We vaccinated 1,200 people in 2 days in a rural area without wasting a single dose. Here's how we did it.

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We vaccinated 1,200 people in 2 days in a rural area without wasting a single dose. Here's how we did it.
Dr Eilir HughesDr Eilir Hughes
  • Dr Eilir Hughes and his colleagues vaccinated 1,200 people over a single weekend.
  • They didn't waste a single dose of the Pfizer jab as they inoculated people despite snowfall.
  • "I wanted to prove that it could be done better and it could be done faster."
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As a general practice (GP) doctor, I was keen and ready to deliver vaccines to my local community - the Llŷn Peninsula, a rural beauty spot in North Wales. So I was frustrated by all the noise I'd been hearing about Wales being slow off the mark when it came to vaccinations.

I wanted to prove that it could be done better and it could be done faster; to say "we're here and we can pull it off." When you live in a rural area, there's an expectation that the services offered will be secondary.

We wanted to challenge that and show that actually, even though we're in the far end of north west Wales, a very rural area, we could get our community, which is one of the most deprived areas in the country when it comes to household income, this new vaccine.

Read more: I'm a doctor in Singapore. Our COVID-19 cases have been low since last fall - here's what we're doing right.

And we did, banding together three practices to successfully deliver 1,200 vaccines over the weekend of January 23 and 24.

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It wasn't easy. First I petitioned the local health board and the Welsh Government to entrust doses of the Pfizer vaccine to us. The policy in Wales at that time was that the Pfizer vaccine would be sent to mass vaccination centres and the AstraZeneca vaccine, which is easier to administer and store, would be sent to GPs.

But the problem was that the supply of the latter had not been great, the number reaching us had been frustrating, and the nearest mass testing hub was a 50-minute drive away, which was not feasible for many of our residents.

There was, however, more Pfizer. There was understandably nervousness around sending it to GPs because it has to be stored at -70° C. As soon as it's taken out of the freezer, the clock starts and you've got five days to use it up. It comes in trays which look like small pizza boxes and in each box there's 195 vials. In each vial there's up to six doses.

We vaccinated 1,200 people in 2 days in a rural area without wasting a single dose. Here's how we did it.
Dr Eilir Hughes with doses of the Pfizer vaccineDr Eilir Hughes

By taking the tray out of the freezer, you're committed to using it all up. You have to then maintain a "cold chain" by keeping that box and the vaccine within a strict range of 2-8° C.

When you're handling the vial, you also have to be very, very delicate and make sure that it's not shaken. And you have to prepare the vial. You have to do that and gently prepare each individual vaccine, whereas with AstraZeneca it's all prepared.

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Nobody wanted to waste precious vaccines but I assured them that GPs and their teams were well capable of doing this and of my confidence that we could pull it off.

Read more: Japan says it has to throw away millions of Pfizer COVID-19 shots because it doesn't have enough syringes to extract them

This was on the Monday. We didn't get permission until Wednesday but I knew the administrative burden was going to be huge, so I had to take a gamble and set the wheels in motion.

On average, when you're calling somebody in for a vaccine, it takes roughly five minutes per person. We booked in 1,200 people, so it was a huge undertaking for the three practices.

We secured permission from Tŷ surgery's neighbors - we're based on a very small industrial estate shared by a coffee wholesaler and microbrewery - to use their space for the cars, as this was to form our temporary vaccine center.

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We needed even more space than we would've for the AstraZeneca vaccine, because this one requires a post-injection 15-minute stay in an observation area, in case of reactions.

We worked closely with local police and area sergeant Colin Jones, who ensured he had a team ready to support us and to create a smooth traffic system.

We vaccinated 1,200 people in 2 days in a rural area without wasting a single dose. Here's how we did it.
Dr Eilir Hughes
We were delivered 150 traffic cones by the council. Police co-ordinated parking based on mobility, so those who were fit parked a bit further away and those who needed assistance got to park up right by the surgery.

Having got to the site at 7.30 a.m. along with our team of approximately 50 people - some of whom were from the local football club, art gallery and supermarket - the day ran quickly and efficiently.

We're in an area that never gets snow, and on the very rare occasions we do it never sticks. But when I woke up on Sunday, it was white everywhere. It was just a horrible feeling in the pit of my stomach. But I thought "I can get very upset and stressed by it or crack on and hope for the best."

Read more: The coronavirus is going to stick around forever. Get ready for the new normal.

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The local council got out to grit the streets and lots of volunteers came out with their shovels to help clear the area, including myself. Incredibly, the vast majority of people still managed to come for their vaccine and, in the end, not one dose was wasted.

Since then, I've had messages from patients and their loved ones who're so thankful to us. It's been quite emotional. My hope is that next time, and we have been asked to do it again, we'll get the vaccine to even more people.

As told to Lauren Brown

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