers have a better handle on COVID-19 than they have previously — but this is mainly because cases have been going down.
“If cases were to pick up again, we would be in a very similar situation because there’s no good outpatient treatment necessarily besides the monoclonal antibodies, and we haven’t really developed a very streamlined workflow of getting people into infusion centers to get those if they were to need it,” Chen said. “Treating the symptoms, that’s pretty much all we have.”
During a recent spike in cases, emergency rooms were full and ambulances were not taking anyone except the more severe cases. If there is another spike, the same challenges could return.
The centers have also struggled at times with their supply of personal protective equipment, or PPE.
“We did have kind of a glove scare last month where we were running extremely low on gloves,” Chen said.
The staff has had instances of running low on masks and face shields as well but were eventually able to replenish their supplies. They also had a shortage of needles when the vaccines first rolled out, but this is no longer an issue.
Most people that visit the centers are there for reasons unrelated to COVID-19. They still get patients for physicals and check-ups, as well as routine follow-ups for diabetes, hypertension, asthma and abdominal pain.
The Harbor Community Health Centers are currently the only clinics in San Pedro where you can get a vaccination. Other locations can be found here: https://tinyurl.com/vaccination-locations/myturn.ca.gov.