Texas Health Frisco Doctor Leads Local COVID-19 Care

It has been just over a month since the FDA announced the approval of the new Pfizer COVID-19 vaccine, followed shortly after by the approval of the Moderna vaccine. Despite the urgent demand to develop an immunization, many people remain uncomfortable getting such a newly developed vaccination, or unsure which of the two they should request. The differences between the two vaccines are most noticeable on the care provider side, as they each require different storage temperatures and preparation methods. Pfizer’s vaccine has been approved for use in individuals at least 16 years of age, while Moderna’s vaccine has been approved for individuals who are at least 18. Although neither vaccine has been shown to be unsafe for children, or pregnant or lactating women, neither company included those groups in their clinical trials. The long-term efficacy of both vaccines is unknown at this time because scientists will need to wait for time to pass before testing the future immunity of those individuals who received the new vaccines. Most people experience mild side effects, such as soreness and swelling at the injection site, similar to that experienced after receiving a flu vaccine.

Both COVID-19 vaccines were developed using modified mRNA (messenger RNA), based on a method developed by biochemist Katalin Karikó and immunologist Drew Weissman, and patented in 2005. After reading their publication, Derrick Rossi started Moderna in 2010 with the intention of using modified mRNA to make various vaccines and therapies, such as the Zika vaccine Moderna was developing in 2017. Karikó and Weissman licensed their technology to German company BioNTech, who partnered with Pfizer in 2018 to develop an mRNA vaccine for Influenza A.

Messenger RNA plays a vital role at the cellular level in the human body. It transcribes “instructions” from DNA inside a cell’s nucleus, then carries that message to ribosomes, which translate the instructions to create the amino acids necessary to create proteins. These proteins are used to create everything in the body, from tissue to blood cells and hormones. Ever since the discovery of RNA in 1961, scientists have been researching ways this cellular messaging system might be used to send messages that teach our body how to fight infections, diseases like cancer, or even how to produce its own medicine at the cellular level. The COVID-19 mRNA vaccine contains modified mRNA which delivers a message with instructions on how to build a harmless portion of a protein found on the surface of SARS-CoV-2. Once these proteins are made, the body recognizes those cells as foreign intruders and begins to develop an immune response. The process teaches the body how to protect itself against any future infections, without any risk of contracting the real virus.  

Texas Health Frisco (THF) received their first shipment of the new Pfizer vaccine shortly after it was approved. A daily vaccine clinic was opened on their campus and employees were categorized into tiers based on their risk of contracting the coronavirus. The first round of vaccines were made available to the tier one group, which included any employee caring for patients who had tested positive for COVID-19. The next group after healthcare workers included high-risk individuals, such as those living or working in nursing homes, followed by relatively high-risk individuals, such as teachers, after which the vaccine is available to the general public. The hospital has its own sub-zero freezer, but shipments are received from their centralized distribution center. Employees can sign up for the vaccine clinics using an electronic scheduling system, which enables the facility to receive deliveries of the exact daily quantity required. A back-up list is maintained in case any employee is unable to show up for an appointment, as the Pfizer vaccine must be administered within six hours after it has been thawed and diluted. Human Health and Services advised the facility that as they use up their supply of vaccines, they will receive more shipments, so more clinics are being scheduled, and the hospital will continue to expand the groups of people eligible to receive the vaccine. “The intent is to make this available free of charge for anyone who would like to receive the vaccine,” says Brett Lee, president of Texas Health Hospital Frisco. “Because it’s a new vaccine, I understand that there can be some hesitancy from folks about being in the early adopter group, but I would encourage everyone to really do their research in terms of the safety and the efficacy of the vaccine, and the fact that this is really our path out of this challenging time that we’ve had for the past nine months. Hopefully, when it becomes available, that research will help them to feel comfortable getting in line to take it.”

Medical Director of the Emergency Department at Texas Health Hospital Frisco Dr. Janie Sanders moved to Frisco the week before the facility opened in December 2019. Dr. Sanders was the first employee at THF to receive the vaccine, and she was also the first physician to treat a COVID-19 patient at THF. “We knew it was in the U.S. and we knew it was getting closer and closer to Frisco, so certainly our guard was up and our awareness was up, but we had yet to see it definitively at our facilities,” recalls Dr. Sanders. “In the Emergency Department, you’re pretty much prepared for anything and everything on any given day, at any time. The initial onset of the pandemic, for us, was kind of what we do; we deal with extraordinary circumstances and we adjust and adapt to take care of the situation. I think the prolonged time period of the pandemic is what really increases the stress of this job. It’s the not knowing when this is going to end or how bad it’s going to get.” 

The new vaccines have generated a mixed reaction from the general public. Many people are eager to get vaccinated, while others are skeptical about how quickly the vaccines were developed. “The reason I got the vaccine is that I feel as physicians, we should be role models and leaders to show the community that it is OK and it is safe,” says Dr. Sanders. “I understand people’s hesitation and reservations about taking a vaccine that was produced so quickly, but I’m hoping that by having people in the community, like your neighbors, kids, parents, etc., getting the vaccine and seeing that they are healthy, will encourage others to get the vaccine because having the physicians and healthcare workers vaccinated is not going to be enough. We need to have the community vaccinated for this to make a difference.” 

Originally a Louisiana native, Dr. Sanders attended medical school at Tulane University, where she met her husband, Drew. They moved to Dallas to complete their residency at UT Southwestern and trained at Parkland. Dr. Drew Sanders, an orthopedic surgeon, also received the vaccine around the same time as Janie. Dr. Janie Sanders decided she wanted to be a doctor when she was five years old after she had a small procedure on her knee and watched the entire thing with fascination. “It was just something that struck me,” said Dr. Sanders. “I thought ‘This is the coolest thing I’ve ever seen,’ and I’ve got to be able to do what I saw. I knew when I rotated to the Emergency Room Department that it was my comfort area. I like to be doing multiple things at one time; I like the variety and I really like meeting a bunch of new people. Getting to help them out on the worst day of their lives just really appealed to me. There’s always variety when you walk into the emergency department and it keeps me engaged and wanting to come back.” 

As a doctor caring for COVID-19 patients, Dr. Sanders is constantly exposed to the coronavirus, causing her to take extensive added precautions to avoid bringing it home to her family. “There’s risk and benefit. I felt that I should follow the CDC guidelines and as long as I was doing that, I should be safe around my family,” says Dr. Sanders. “Of course, that comes with a lot of increased stress and anxiety because there’s always the second-guessing and the doubting. I remember the first time I did CPR and intubated a positive COVID-19 patient. I left the hospital and I called my husband and said, ‘What do I do? Do I come home?’ It was very emotional. I drove around the block a couple of times before coming home and I took a deep breath and said, ‘You know what? I have to leave it at the hospital. I’ve done everything I can do and I’m going to come home and be with my family.’ It’s just a lot of trauma and a lot of stress. I can now see the light at the end of the tunnel and it’s getting closer, but we still have a long way to go.”

Dr. Sanders’ youngest son would have started preschool this year, but she and her husband felt that the risk to the community and their patients would be too great if the kids attended in-person classes. Her oldest son was able to start kindergarten virtually. “I’m just grateful that he was able to begin with school and be a part of the school system. I think that Frisco ISD and his teachers are doing a great job considering how fast they were able to put all this together,” says Dr. Sanders. “I don’t think academically he will suffer; obviously socially that’s something we’re going to focus on. I’m really impressed with the extent of content that his school has provided us. It’s hard work on us but he gets it done, and I see him improving, learning and growing. I’m happy with the academic progress he’s made over the year.” When they’re not focusing on school, the family likes to spend as much time outside as possible and they enjoy watching YouTube videos about science experiments the kids can do at home.

There is still a large group of people who are uncomfortable being among the first recipients of the new COVID-19 vaccines. Although modified mRNA vaccines are relatively new, they have been in development for more than 15 years and there is no data to indicate that they cause any side effects or adverse reactions that outweigh the risks of opting out of being immunized. The mRNA development method has significant advantages compared to the traditional method of using a dead or inactivated form of a virus to create an immune response; it is less time-consuming and there is no risk of contracting the virus from the vaccine, making it far more efficient in the efforts to globally eradicate this highly contagious and harmful virus. “This vaccine doesn’t even contain the coronavirus; it can’t give you coronavirus,” says Mr. Lee. “It just promotes an immune response. The technology that they used to produce this vaccine has been around for 15 years so they didn’t start from scratch; they built on existing science. That’s how they were able to get it done so quickly.” 

Dr. Sanders hopes that people with reservations will be encouraged to ask questions that help them make an educated choice about if, and when, to get vaccinated. “I would hate to see people just wait and see what happens; that’s not what we should be doing,” says Dr. Sanders. “We should be seeking the advice of the scientists and physicians so that we can make smart decisions because the longer we wait, the longer this thing lasts and the more people lose their lives. It’s important to eventually vaccinate everyone because an eighteen-year-old who has mild symptoms and doesn’t develop a severe disease can still transmit it to others. We need to be able to stop the transmission of the virus. COVID-19 has made me more aware of my family and my purpose, and I’m emotional because I feel so strongly about this. I want this to work. I really, really want this vaccine to work. We’re getting there, but it’s going to take the whole community.”

Juliet Cimler is a freelance writer and project manager for a biotech consulting firm in Frisco. She has a B.S. in Business Administration and is pursuing an M.S. in Computer Information Systems.

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