Medical workers in Puerto Rico sleeping outside to get vaccine

By Syra Ortiz-Blanes
Miami Herald/TNS

SAN JUAN, Puerto Rico - Juan Maldonado arrived at the stadium in Puerto Rico's capital where COVID-19 vaccines are being administered ready to wait all night.

Over the last week, he'd gone twice to the Coliseo Pedrín Zorrilla only to find endless lines. Eager to get vaccinated, the pediatric occupational therapist opted to sleep in his car with a colleague in order to ensure they'd be among the first in line.

Nearby, a group of fellow health care workers also staking out spots blasted music at a makeshift dance party. He struggled to sleep, anxious about not being awake on the open road.

"When the going gets tough, the tough get going," he said.

As Puerto Rico embarks on a massive vaccination campaign, getting access to the shot has become yet another source of anxiety for many health care workers on the frontlines of the pandemic.

Thousands of hospitals workers have already been vaccinated on site, but now the larger field of medical workers are vying for the vaccine and finding it not so easy to get. No vaccination appointment system has been set up for the over 130,000 medical workers included in the first phase of vaccinations.

Department of Health deputy secretary Dr. Iris Cardona said in a WKAQ 580 radio interview Monday that setting up an appointment system was "difficult" in a large-scale vaccination program. The first come, first serve approach is frustrating health care workers, many already skeptical from public officials' past record on emergency management.

"I'm not asking for a privilege," said Mayra Martínez, a child psychologist who went to the stadium three times trying to get the first of two shots. "The conditions in which health professionals are being subjected is not healthy for overall well-being."

Vaccinations against COVID-19 in Puerto Rico kicked off with hospital workers on Dec. 15. Cardona called the first week of vaccination "impeccable." Within 4 days, the majority of the over 30,000 vaccine doses that arrived in the first shipments had been administered, she told the Herald.

But when the first phase of inoculations expanded to include all the island's health care workers, logistics went haywire.

The Coliseo Pedrín Zorrilla opened its doors last Wednesday, and hundreds showed up on the first day to get their shots, causing chaos, confusion, and traffic jams in San Juan. Some health care workers have since chosen to violate the government's 9 p.m. curfew, lining up on a highway in the middle of the night.

The Miami Herald visited the stadium on Tuesday and spoke with almost a dozen health care workers about their experiences waiting to be vaccinated. Several said the process is getting quicker. Still, they'd decided to arrive by the late night or early morning hours to wait outside the facilities before they opened because of previous first-hand experiences or other people's stories.

"They say there is a plan, but where is the plan?" Martínez asked. "I am skeptical of what the government says. And after [Hurricane] Maria, even more. Since when do they know that the vaccines are coming? Why was there no plan?"

Members of the National Guard, in charge of vaccination distribution in Puerto Rico, said a reduction in people coming in and operational adjustments have improved the process. Adjutant General José Reyes, who oversees the planning in coordination with the federal and local government, has acknowledged the chaotic process.

"Not all emergency processes are going to have a perfect operation, there are areas for improvement, so we have to improve the vehicle traffic process to make sure we don't cause this line," Reyes told Nuevo Día on Dec. 23, the first day of operations.

COVID-19 confirmed cases, hospitalizations, and deaths in the U.S. territory reached record numbers in December, although they have declined in recent days following the enactment of a more stringent executive order to curb the coronavirus.

The arrival of the vaccine in mid-December was a moment of relief for the island's providers who have worked around the clock to treat the sick, become infected themselves, and lost colleagues and loved ones. At least 11 doctors and 12 nurses on the island have succumbed to COVID-19.

Maldonado, the pediatric therapist, went to the stadium with a colleague on the first day of vaccinations at around 5 a.m. and found endless lines of cars. At around midday, he said he found out through local press that there were no more coronavirus vaccines available.

"Rosa [the colleague] approached to ask [the National Guard]... but they informed her that they could not say anything because they did not have an official order," Maldonado, 51, said. "How is it possible that all the media outlets found out, and they didn't?"

As of Dec. 28, Cardona estimates that over 35,000 people have been vaccinated in Puerto Rico, according to interviews given to local media outlets. The deputy health secretary previously told the Herald in an interview she hoped the majority of the island's health care workers could be vaccinated by early-to-mid January.

Adjustments have been made, and expansions are coming, to the National Guard's vaccination program.

The National Guard is expected to open ten additional regional centers across the island in the coming weeks, including in the municipalities of Ponce, Mayagüez, Arecibo, and Humacao. Both of Puerto Rico's island municipalities, Vieques and Culebra, will also have vaccination operations set up in January.

They will join the Pedrín Zorrilla and over 100 health centers, including hospitals and primary care clinics, in the efforts to vaccinate health care workers.

The San Juan stadium facilities are also only vaccinating people from San Juan and surrounding cities and towns, and the National Guard vaccination centers will exclusively inoculate doctors and dentists on Saturdays.

The next vaccination center opens Wednesday in Caguas, a city located in the central mountainous region of the island.

An appointment system that can be accessed through an application will also be launched. El Nuevo Día reported on Monday that the methodology is slated to eventually be used across Puerto Rico.

Medical students from different universities on the island are now also helping with vaccination efforts at the Pedrín Zorrilla. This increases vaccination stations in the stadium from 16 to 26, and boosted daily vaccination capacity at the facility.

Martínez, the child psychologist, said she drove by the stadium Tuesday on the way to a doctor's appointment and saw its gates open. She and her husband, who is also a psychologist, were able to receive vaccines.

The process, she said, was "reasonable," and took only two hours. But she also described it as "sheer luck," and "coincidence" and she worries still that the logistics will be complicated in the future.

"The system is promoting chaos," the psychologist said.

Maldonado, for his part, finally entered the stadium after sleeping outside overnight this past weekend. He and his coworker were approximately the 152nd vehicle to enter the premises.

He said he was relieved to initiate the vaccination process because many of his young clients have fragile health. He's also the caretaker for his 93-year-old mother, who is a metastatic cancer patient.

"I say that the only side effect is a terrible drowsiness," he joked about his three attempts to get vaccinated.