An army of vaccinators

Benjamin Potee, SOM ’24, goes over the vaccine record with a recipient.

UMass Medical School Vaccine Corps delivers relief from pandemic

By Susan E.W. Spencer

A year after the COVID-19 pandemic shut down life as people knew it, rays of hope appeared on the horizon. Two mRNA vaccines against the SARS-CoV-2 virus, one made by Pfizer-BioNTech and the other by Cambridge-based Moderna, received U.S. Food and Drug Administration emergency use authorization in December 2020; a third vaccine, by Johnson & Johnson, was added in February 2021, with others in the pipeline.

But a daunting challenge remained: How would the vaccines make their way into the arms—and immune systems—of most Americans—enough to reach herd immunity—especially those in hard-to-reach communities?

In Worcester, UMass Medical School and its community partners were building the foundation of what would be envisioned as “an army of vaccinators,” with students and other volunteers fanning out to inoculate people who could not easily navigate getting a vaccine on their own.

At the Rock of Salvation Pentecostal Church on Main Street one morning in March, six School of Medicine student volunteers administered the Moderna vaccine, while Matilde Castiel, MD, associate professor of medicine and commissioner of health and human services for the City of Worcester, filled syringes with the day’s allotted 100 doses and oversaw the clinical team. Many of those showing up for their vaccine appointments were people of color, a community particularly burdened by severe COVID-19 disease, and were excited to take this first step toward immunity and reconnecting with their neighbors.

“There is no way we could pull this off without the Medical School volunteers,” said Worcester City Manager Edward M. Augustus, Jr., who stopped by.

UMass Medical School volunteers have played a key role with Dr. Castiel and regional public health groups to bring vaccines to where they are needed most, such as churches and community centers in hard-hit neighborhoods, the Worcester Senior Center, the YMCA, and senior and low-income housing complexes.

“I feel like we’ve been waiting a year and now I can finally help. It feels really good,” said Emily Farbman, SOM ’23, as she waited for her next vaccination patient at the church.

Alex Richard, SOM ’24, had already volunteered at several Worcester Senior Center vaccine clinics and the large-scale vaccination site set up in February at Worcester State University, a collaboration with Saint Vincent Hospital and Commonwealth Medicine, the health care consulting and operations division of UMass Medical School.

“I read Chancellor Collins’ and UMass President Meehan’s op-ed in the Boston Globe, calling for the Vaccine Corps, and said, ‘This sounds awesome,’” Richard said. “It’s such an opportunity for us to be here. It is really a sense of hope.”

A national purpose

“Health and public officials would be wise to mobilize a most precious and treasured resource—young people—to serve as the foundation for a well-trained, public service-oriented COVID-19 Vaccine Corps,” Chancellor Michel F. Collins and UMass President Marty Meehan wrote in the Globe editorial, which was published Jan. 1. “The nation must not delay in utilizing this sizable group of motivated Americans who are ready, willing and able to step up to assist with the unprecedented vaccine campaign that will help to usher in the end of this pandemic.”

Chancellor Collins said that the idea for a COVID-19 vaccine corps, based on service models of the Peace Corps, AmeriCorps and Teach for America, stemmed from conversations with students who were frustrated about being on the sidelines and not being able to help during the COVID-19 pandemic.

It was the same desire to serve that led UMass Medical School to be the first in the nation to graduate its fourth-year medical students two months early last year, so these new doctors could immediately join the front lines against COVID-19, according to Collins.

“We’d go wherever people needed help,” said Collins. “It’s time for a national purpose.”

Vaccinating the commonwealth

Collins described the Vaccine Corps as “a perfect model for interprofessional collaboration,” with involvement from all three UMass Medical School graduate schools as well as others in the community such as dentists and pharmacists. Vaccination programs developed locally started out as building blocks, but more work would be needed to scale the effort to reach across the state.

Administering the inoculation, colloquially called “giving the jab,” is the easy part, said Collins. The hard part would be setting up the structure for the Vaccine Corps, vetting volunteers, scheduling them at a growing number of sites and coordinating with delivery of vaccines.

Commonwealth Medicine, a division of UMass Medical School with more than 1,000 professionals experienced in supporting public agencies on a wide range of health care system and project management solutions, filled the need for technical expertise.

“We have the nimbleness to develop targeted solutions for complex public health problems,” said Lisa Colombo, DNP, MHA, RN, executive vice chancellor for Commonwealth Medicine.

The large-scale vaccination site at Worcester State University relied on thousands of volunteers to deliver vaccines to more than 50,000 people.

FAITH NINIVAGGI

Commonwealth Medicine launched the Vaccine Corps volunteer portal in February, and by May, Commonwealth Medicine had registered more than 7,000 volunteers from across the state. Volunteers included licensed clinicians and those who stepped up to support their efforts by registering patients, scheduling follow-up doses, greeting patients and other nonclinical duties.

In addition to students from UMass Medical School, Commonwealth Medicine collaborated with more than a dozen academic partners to enlist volunteers.

Multiple clinical partners requested volunteer support to deliver vaccines to their populations. Perhaps the most visible example was Commonwealth Medicine’s regional collaboration on the large-scale vaccination site with partners at Worcester State University and Saint Vincent Hospital, that administered as many as 2,300 vaccinations in a day. In addition, the Vaccine Corps has been deployed in dozens of clinics, including sites affiliated with the City of Worcester and the Worcester Housing Authority, homeless shelters, UMass Memorial Medical Center, colleges and universities, and in other regions such as East Boston Neighborhood Health Center, a clinic in Springfield and a statewide homebound vaccination project.

Approximately 83,000 vaccine doses had been given to nearly 50,000 recipients by Vaccine Corps volunteers by June at the Worcester State University site.

“This work is what UMass Medical School and Commonwealth Medicine are not only built for but, more importantly, are passionate about,” Dr. Colombo said. “Making an impact on public health is what energizes the volunteers. And the clear sense of relief and appreciation from people after receiving their vaccine has made an indelible impression on all who have participated in this effort.”

Supporting the Vaccine Corps’ equitable distribution of vaccine to vulnerable populations were philanthropic donations totaling $435,000. Contributions were led by a $200,000 gift from the Woburnbased Cummings Foundation that UMass Medical School was challenged to match. In response, the leadership and board of directors of the United Way of Central Massachusetts approved a six-figure donation. Contributions were also received from the Frias family/S&F Concrete, The Kraft Group, the Tsotsis family, the Melvin S. Cutler Charitable Foundation and the DuFour family.

Additionally, Wagner Automotive Group of Shrewsbury generously donated the lease of a van to assist Vaccine Corps volunteers in delivering vaccines to special populations in Massachusetts.

Driven by students

The Vaccine Corps grew out of the confluence of student-driven initiatives at UMass Medical School. One was a movement for medical students to serve vulnerable populations in Worcester; the other expanded a Graduate School of Nursing program that led to GSN students teaching medical students how to give injections.

“About five years ago, we trained a group of medical students to give intramuscular injections for the flu vaccination,” said Jill Terrien, PhD, ANP-BC, associate professor of nursing and associate dean of interprofessional and community partnerships in the GSN. “I teach a course in the fall semester where students are encouraged and required to get involved in the community and this seemed like a perfect fit.”

Dr. Terrien worked with the medical student representative to the Wellness Committee, Christopher Lee, SOM ’22, and 13 GSN students who are registered nurses in the Doctor of Nursing Practice program to update the earlier work as a PowerPoint module that SOM students would take online before receiving practical training from the nurses.

Nearly 500 medical students were trained over the winter and spring. In addition, health practitioners in the community who wanted to refresh their knowledge received training from GSN students, bringing numbers of ready volunteers to more than 700. GSN students and faculty then reached out to other medical schools in the state, training medical and dental students at Boston University in March.

Commonwealth Medicine staff asked GSN students to develop a condensed training module, focusing just on intramuscular injection in the arm, which could be widely shared with nursing, medical and dental schools.

“It’s been this kind of flowering from a small group of nursing students to this statewide effort,” said Lee. “And at each step, every entity gave what they could. It’s making a huge difference.”

Emily Everett, BSN, RN, a student in the GSN’s Doctor of Nursing Practice program, joined the injection training team because she wanted to explore clinical teaching and give back to the community. She was surprised by the overwhelming response from medical students wanting to be trained.

“It’s like this little seed was planted,” Everett said. “It means a lot that within the program, we have been able to make such a difference already. It’s snowballed into a bigger thing and hopefully, we’re going to help everyone in Massachusetts.”

Graduate School of Biomedical Sciences students such as Ekaterina Korobkina helped with inoculation training too, greeting and registering students and making sure they had proper protective equipment.

“I think it is important to give back to the community and this was my small contribution,” Korobkina said. “These students are out there now, vaccinating people and helping get the pandemic under control.”

The GSN-led training connected with teams of medical students who were already volunteering with free clinics and shelters in Worcester, offering help with telehealth programs, medication assistance and links to services.

Mina Botros, SOM ’24, copresident of the Worcester Free Care Collaborative, applied skills from his engineering background to administer student vaccinator volunteer assignments in the city’s vulnerable neighborhoods.

“At the start, a lot of it was just open Excel spreadsheets, people posting times so that we knew when students were supposed to be coming to the clinics,” Botros said. “A lot of it was serendipitous, building and evaluating as we went, until we got to the point where Commonwealth Medicine said to us, we’ve blazed a path and they can help pave it behind us. Their ability to handle all the nitty-gritty details has been instrumental.”

Mina Botros, SOM ’24, at a community vaccination clinic at the YWCA Central Massachusetts in Worcester.

FAITH NINIVAGGI

Alex Richard, SOM ’24, was on the team of student clinical volunteers working an April clinic at the YWCA Central Massachusetts.

Thomas Pomfret, PharmD, MPH, BCPS, clinical consultant pharmacist team lead, and Daniel Wenzel, MD’21, discuss the upcoming shift at theWorcester State University large-scale vaccination site.

Botros said he never anticipated, coming to medical school, the importance of playing a connecting administrative role between students, city health officials and statewide efforts, looking into what it takes to get several groups collaborating.

“What I truly like most about these efforts is working with patients in the community and working alongside my peers. I love to learn from those who have come before me— including leaders of the Medical School and its clinical partner—and interwoven both clinical duties and administrative ones so beautifully.”

The human response to the pandemic is also something Botros would like to study further as more information comes in. “We’re in the midst of a life-altering pandemic and out of it came this monumental showing of human ingenuity, collaboration and caring,” he said. “When catastrophe strikes again, how do we engage people? The experience of getting out there and doing something that is so much bigger than yourself is huge.”

Long-term outlook

Terrien agreed that responding to the pandemic would not be a short-term exercise, with continued need for vaccinations in younger populations and perhaps booster vaccinations as well. “But these are the building blocks we have now, and I hope we can keep reactivating whenever we need it,” she said.

Michael Hirsh, MD, professor of surgery and pediatrics and assistant vice provost for wellness and health promotion at UMMS, said, “This is an example of how we lead from the front.”

Reflecting on the one-year anniversary of the pandemic becoming a national emergency, Dr. Hirsh, who is also medical director of Worcester’s Division of Public Health, said, “We’ve exposed now, with this terrible year, all the health care disparities that students really care about. I think these students have opened a lot of eyes up that this is part of the problem. And I think things will be very different moving forward, about how we look at public health and how we look at the social determinants: Public health is everybody’s business.”

Collins said the Vaccine Corps has offered another benefit—a way for UMass campuses to unite and connect with thousands of residents interested in serving the commonwealth. He saw opportunity for sustained growth and meaningful impact as the Vaccine Corps develops relationships with more local boards of health and academic and health care institutions.

Collins said, “We dropped a little pebble into the pond, and now we can see the ripples.” ■