One day in late April, Howard Schapiro, MD, gathered with a group of about 50 nurses, vaccinators, pharmacists and support staff to pose for a group photo. He stood toward the back, cracking a wide smile behind his mask.

The photo was a tribute to the people who had worked to set up the COVID-19 vaccination clinic at the Champlain Valley Expo in Essex. Dr. Schapiro, UVM Health Network Chief Population and Quality officer, remembered all too well how overwhelming it had seemed when they first began setting up the clinic four months earlier.

Months before the Centers for Disease Control and Prevention (CDC) rolled out a system for patients to self-schedule appointments, before anyone even really understood how a mass vaccination system was going to work, the State of Vermont put out calls to health care organizations asking them to create high-capacity vaccination centers as fast as possible. The UVM Medical Center responded, administering the first COVID-19 vaccines in the state at a small clinic set up at the hospital.

Howard Shapiro, MD, Senior Vice President of population health at the University of Vermont Health Network, looks over spread sheets and other data surrounding his desk like a soldier might remember a battlefield. It was Dr. Shapiro’s job to oversee the daunting challenge of creating a massive vaccination program reach as many people as possible to turn the tide in the war against COVID-19.

But more was needed, and soon the most urgent and profound public health challenge of our lifetime fell onto Dr. Schapiro’s desk: How to vaccinate tens of thousands of people as quickly as possible.

“Today, sitting here, I think of that as a privilege,” he says, breaking into a wide smile. “But I didn’t think that on that day.”

Understanding what was at stake, he started building an army of allies, the vaccine their only weapon. He called in experts from UVM Medical Center’s pharmacy department and technology team, as well as the Network’s Critical Care Transport Team, who had experience setting up the UVM Health Network’s first mobile COVID-19 testing site. Next, the Expo, for help with the site and facilities; Green Mountain Messenger, for assistance shuttling of vaccines back and forth every day from UVM Medical Center to the Expo, following exacting temperature protocols. The lineup of partners was long, but time was short.

At times, there were significant hurdles, especially at the beginning. While the state had provided a list of first responders to contact – those in Tier 1A, eligible for the first vaccinations – the list was incomplete; fire departments, police departments, EMTs and other first responders in Chittenden County didn’t have complete contact information themselves. So, it was left to Dr. Schapiro’s team to track down thousands of people.

“We started making hundreds and hundreds of phone calls every day,” said Scott O’Neil, head of UVM Health Network’s Patient Service Access Center.

Dr. Schapiro tapped Todd Young, head of the UVM Health Network’s Telehealth program, to help things move faster. Young worked with people like senior project manager Roberta Mitchell, to come up with a patient self-schedule model ahead of the CDC’s rollout, allowing the number of vaccine doses administered to rise from a few dozen a day to hundreds.

By the end of January, the UVM Medical Center and the vaccine clinic at the Expo had administered more than 10,000 COVID-19 vaccine doses to frontline and community health workers.

From there, Dr. Schapiro, a former anesthesiologist, put together a team of what he calls “very good thinkers.” People like Nurse Manager Nicole Courtois, of UVM Medical Center’s process improvement department, who took over from Mike Conti from the Critical Care Transport team. Her mission: scale up operations as much as vaccine supply would allow.

By late May, about 120,000 COVID-19 vaccine doses had been administered by Network COVID-19 clinics throughout the region, at least 65,000 at the Expo alone.

“To a person, the team’s commitment, their willingness to give their time, to think outside the box . . . to do whatever it took to get it done, has been just amazing,” says Dr. Schapiro, who clearly enjoys talking about the whole experience… now. He credits his team for making the clinic what he refers to as “the happiest place on earth.”

“I remember a 92-year-old woman who said that she planned on celebrating her vaccination with a trip to Ray’s Seafood for fried clams,” Dr. Schapiro recalls fondly. Later he remembers a 102-year-old woman who bantered with him about whether she had driven herself to the clinic (she hadn’t; her daughter was with her).

“During my entire anesthesia career, I could probably say I contributed to saving a few lives,” says Dr. Schapiro. “Today I can say that I’ve been lucky to be part of a phenomenal team that has so far put more than 80,000 doses of a lifesaving vaccine in people’s arms.”

Many of the original crew who helped set up the site have since moved back to their normal full-time jobs, and new, equally dedicated people have taken their place working at the Expo. Stephyne Burke, Transplant Acute Care Coordinator at UVM Medical Center, took over site management from Nicole Courtois.

On that photo-op day in late April, both women happily joined Dr. Schapiro at the back of the crowd as the picture was snapped. The whole group was giddy. They knew they had saved many lives and given hope to thousands more.

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