Dr. Kenneth Chatriad took a break from his work to wipe down the 12 smooth, light blue plastic chairs spaced out in a Curry Health Center hallway. Chatriad, the center’s pharmacy manager, walked through his newly constructed immunization center. Though it was hard to tell under his mask and face shield, he was probably smiling.
“It is an exciting day today, finally,” Chatriad said as he brought his attention back to new faces coming down the corridor. They were frontline healthcare workers, including Curry doctors and test takers at the University of Montana, and they quietly picked a socially-distanced seat near the pharmacy center corridor.
A table stacked with Gatorades and a candy bowl in the corner also held a vaccine fact sheet and health screening form on the table’s edge. Patients brightened up as they read through the two.
“What did I have for breakfast?” read Chris Peterson. “I had two almonds, a mandarin and an apple.”
“Oh, and a handful of gummy bears.”
Laughter echoed down the skinny hallway. It felt more like a living room than a vaccination station.
“We know each other well, in fact we all work together,” said Kimberly Stanek, an adjunct professor at UM. Stanek and the others in the hall were part of the UM Genomics core, and their current job involves handling COVID-19 samples for tests around Missoula.
The people there were some of the first members of UM to receive their COVID-19 vaccination at Curry Health Center. And, for Curry and UM, the vaccine could not have come sooner, after health officials faced months of constant operation readjusting to fight the coronavirus, which has already infected roughly 500 UM students, faculty and staff.
For the last 10 months, Curry medical staff dealt with the immense pressure of the pandemic—working to continue normal services and manage the pandemic’s damage at the same time. And now, though it will likely still be months until UM students have a chance at immunization, Wednesday marked a moment of hope for members of the University’s healthcare community: A vaccine, self-delivered by UM’s own clinic.
In December, the U.S. Food and Drug Administration approved two COVID-19 vaccines, from pharmaceutical companies Pfizer/BioNTech and Moderna. The vaccines are the first widespread version of an RNA sequenced vaccine, which delivers a blueprint of the coronavirus-spiked proteins and creates an immune response.
Tens of thousands of people participated nationwide in clinical trials for vaccine approvals. A group of 100 Montanans were involved in these trials, including Montana Sen. Steve Daines and his wife, Cindy.
Since the approval of the vaccines, the Montana Department of Health and Human Services sent 36,000 vaccines to hospitals, health departments and pharmacies like Curry by Jan. 7. The statewide department also expected to receive more than 41,000 more doses in the coming weeks.
Jeffery Adams, the director of the Curry Health center, said 100 doses reached campus on Dec. 5. The University stored the vaccine, from Moderna, in the center’s advanced freezer, though the doses did not need to be as cold as the Pfizer version.
Adams said it will be months before the student population will have general access to a vaccine, as Montana is still focusing on vaccinating its healthcare workers. However, he hoped individuals with underlying health conditions, whether students or staff, would be able to get a dose.
“We expect the health care workers here will be among that first batch that’s vaccinated,” Adams said. “UM will get a campus-wide vaccination plan, but right now, it’s in the planning stages. We’re meeting, we’re talking about how to do the logistics of it.”
The state of Montana is in phase 1A of a four-part implementation plan. The first section, health care workers and senior living residents, is expected to be completed by Feb. 26, according to a Jan. 5 information sheet from DPHHS.
Phase 1B includes all people age 70 or over, Native Americans and people of color with heightened virus risks, and people over 16 with high risk medical conditions like cancer or heart conditions. Doctors can recommend people they consider high risk for COVID-19 complications to get expedited vaccines as well.
At Phase 1C, frontline essential workers, all people 60 years or older, and people in prisons and congregate care facilities are eligible. This section includes people with less severe health risks like asthma or high blood pressure.
Phase 2 is all Montanans over the age of 16. Outside of phase 1A, though, there is no definitive timeline for these groups to begin receiving immunization. There is no specific designation for students or those living in congregate facilities like residence halls.
Newly-elected Montana Gov. Greg Gianforte edited Montana’s immunization plan Jan. 5 to prioritize people with compromised immune systems. High-risk students will have access to the vaccine when section 1B begins, though that may still be months out.
Curry’s first day of vaccinations featured internal members of UM medical staff across campus. Dawn Camara-Clark, a worker at Curry’s insurance desk, walked just 20 feet from her normal desk to her vaccine.
“This felt awesome, especially to get it in the building. You know when someone gets a flu shot? That’s it, that’s how it felt,” Camara-Clark said. C
amara-Clark has worked in Curry since 2000, first at the front desk, and then behind the scenes working on student insurance. She greeted her vaccinator, pharmacy manager Chatriad, by first name.
“I trust Ken, I get my prescription from him,” Camara-Clark said. “I’ve been here longer than he has, but he’s always been great at his job.”
Chatriad graduated from the UM School of Pharmacy in 2006, and returned to Missoula one year later to manage Curry’s pharmacy center, where many UM students get their prescription medicine.
He not only is responsible for tracking the inventory of his pharmacy, but also handling billing and his own human resources. His goal is to get as many of his colleagues vaccinated as soon as possible.
“Right now we have that first 100 doses batch, but we are still requesting more shipments of the vaccine,” Chatriad said. “We will have 400 more [vaccines] soon, and this is just the beginning.”
Alongside Chatriad were his technician interns, UM students enrolled at the School of Pharmacy. The school of pharmacy includes graduates and undergraduates alike, some of whom Adams said will be an important vaccination workforce.
“The pharmacy program has 225 people. That can be almost an army of vaccinators,” Dr. Adams said. “They’ve gotten pretty good at the logistics of mass vaccination, especially moving mass vaccination.”
Adams listed vaccination booths in the University Center or in tents in the parking lots next to the Adams Center and Law Building. Curry plans to keep its vaccination plan exclusively for members of the UM community, but more parts of Missoula could get immunized by the University based on testing needs.
Cindy Farr, COVID-19 Incident Commander at the Missoula City County Health Department, explained that all vaccine providers in the county meet once a week as a coalition to distribute leftover doses.
“What we are doing is trying to say, ‘Okay, who’s done vaccinating their own people, and who still has vaccines leftover that they can maybe reach out to a different provider?’” Farr said. “We’re spreading the love a little bit so that we can get people vaccinated as quickly as possible.”
So far, the vaccine distribution efforts are conducted by medical centers like Missoula’s Providence St. Patrick Hospital and Curry Health Center, Farr said. She added public pharmacies like Walgreens and CVS will get their first shipments of doses at the end of January, focusing on residents in long-term senior living centers.
In the long term, Chatriad and Adams want to expand from the UM community to the Missoula and rural Western Montana areas. Adams said he wants the center to be giving back to people who support public institutions.
“Let’s say we picked up the upper Blackfoot, one of our pharmacy teams could travel there [and] vaccinate those people,” Adams said. “It’s the mission of UM to want to be part of a community effort to protect people, and to use the skills that we get here at UM to help the general community.”
Chatriad took another sweep through the hallway as he monitored his patients for 15 minutes for any side effects. Most of his patients felt completely fine, save for some minor symptoms like a sore arm or fatigue.
Most of those vaccinated grabbed candy or drinks from the table in the corner, taking Chatriad’s advice that the glucose from the sweets would help recover from the shot.
Julia Schechter, a UM student who works at Griz Health, walked into the hallway about half an hour into the vaccination effort, and more people began to occupy seats. She immediately picked up a conversation with her coworker, who arrived 10 minutes earlier to get the vaccine. The two students took it with no hesitation.
“I feel excited and grateful to get this so early, and in such a familiar place,” Schechter said. “For the last few months I have been working in Curry’s lab testing COVID samples.”
Griz Health and other lab workers in Curry had to handle thousands of COVID-19 tests over the last semester. Griz Health staff also work as contact tracers, conduct symptom checks on campus and sponsor informational booths.
At the peak of UM’s COVID-19 outbreak in early October, there were over 100 active UM cases. Some reports from Curry estimated positivity rates for tests reached 20%, higher than the 5% threshold for uncontrolled spread as defined by the World Health Organization.
As of Jan 11, there were 14 active COVID-19 cases tied to UM and 356 active cases in Missoula County, down from a high of 1,200 countywide cases in late November. The drop of active cases, Farr said, could be due to people avoiding testing in order to attend holiday events.
“The testing numbers were down because nobody wanted to get tested and be told that they couldn’t participate in whatever holiday activities that they had planned,” Farr said. “Now that everybody’s kind of back in the swing, I think that we are starting to see the uptick.”
As spring semester approached, Curry braced for students’ return to campus. Adams said it had been smooth over the break, with his team seeing positivity rates lower than 6% and going days without any new positive cases.
However, Adams is careful to not be overly optimistic. Last fall, UM saw a steep and sudden increase in cases as the semester progressed, from less than 10 cases total in August to dozens of new positives each week of class.
“We all expect another wave is coming, because when the students travel, and they intermingle, our testing volume is going to have to increase,” Adams said. “We’re going to say that we can test all the symptomatic students on campus.”
One advantage UM and Missoula boasts is an on-campus COVID-19 lab, partnered with Montana’s State Public Health Lab, where tests can be sent and processed directly, instead of going through the state lab in Helena. Adams said the more streamlined system will help the center run more tests, and outsource to the public health lab in case there are more than 80 tests in a day, which is Curry’s maximum.
UM spokeswoman Paula Short said the University took steps to mitigate another wave of the virus as students return from around the country for class by sending postcards to students after Christmas with the message to limit social circles and gatherings.
“One of our concerns is that students may be going to UM from places both in and outside of Montana, where masking is not as prevalent,” Short said. “We really want to encourage them to be really practicing those same mitigations that they’ll need when they get to campus.”
A new aspect to UM’s COVID-19 mitigation plan is a surveillance testing operation, which gives tests to specific communities of asymptomatic people, for students returning to residence halls. On-campus residents can get a guided self-test the first week of class at the University Center.
The surveillance testing is a part of the larger Montana University System plan, which includes other large campuses like Montana State University and Montana Tech. UM has not done surveillance testing since September. As Short explained, supplies had not been sufficient enough to divert from symptomatic testing.
“Our ability to do asymptomatic or surveillance testing has always been a matter of the availability of those testing resources,” Short said. “Should those become more widely available we certainly could look at another offering of that voluntary asymptomatic testing.”
Short said there was not significant evidence that classrooms and other academic spaces were spreading places for the virus, as those spaces had strict social distancing and mask requirements. She added that 78% of the spring semester classes are scheduled to be held either in-person or in a hybrid model.
At Curry, where medical staff have spent months juggling students’ usual medical needs and the unique challenges of a pandemic, the vaccine marks the beginning of much-needed relief.
While the future remains uncertain, for Adams, it’s about sticking to the mission statements. For a University-based clinic, it’s always been about providing for students, since its creation in 1956.
“As Doc Curry used to say: The students are our bosses. They should dictate what we provide for them,” Adams said. “I want students to know about us, I want students to use us, I want students to trust us."
“A big focus of mine is getting us back to a regular way of doing business … to enjoy a campus experience that is not completely hijacked by COVID-19 concerns,” Adams said. “Even if we’re still in a pandemic, we can start to allow a little bit more movement in our community without worrying about transmission.”