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As news began circulating in Finland in early January that COVID-19 vaccines could soon be approved, the nation’s health authorities cautioned an excited public that it would take time to distribute the vaccine supply and train enough people to administer them. Retired doctors Matti and Virpi Honkala learned about the potential shortage of vaccinators and contacted their region’s medical director to volunteer their services in Raahe and the surrounding area. “There was such a buzz and everyone wanted to get going right way,” says Virpi, a Rotary International director and member of the Rotary Club of Raahe who previously worked as a surgeon and medical director. Her husband, Matti, Rotary’s PolioPlus national advocacy adviser for Finland and a member of the Rotary club of Pietari Brahe, had been a chief of internal medicine. Both are still licensed to practice medicine. “We knew that if they had a shortage of vaccinators, they would have to pull people from their other duties, and then those services would be put on hold,” Virpi says. “We knew we could step in wherever needed.” Both Virpi and Matti have experience managing vaccination campaigns. During the 2009 outbreak of H1N1 (also known as swine flu), they oversaw the inoculation of nearly 1,000 health care workers prior to the mass vaccination of the general population. “We have been retired for some years, but we still know how to vaccinate people,” says Virpi. Eager vaccinators By the end of April, the Honkalas had vaccinated more than 5,000 people in Raahe and two smaller municipalities nearby — accounting for about half of the vaccinations in their region, by Virpi’s estimate. In these three communities, about a quarter of the people, including almost all of those 75 and older, have received a first dose of the vaccine. People 60 and older were able to make appointments as of May. “Two eager vaccinators can do quite a lot,” Matti says. People have been excited and feel relieved about the vaccine rollout. “They are happy,” Virpi says. “And they are so grateful.” Virpi was keen to get their Rotary clubs involved in the effort, and Matti wanted to promote the importance of vaccines. “We said, this could be our Rotary project, and our project for our community,” Virpi says. “We know how eager Rotary members are to promote vaccinations, whether it’s against COVID-19 or polio.” Members of both Rotary clubs volunteered to act as ushers and park cars at vaccination sites. Rotary club members played a crucial role directing people in and out of a closed school that was converted to a vaccination center. Virpi says staff members were thrilled to have the help, because the school layout was more complicated than the setup at other vaccine locations. Vaccination strategy Finland’s ministry of health sets the country’s vaccination strategy. The Pfizer vaccine, the first that became available in Finland, has to be kept at around -70°C (-94°F), so a cold chain must be maintained for doses to remain effective. Vaccine doses are packed in large containers filled with dry ice and flown from a pharmaceutical factory to Helsinki, Finland’s capital. The doses are then distributed to regions according to their population and their needs. Each region’s medical director and nursing staff schedule vaccination appointments as doses become available, and university hospitals distribute vaccine batches to municipalities. The vaccines for the Raahe region come from a university hospital about 75 km (47 miles) away. In early January, the Honkalas were vaccinating mostly front-line health care workers. Then in February, they assisted with vaccinations in nursing homes and retirement communities. As supplies increased, the Honkalas began providing vaccinations several days a week, including at the hospital in Raahe and at smaller clinics in the two neighboring towns. “At first we had only shorter days,” Virpi says. “The nurses in charge of scheduling set up one appointment every 10 minutes. I think they thought because of our age, we would be slow. I have never spent so much time walking corridors! Then, they realized we could do more and increased the pace to two every five minutes.” Matti Honkala administers a dose of the Pfizer vaccine to his wife, Virpi, before they start their service as vaccination volunteers. Virpi says the vaccination effort has been a welcome relief from the isolation of the pandemic. “We are seeing and meeting our neighbors, our work colleagues, and former patients as they come in for their vaccinations,” she says. “It’s really amazing. As a surgeon, I never saw people much after their operations — only if something went wrong. Now, I am seeing people who remember that I operated on them as many as 30 years ago, sharing how well they have been doing since.” Combatting misinformation Matti says he has also been working to fight vaccine misinformation and hesitancy, drawing on years of experience with the polio campaign. He finds opportunities to talk to people while they are waiting, using his knowledge as a polio advocacy specialist to speak about the power and efficacy of vaccines. In Europe, he says, there are pockets of distrust, and rumors can spread easily based on a rare case. For instance, after the AstraZeneca vaccine was paused because of some reports of blood clots, he found that more people came in expressing concern about which vaccine they were receiving. Virpi says she also uses humor to allay people’s concerns. “One of the men yesterday asked me, ‘Which did you inject me with?’ I told him, ‘All of them. And I will be able to follow you with the gadgets I have,’” she quipped. Having administered more than 5,000 vaccinations, Virpi suggested to her husband that they could stop after they reached 10,000 and let others do the rest. “But,” she says, “he said, ‘When we have done the first 10,000, then we can start the second.’”
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