#BehindTheVaccine – Meet the pharmacy team at Michael Garron Hospital and East Toronto Health Partners

#BehindTheVaccine tells the stories of Michael Garron Hospital’s (MGH) and East Toronto Health Partners’ (ETHP) COVID-19 vaccine team, a group of dedicated staff, physicians and healthcare leaders who have administered more than 600,000 doses of the COVID-19 vaccine to East Toronto residents since December 2020. Meet the pharmacy team.

“We’re not a team that looks for the limelight, but we’re always there to be a key support,” says Andrew Liu, Director of Pharmacy Services at Michael Garron Hospital (MGH).

Throughout the COVID-19 pandemic, MGH’s pharmacy team has played a critical role in the hospital’s emergency response. Led by Liu and made up of more than 100 people, the team is responsible for ensuring the hospital has the necessary medications on hand to care for patients with COVID-19 and that the right medication is given to the right patient at the right time.

Now as part of the COVID-19 vaccine rollout in East Toronto, their work has evolved to ensure the hospital and member organizations of East Toronto Health Partners (ETHP), the Ontario Health Team (OHT) that MGH is part of, have the information, supply and quality control processes they need to get the COVID-19 vaccine into arms as quickly and safely as possible.

“We didn’t initially know that hospitals would play such a fundamental role in the vaccine rollout,” Liu says. “It’s been incredibly rewarding to be part of this effort. I’m proud of the team for being able to pivot so quickly and band together to tackle every new challenge that’s come with each wave of the COVID-19 pandemic.”

Working closely with MGH and ETHP’s clinic, mobile and strategy and operations team – the last of which Liu also plays an active role in – the pharmacy team has been a mainstay at the 900-plus vaccine clinics that MGH and ETHP have operated since December 2020. Behind every clinic – whether it be at a park, mosque, grocery store parking lot, school or one of MGH and ETHP’s fixed clinics – there are pharmacists and pharmacy technicians, assistants and students working diligently to prepare adult and paediatric vaccines for administration.

Often, the team has gone above and beyond – for example, exploring every possible avenue to ensure not a single dose goes to waste and waking up in the early hours of the morning to prepare vaccines for MGH and ETHP’s record-breaking clinics at Thorncliffe Park Community Hub and Scotiabank Arena. Memorably, the team transformed the Raptors practice court into a dedicated pharmacy area during the Scotiabank Arena clinic in May 2021, when more than 26,000 doses were delivered within 24 hours. Some pharmacy staff have even travelled long distances and trekked hours through the snow to ensure they can assist at vaccine clinics.

Below, meet some of the many members of MGH’s dedicated pharmacy team who, more than one year into East Toronto’s COVID-19 vaccine rollout, continue to work together to get doses into arms.

Andrew Liu
Director, Pharmacy Services, Michael Garron Hospital

“The demands of the pharmacy team have sometimes been unpredictable during this pandemic, but I am incredibly proud of the work this team has done,” Liu highlights.

Liu oversees the management and direction of COVID-19 vaccines at MGH and across ETHP member organizations, as well as the necessary medications to care for patients who are COVID-positive. The medication distribution system mitigates errors and ensures medicines are provided to various clinical areas using the most up-to-date safety measures.  

“Vaccinating the East Toronto community has always been top of mind, but it was unclear if this responsibility should fall onto our hospitals or others during the pandemic,” Liu says. “However, with a strong sense of purpose, we saw an opportunity to help protect our community and strengthen our ties with fellow partners when COVID-19 vaccines became available – hence why we have collaborated so closely with our ETHP organizations.”

Each wave of the pandemic has presented new challenges to the pharmacy team. The first wave of the pandemic significantly increased consumption of critical care medications; the third wave increased this consumption to 300 per cent. As a result, the pharmacy team took extra efforts to procure more of the key critical care drugs and take proactive measures to be prepared for future increased demands.

“We leaned heavily on our technician experts when preparing medications, especially intravenous or sterile medication, which is critical to vaccine preparation,” Liu explains. Vaccine preparation involves the specific handling of medication that minimizes contamination with bacteria or other harmful impurities from the environment. “The meticulous details to ensure vaccines are properly made gave us the peace of mind that our vaccine clinics would be supported with high reliability.”

The pharmacy team is responsible for tasks related to ensuring vaccine safety, including an accurate colour-coded process for labelling appropriately diluted syringes and following strict guidelines in aseptic technique. Prepared vaccine syringes are identified with specifically coloured labels to aid clinic staff in administering the correct vaccine to each client. To ensure quality vaccines are administered to each eligible individual, an expiry date is put on every vaccine dose to ensure they are used in a timely manner and that expired vaccines are not distributed.

Supply and demand issues and rapidly evolving eligibility are other components the pharmacy team must be vigilant of. The team plays a critical role to ensure the correct vaccine dose and type are available for each patient and that each patient is eligible to receive the vaccine.

Liu highlights how the team is strongly supported by other departments at MGH and parts of the vaccine team, including the mobile, clinic and strategy and operations areas. He says without continuous communication and collaboration between hospital and community teams, as well as stakeholders at various levels of government, MGH and ETHP’s COVID-19 vaccine rollout would not be possible.

“It has been quite rewarding and validating to see the critical role the pharmacy team plays in these urgent types of situations,” Liu continues. “The different waves of the pandemic have shown us different issues, but the team continues to push through the barriers and provide care, resiliently, for our community.”

Grace Ho
Clinical Manager, Pharmacy Services, Michael Garron Hospital

With her previous experience as a clinical pharmacist, a clinical operations lead, vaccine lead and now clinical manager over the span of 10 years at MGH, Ho understands well the important role pharmacy plays in an effective hyperlocal immunization strategy. When COVID-19 vaccines arrived in Ontario in December 2020, she was prepared for the expected demand.

“Being a pharmacist put me in a unique position to readily jump in and help out with this monumental task of vaccinating our community,” Ho begins. “At the beginning of the vaccine rollout, we were focused on building the vaccine preparation program from the ground up, sourcing all the supplies that we needed, hiring staff and creating all the standard operating procedures, such as how to make and store vaccines given all of the vaccine handling restrictions.”

When COVID-19 vaccine eligibility expanded to the general public in spring 2021, MGH and ETHP began taking vaccines on the road and set up clinics in parks, plazas, apartment building lobbies and other sites in the community. This low-barrier approach to vaccinations continues in East Toronto today.

“On any given day we have around 30 to 40 vaccine staff working, including at our fixed and mobile clinics,” Ho explains. “Our staff have been amazing, being flexible and adapting to different environments with an eager attitude.”

Reflecting on her work during the vaccine rollout in East Toronto over the past year, Ho says she’s grateful to have played a part in MGH and ETHP’s record-breaking clinics in Thorncliffe Park and at Scotiabank Arena. “I never thought in a million years we could participate in such significant milestones during this pandemic. MGH is among the hospitals in the city that have administered the most vaccines to local residents – I find it remarkable how a small community hospital like ours in East Toronto is able to vaccinate so many people.”

“The experiences I’ve had over the past year have inspired me to pursue a formal pharmacy leadership role,” Ho continues. “When a group of leaders and frontline staff all come together across sectors – both at the hospital and in the wider community – and take on big projects to help their community, it inspires me to continue working hard at what I do.”

Yesha Desai
Pharmacy Assistant, Michael Garron Hospital

Desai’s journey has been one surrounded by support and passion. After working at an international pharmaceutical company in India for five years, she came to Canada to continue her studies and further her career. In 2021, she completed a training placement at MGH from Centennial College and, shortly after, was hired as a Pharmacy Assistant.

Since then, she’s been working closely with the MGH and ETHP pharmacy team on the COVID-19 vaccine strategy in East Toronto, offering her opportunities to grow both professionally and personally.

“This is my first hospital experience and I am beyond grateful for all the work MGH has done,” Desai describes. “I’m so glad I am able to be a part of a team that is preparing life-saving vaccines and giving back to the community.”

Pharmacy assistants play a critical role in the handling and distribution of the COVID-19 vaccine. It is their responsibility to prepare and distribute the vaccines to the nursing teams, check all labels and expiry dates on vaccines and maintain the temperature conditions for the vaccine.

“It’s my pleasure to play such a critical role in the vaccine rollout,” Desai says.

The hours at MGH and ETHP’s vaccine clinics can be long. At times, some clinics have operated for more than 12 hours a day to ensure local residents are able to get vaccinated at a time that is most convenient for them. Despite these long days, Desai says it’s easy to remain motivated.

“We’ll work long hours and administer vaccines to hundreds of people at a time, but we don’t feel tired,” she says. “It gives us energy to see people getting vaccinated and showing their support and appreciation for us – it’s the community’s spirit and thankfulness that keeps us going through this pandemic.”

Aaron Zhang
Pharmacist, Michael Garron Hospital

Clinical rotations and student placements are paths through which many students start their careers in healthcare, but landing a student placement during a pandemic has made for a particularly accelerated experience for many, including Zhang.

“It’s interesting to see how much my role has changed since I started with the pharmacy team at MGH,” says Zhang, who started at MGH after completing a student placement at the hospital in 2019 as part of his fourth-year rotation at the University of Toronto’s Leslie Dan Faculty of Pharmacy. “I first started my role when Ontario began receiving COVID-19 vaccines, so I was responsible for developing tools that helped track our supply.”

Zhang assisted in preparing vaccines and was one of the first individuals on the team to draw up the first doses of the COVID-19 vaccine. He currently works as one of the lead pharmacists at MGH and ETHP’s Thorncliffe Park Community Hub clinic.

“One of the most important parts of my current role is ensuring we minimize medication errors,” Zhang says. “This means making sure the right vaccine and dosage gets to the right patient at the appropriate time in a safe manner.”

Zhang is proud of the work his team and other departments in the hospital have done to allow this vaccine rollout to happen.

Jonathan Ko
Pharmacy Student, Michael Garron Hospital

Jonathan Ko is a fourth-year Pharmacy Student at the University of Toronto’s Leslie Dan Faculty of Pharmacy. He works at the various COVID-19 vaccine clinics that MGH and ETHP operate throughout East Toronto.

“When I first started working at MGH, vaccines were only being administered at the hospital,” says Ko, who has been working at the hospital for more than a year now. “Now, they’re delivered all over the community – at schools, at shopping plazas, in apartment buildings and more – which means our team is in all areas of East Toronto helping to get doses into arms.”

At the clinics, Ko is responsible for appropriately storing and preparing vaccines, ensuring they are ready for injection by clinic staff. The work he does helps to prevent vaccine wastage, keeps vaccine clinics running smoothly and, most importantly, protects patients from COVID-19. Another key part of his role is keeping up-to-date on evolving studies, real-world data and guidance around COVID-19 vaccines so the team can ensure it is following best practices in administration.

Ko says he is in awe of the degree to which MGH and ETHP have been able to scale up their vaccine operations over the past year. From a small clinic at MGH that only served eligible long-term care staff in December 2020 to large-volume clinics that have delivered hundreds of vaccines per hour to children, youth and adults, he is proud to have been a part of it all.

“It has been an amazing and rewarding experience working with this team to keep people safe during the pandemic,” Ko says. “Although it has been challenging at times, it has shown me how integral of a role the pharmacy team plays in keeping our community safe and healthy, along with our other strong teams at the hospital and in the larger community.”

Ko would like to give a huge shout out to the pharmacists, pharmacy technicians, assistants and students who have made this entire process at MGH and ETHP possible.