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Four months at vaccination locations

What my weekends look like since early 2020

All pictures in this post were taken before the locations were open and without any people in them. Please refrain from taking pictures yourself, except at the designated selfie wall

Since May 2020 I’ve been helping in the weekends at various locations fighting the pandemic. First for “Ready to help”, a citizen branch of the red cross. For several weeks we helped at hospitals doing entry checks and measuring temperatures. In a plastic yellow gown, protective glasses and gloves the days were hot and tough. We had to tell parents they couldn’t both accompany their child that was ill. We also saw several people with very serious breathing problems enter.

The first wave was soon over, but after the summer the virus grabbed around itself again. A test location was set up at the Netherlands’ main airport, Amsterdam Schiphol. Another call was sent around by “Ready to help” for people to assist. People that arrived in the gate (where they were usually awaited by their loved ones) were guided and persuaded by us to get themselves tested, as it was not required by law. More than half the people that arrived didn’t get tested, but that was not the reason the test location soon closed. As I had to get up at 04:00 to get to the airport on time (By car and then by train) I was about to get to bed on september 11th, when I got a call at 20:00 that we wouldn’t have to come to the test location as it was not opening again due to lack of testing capacity. Asymptomatic testing would now only be available for people working in healthcare and education. A day later an article about the test location would also be published by Jeroen van Bergeijk, a friendly guy that I also worked with but didn’t know was a reporter. It showed that he was asked to process people’s private information, without him signing any document agreeing on secrecy or any limit on the information he could see.

Early december 2020, a request for help with Contact Tracing was issued. I already got a John Hopkins contact tracing course because I was interested in the how and why, but now I could really help! After following three full online training days in late december, signing a lot of documents and waiting for the government to give a statement of conduct I was finally ready to assist in the first week of january 2021. But when our shift started, we were asked to call general practitioners informing them one of their patients got COVID-19, one patient at a time. The normal daily email functionality in the system was broken, so for every patient a call was made by one of us resulting in angry assistants because they were flooded with calls. After my first day I quit, as I wasn’t going to do the job of a computer.

As the vaccination efforts were also starting and capacity going up, it was obvious that more help was needed. In the middle of february a request for people with first aid certificates was sent out, even offering new first aid courses to be given. After an onboarding, a lot of signed documents again, 14 hours of e-learning and a physical training day I was a certified first aider again, and ready to assist at the vaccination locations.

At the beginning of april I worked my first shifts. As there were still not a lot of vaccines available, the opening times of locations were short, the days quiet. As first aiders we are walking through the waiting area, watching people for any possible allergic reaction or fainting due to stress or nervousness.

The groups that could get a vaccine back then were people older than 80 and people that worked in healthcare. As the older people were not very mobile, our day consisted a lot of helping people get up, walking them around in wheelchairs and especially getting coffee for them. The atmosphere was very laid back and calm, especially because we could only administer 200 doses per day (At a location that is now handling 10 times that amount) due to lack of vaccines. Except for some falls of walkers there were not a lot of incidents we had to take care of.

As the vaccination program was already a few months on its way when I joined, a process was already established that would eventially grow out into the current way the vaccination location works. When a person arrives at the front door, one or more hosts are checking they carry their id and a filled in health declaration. At the second stop another host checks their appointment and id and that health declaration. Based on if any questions (about medication, health status etc) are answered with “yes” - indicating a special case - they are sent to a doctor. If they are, the doctor will check if they need to wait half an hour instead of the 15 minutes after their vaccination if they have any known allergies, or need to apply extra pressure to the vaccination spot if they use blood thinners. Other edge cases are also checked here.

The queue and desks where appointments and identities are checked (Nieuwegein)

A host then points the person to a queue for the actual vaccination. When there are different types of vaccinations given at one location, the person will be assigned a line based on ‘their’ color vaccine they wil get - a sticker for which is given at one of the host stations. Green for J&J, orange for pfizer, blue for Astrazenica and pink for Moderna.

Cubicles where vaccinations are received (Nieuwegein)

In the meantime a vaccine will be prepared. A bottle is taken out of the cooling, and a dose is extracted. For every vaccine given at a location, there are several people doing this very precise job, sitting in a special room where the vaccines are safely guarded. Depending on their skill level and the type of vaccine a certain number of doses can be extracted per bottle, sometimes half a dose more by the skilled people (Since a couple of months it is now allowed in the netherlands to have one dose consist of vaccine from 2 different bottles).

A buffer of several vaccines are kept at the vaccination booths. When these vaccines run out, new doses are delivered by someone solely responsible for delivering these vaccines and making sure none disappear. New cotton balls, tape and band aids are also delivered to the booths, so that people that administer vaccinations never have to leave the buffer vaccines alone and none end up missing.

Exits to cubicles (Leiden)

When the person that administers the vaccines is ready, the persons’ information gets checked once again, and a confirmation paper is printed and given to the person administering the vaccine. The person gets the shot, and a band aid or cotton ball with tape. Depending on if the person uses any blood thinners, he is instructed to apply extra pressure. The confirmation is given, and the person is pointed the waiting area.

Waiting area (Amersfoort)

This is where we come in. Depending on the person having allergies or not, everyone has to wait 15 or 30 minutes here. Surely we can’t enforce people to wait here, but part of our task - first aiders - is to make sure people do stay. Several people from the red cross await everyone in the waiting area. Some places offer coffee and tea or ice cream, others only water. You are then guided to a seat by either someone from the redd cross or a host from the GGD.

The chance something happens is very small, but with millions of people going through the system stuff is bound to happen. The thing we are most alert on is an anaphylactic shock, specifically someone who might be unable to breathe. For the tens of thousands of people that passed our waiting area, I luckily haven’t seen this happen. We are prepared to treat this however in cooperation with an onsite medical professional. Epi pens are available, along with a variety of other medicine. There is even one or more AEDs available should a resuscitation have to take place, which is highly unlikely. The cases of allergic reactions we encountered were very rare, and all very light symptoms. 1 person presented visible rashes, 2 experienced itching skin and about 10 people experienced the feeling of light swelling without that being visible. We stay with them once they mention or we see any symptoms of an allergic reaction occur and stay with them until they subside as a preventive measure.

Inside a red cross post (Leiden)

The small chances for anaphylaxis doesn’t mean that people from the red cross don’t have anything to do though. At the start of the campaign there were a lot of elderly that needed to be pushed in wheelchairs or helped around with their walker. With the people getting younger, a new group came to the vaccination location: people with a fear of needles. With every more recent birth year being allowed to make an appointment, a higher percentage of people had some level of stress before or after getting their vaccine. People prone to fainting could get vaccinated while lying down as a preventive measure, but often people became pale and sweaty in the waiting area. The summer heat also made people more prone to dizziness, where better ventilated and colder locations were usually more quiet. Depending on how people looked, we usually sat down with them to distract them with talking, or walked with them (sometimes in a wheelchair) to the first aid post for them to lie down on a bed there. In only a couple of cases we let the person lie down in the waiting area for a couple of minutes because we couldn’t get them on a bed in time. For every thousand people getting the vaccine, dizziness occured with 1 to 5 of them depending on the weather and the general atmosphere of the location. Most if not all of these cases could be attributed to people either being afraid, stressed, affected by the heat or not having breakfast. (The last one happening surprisingly often with men in the age group of 30 - 45)

Then there were some cases not related to the vaccine itself. A huge amount of people coming every day also means that a lot of people with underlying conditions come to the locations. Some people postponed going to the doctor because of the risk of covid, so it was very nice that we had medical professionals on site we could contact with questions or concerns. Some people were referred to a doctor which they really needed to see after a year of not going to them. In one instance an ambulance was called for a checkup which luckily turned out not to be needed. For some people the vaccination location was also the first safe place to mention domestic abuse.

With the vaccination campaign now coming to an end, I will only work two remaining shifts after my holiday. The campaign continues with specific areas being targeted with busses and smaller local setups. The people that get vaccinated there can be monitered by the doctors there, so we will not be needed anymore. I am glad that I could be a part of it though!

All pictures in this post were taken before the locations were open and without any people in them. Please refrain from taking pictures yourself, except at the designated selfie wall

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