COVID-19 vaccine for ASC staff: Where 18 centers stand, what they expect in 2021

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The COVID-19 vaccine has been available for front-line workers and clinicians in many states, but where ASC staff fall in prioritization depends on the state.

Most physicians began receiving the vaccine in mid-December, including specialists at ASCs. Jennifer Fowler, administrator of Pacific Surgery Center in Paulsboro, Wash., said physicians were vaccinated through their hospitals, and staff received the first dose on Dec. 23.

Steve Gunderson, DO, CASC, administrator and medical director of Rockford (Ill.) Ambulatory Surgery Center, said most staff physicians at his center began receiving the vaccine last week, and staff gained access Dec. 29. The center's staff members are receiving the vaccine in shifts, with about 10 being vaccinated at a time in coordination with the Winnebago County Health Department.

"The only challenge I anticipate is potential issues with the second injection in the series," said Dr. Gunderson. "Hopefully this will not present an issue, and everything will go smoothly."

Simone Mueller, administrator and director of nursing for Oak Park Surgery Center in Arroyo Grande, Calif., said all the center's medical staff have privileges at the local hospital and received the vaccine there. The county also made the vaccine available to nonclinical ASC staff on Dec. 28, although some staff members expressed fear of potential side effects and are resistant to receiving the vaccine.

Kelly Rhineberger, administrator of Bayfront Health – Florida Endoscopy & Surgery Center in Brooksville, said the vaccine is available to physicians and staff at the center's partnering hospital and had no challenges receiving the vaccine.

Linda Meikle, RN, BSN, administrator of Taylor Station Surgical Center in Columbus, Ohio, reported similar access for the ASC clinicians and team through its joint venture partner Mount Carmel Health System, part of Trinity Health. Access to the vaccine hasn't been a challenge and coordinating administration is Ms. Meikle's chief focus.

"Ensuring we have support during the workday so [staff] can go to the hospital vaccination clinic across the street [is our focus]," she said. "Coordination of how many colleagues get vaccinated on the same day in the same department is essential to mitigate any staffing shortages in case of side effects that require the colleagues to stay home."

With the hospital having more patients and other challenges related to COVID-19, Taylor Surgical Center's staff has been pitching in to help, Ms. Meikle said.

"We need to manage wisely and efficiently for our colleagues to ensure their safety and support of our health system at the same time so we can continue to serve the community," she said.

In Texas, the physicians and staff at Covenant High Plains Surgery Center in Lubbock received the vaccine through its partner, Covenant Health System. However, administrator Alfonso del Granado said convincing staff to receive the vaccination has been a challenge and about half of the staff received it voluntarily. He is also concerned about the potential side effects.

"I had one nurse with a sufficiently strong reaction that she had to stay home and several staff members are somewhat lethargic during our busiest week," he said. "Another challenge is that some who receive the vaccine may experience cold- or flu-like symptoms, and our current policies require that they quarantine and get tested for COVID-19. This is not purely academic; earlier this year during the initial flu vaccination cycle several people had these symptoms and had to be quarantined, myself among them, and as it turned out I was indeed COVID-positive so the policy proved worth it."

Danilo D'Aprile said the vaccine is available to his surgery center, Orthopaedic & Specialty Surgery Center in Danbury, Conn., and staff will likely begin receiving the vaccine around Jan. 4.

"The only challenges I anticipate are individuals getting to make appointments," he said. "Being that the vaccine is not distributed to the ASC for management purposes and purposes of proper storage requirements, individuals must self-schedule at an approved facility."

In New Jersey, Memorial Ambulatory Surgery Center administrator Catherine Retzbach said her team has had access to the vaccine through Virtual Health, its hospital partner, since Dec. 26. She said one team member reported a sore arm after the vaccine, but otherwise the process has been smooth.

"There was a lot of work done before and since to keep the process easy for people to obtain the vaccine," she said. "It helped to have Virtua Health as a hospital partner that was able to put a plan in place and have a large number of people willing to work and volunteer their time to move the vaccination process forward."

The team at Black Canyon Surgical Center in Montrose, Colo., also has access to the vaccine and began receiving it last week. Administrator Don Soderlind said all staff wanting immunization will likely be vaccinated in the next two weeks.

The timetable is less apparent for ASC staff in other states, where the rollout will depend on how quickly the most vulnerable will be vaccinated.

"I've been in weekly contact with our local health department. We have submitted an application with an estimated number of employees who want to receive the COVID-19 vaccine," said Taylor Cera, COO of Orthopaedic Surgery Center in Youngstown, Ohio. "After verifying our organization is eligible, they will work with us to schedule the location, time and method of registration for the vaccine."

Jacqueline Barrett, RN, administrator of Pomona, Calif.-based Casa Colina Surgery Center, said nonclinical staff members haven't been vaccinated since they aren't considered front-line workers. However, in recent days neighboring Casa Colina Hospital and Centers for HealthCare has offered to provide the vaccine to the center's staff.

Suzi Cunningham, administrator at Advanced Ambulatory Surgery Center in Redlands, Calif., has been told her centers are in phase 1a, tier 3 and will be notified by the county hospital when staff members are able to receive the vaccine. She has been in contact with the hospital daily to work on a plan for administration, she said.

"We have been given the portal information to possibly enroll to obtain the vaccine in bulk, but we would need to be able to take and dispense a minimum of 1,000 doses within a defined period of time and agree to be a testing site, which as an ASC, we don't have the resources to do," she said.

The staff of Illinois Sports Medicine & Orthopedic Center in Morton Grove also lack access to the vaccine as a standalone facility. Administrator Lawrence Parrish said the center and its affiliated orthopedic surgery practice submitted documents to the Illinois health department to eventually receive the vaccine at the ASC, but doesn't have a timetable set.

"We are fully prepared to administer and document the administration of COVID-19 vaccine to our staff," said Mr. Parrish. "However, we will be unable to utilize Pfizer's vaccine because of the ultra-cold storage requirement. We do have the capacity to store Moderna's vaccine."

Brian Bizub, CEO of Raleigh (N.C.) Orthopaedic, said his staff is part of the phase 1B vaccine rollout, and he expects to have access in the next five to 10 days. He is balancing future vaccinations with concerns about mandates that could come from the North Carolina health department as COVID-19 hospitalization rates increase.

"We believe that ASCs provide a safer environment for patients who need time-sensitive surgical procedures and that ASCs should remain able to provide services through the pandemic to the communities we serve," he said. "As the vaccine becomes available, the challenges foreseen are patients who have been vaccinated versus patients who have opted not to be vaccinated and how we will create policies and procedures to manage and protect staff and patients from being exposed."

In North Carolina, staff members of Fellowship Surgical Center in Mount Laurel expect to have access to the vaccine in the next week or two. Administrator Kathleen Ciminera said all clinical staff have been vaccinated, but some of the nonclinical staff are hesitant to receive the vaccine.

John Gray, administrator of Atlantic Surgery Center in Daytona Beach, Fla., said his staff doesn't have access to the vaccine yet, but it likely will in the next four weeks. About 30 percent of his staff requested to wait until results from the second round of the vaccine show no negative side effects before being vaccinated themselves, he said.

Tracy Hoeft-Hoffman, administrator of Heartland Surgery Center in Kearney, Neb., did not make the vaccine mandatory but is educating staff members regarding the vaccine so they can make an informed decision about whether to receive it. She has also been confronted with the challenge of staff members thinking they are in a higher tier than the state's vaccine distribution plan dictates.

"We are following our state's COVID-19 vaccine phase 1A allocation recommendations, which has us at tier 4 with the time frame yet to be announced," she said. "We are working with our joint venture partner to provide the COVID-19 vaccine to our employees. Our state is in tier 2now, so I anticipate we will be able to get them sometime in January. Our local public health department has also reached out to us to assure we have access for employees to receive the vaccine."

Becky Ziegler-Otis, administrator of Ambulatory Surgical Center of Stevens Point (Wis.) echoed Ms. Hoeft-Hoffman's sentiments. She said the vaccine is being provided through the county health department and will be available to the surgical center direct caregivers the week of Jan. 11 unless there are further delays. The center may stagger vaccine administration over several days to avoid understaffing due to side-effects or having staff get the vaccine on Friday to recover over the weekend.

"Another challenge could be not receiving the number of doses required for those that are interested in receiving the vaccine thus needing to prioritize the distribution," she said. "Fortunately we were able to collaborate with the county health department to obtain our needed doses and thus not needing to work through the obstacles related to storage and distribution."

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