Sarimer Margarita Sánchez, MD, MPH

2020-2021

Infectious Diseases Bureau Director, Boston Public Health Commission, Boston, MA

Sarimer Margarita Sánchez, MD is a Research Fellow at Massachusetts General Hospital. Dr. Sánchez recognizes the importance of public policy in the control of emerging infectious diseases, particularly among vulnerable communities. She aspires to implement policies that strengthen outbreak preparedness and response and effectively address social determinants in health to improve health care outcomes in minority populations. Dr. Sánchez received her medical degree from the University of Puerto Rico School of Medicine in 2015. She completed an internal medicine residency at the University of Pennsylvania in 2018 and a Fellowship in Infectious Diseases, with a focus on Infection Prevention, Hospital Epidemiology, and Antibiotic Stewardship, at Massachusetts General Hospital in 2020.

“Operationalizing a Pfizer BioNTech COVID-19 Vaccine Clinic for the City of Boston: Lessons Learned”

Objectives:

1.Develop a clinical staffing model, vaccine management protocols, and infection control guidelines for BPHC’s COVID-19 Pfizer-BioNTech vaccination clinic

2. Identify best practices and strategies to increase vaccination of Roxbury residents and racial and ethnic minorities in the City of Boston

Background:

Ensuring timely access to COVID-19 vaccinations and outreach for our most vulnerable communities is a priority for the Boston Public Health Commission (BPHC). In February 2021, BPHC established a Pfizer-BioNTech COVID-19 Vaccination Clinic in Roxbury, a predominantly Black and Latinx neighborhood, to improve vaccine access for Boston’s residents of color.  At the time, there was a paucity of clinical and operational models for public health departments to rapidly stand up a COVID-19 vaccine clinic with use of the Pfizer-BioNTech COVID-19 vaccine. There was also limited guidance on best practices to operationalize equity with vaccine clinic planning.  

Methods:

• A literature review of vaccine storage, transport, and administration safety guidelines, as well as Pfizer-BioNTech COVID-19 vaccine educational materials, was conducted to inform rapid development of our standard operating procedures. 
• The PrepMod digital platform served as the primary registration method for our vaccination site. We also leveraged community partnerships to facilitate vaccine access for Boston’s most vulnerable residents through use of dedicated appointment slots and creation of on-call “waiting lists” to be used in the event of extra vaccine. 
• Individual demographic and clinical information was collected and extracted from PrepMod to continually monitor outcomes and prepare this analysis.

Results:

• 4,186 individuals were vaccinated at our COVID-19 vaccination site from February 2-February 24. An average of 233 vaccines were administered during each clinic session. 
• A total of 2,287 doses were administered to Boston residents. Residents from adjacent Roxbury, Dorchester, and Jamaica Plain neighborhoods constituted 47% of vaccinated Boston residents at our clinic. Among vaccinated Boston residents, 31.9% were Black/African American and 14.9% were Latinx/Hispanic.

Future Directions:

• Our experience suggests that proximity to a COVID-19 vaccination site improves vaccine access for residents in nearby neighborhoods. Strategic planning with regards to the geographic distribution of vaccine sites across Boston neighborhoods, especially those that have been disproportionately affected by COVID-19, is critical to ensure equitable access.
• Clinical staffing models to deliver Pfizer-BioNTech COVID-19 vaccines should incorporate heterogeneity in number of doses per vial into their operational planning strategies.
• Use of community partnerships to assist with appointment enrollment and creation of “on-call lists” is an effective strategy to increase equitable vaccine access for Boston’s residents of color and minimize wastage of doses. 

Preceptor: Jennifer Lo, MD, Medical Director, Boston Public Health Commission