Production of Comirnaty® vaccine doses by the pharmacy: how to organize?

L. Champmartin, S. Huet, E. Nevado, J. Couturas, B. Crosio, Y. Fromage, K. Itoua-Gassaye, JP. Lebon, E. Montanard, V. Perrier, M. Pradera, O. Dauriac, S. Lopez, H. Carpenet, V. Ratsimbazafy, A. Marie-Daragon, G. Maillan
Pharmacy, University Hospital Center Dupuytren, 2 avenue Martin Luther King, 87000 Limoges

In a context of increasing in the number of vaccinations, a mobilization of all health professionals on this activity is needed in addition to their daily missions. Technology sector (ST) of the hospital pharmacy has been assigned a new mission of Comirnaty® (Pfizer, BioNTech) vaccine doses centralized preparation for so-called fragile patients. The objective of this work is to describe the human resources (HR) organization to perform this new activity.

In practice, each production is ensured by a pair (manipulator and assistant manipulator). To meet these needs, all ST staff were trained in dose preparation: 7 pharmacists, 9 pharmacy residents and 12 pharmacy technicians.

Two production slots were selected from Monday to Friday: one outside of working hours (7:00 to 8:30 a.m.), resulting in overtime hours, and one during working hours (11:00 to 12:30 a.m.), leading to understaffing of the production units.
Each production run is planned according to the data entered on Doctolib®. The medical devices sector prepares one reconstitution kit per vial, containing the necessary materials (solvent, needles and syringes). The drug sector prepares the number of vials required for the two daily productions.
From January 20 to June 17, 2021, i.e. 104 working days, 120 slots out of 208 (58%) were effective (confirmed production), with 39% of slots at 7:00 a.m. (55% of production carried out by pharmacy technicians and 45% by pharmacists) and 61% at 11:00 a.m. (16% of production carried out by pharmacy technicians and 84% by pharmacists).
28 agents (45% pharmacists, 25% residents and 30% pharmacy technicians) were mobilized.
6214 vaccine doses were produced, with an average of 26 [6 - 66] doses per production, or 1035 reconstituted vials. The average production time was 74 ± 23 min [30 - 165]. This time includes the sterile dose preparation times and the auxiliary times (20 - 25 min): room preparation, prescription form traceability, labelling, release and dispensing in the department. The average preparation time was 3 ± 1 min per dose [1 - 7].

Staggered working hours implementation allowed us, with a constant number of staff, to participate in the collective effort to fight COVID-19 while having a moderate impact on the production units. The increase in the vaccinations number requested in April-May led us to opt for an HR reinforcement (pharmacy student) as an assistant manipulator. This organization now requires only one full time equivalent PT for 1.5 hours on working days. Staggered working hours, combined with HR reinforcement, allow us to maintain production activities while dealing with the vaccination increase following the eligibility of the entire population.

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