Federal Pharmacy
Laurrie Lorenzo, PharmD
In a year when we learned to expect the unexpected, the U.S. Coast Guard motto—”Always Ready”—served CAPT Paul Michaud, PharmD, and his pharmacy team well. With flexibility and determination, the chief pharmacist for the U.S. Coast Guard coordinated vaccine delivery to U.S. military personnel deployed around the world. CAPT Michaud was presented with the prestigious Legion of Merit award earlier this year in recognition of his significant achievements and outstanding performance in service to others.
Pharmacy Today spoke with CAPT Michaud as he reflected on this year.
What was involved in COVID-19 vaccination efforts for the U.S. Coast Guard?
PM: The Coast Guard COVID-19 vaccination of its workforce was part of the Department of Defense (DoD) plan for the joint force since August 2020. The Coast Guard prioritized its personnel to receive the vaccine based on CDC guidance and on the DoD COVID-19 Task Force assessment of unique mission requirements. The incident command (IC) was created to address the challenges of distributing a vaccine with complex ultra-cold storage and handling requirements with a constrained supply chain. The Coast Guard has many units in remote regions of the United States and the IC ensured distribution was done in an equitable fashion to reach all service members regardless of locale.
To reach the 50% vaccination mark in only 4 months is remarkable. What were some of the tools that helped you coordinate vaccination efforts?
PM: This was a fast-paced evolution with a lot of challenges, so communications and information sharing was key to our success. The Coast Guard IC joined the [Defense Health Agency] Operational Planning Team from the start and participated in the initial planning and training evolutions. Prior to shipment of the vaccines, the IC held internal training with key leadership from the field to address gaps and questions with the plan and leveraged technology to assist with planning and communications to and from the field.
What were some of the major challenges you were up against? Are there innovative solutions that helped your team and could be employed in other sectors of the population?
PM: As stated previously, the major challenges were on the logistics and communications side of the evolution. COVID-19 vaccine manufacturing started during phase III clinical trials, resulting in vaccine shipments the day after FDA and CDC voted to approve the vaccine for use. This created communication issues that were overcome by utilization of the established Coast Guard chain of command. Multiple training sessions were held with key leadership from the field and included pharmacy officers, clinic administrators, medical officers, and unit commanding officers. Coast Guard pharmacists manage the medical logistics for all medications and vaccinations, so we relied on them heavily to assist with the distribution, storage, and handling of the vaccines.
The Legion of Merit award is given for exceptionally meritorious conduct in the performance of outstanding services and achievements. What does that mean to you?
PM: I’m grateful, humbled, and honored to receive this award, and it demonstrates the impact pharmacists can have outside of their traditional roles. Although some of my specific actions and accomplishments were highlighted in the award citation, the credit for the overall success of our vaccination program belongs to our vaccination team and the thousands of Coast Guard members across the country who helped us administer more than 78,000 vaccine doses to active duty, reserve, and civilian personnel this past year. Nothing is achieved in a vacuum or individually, and I had an amazing team with me throughout this complex evolution [in care].
How does your accomplishment highlight the important role pharmacists play in vaccination efforts?
PM: The pharmacist is an integral part of the team required to conduct large-scale mass vaccination operations. We excel in complex logistical challenges, mass vaccination events, training, and leadership. It demonstrates that pharmacists can work outside of traditional roles and successfully lead complex logistical evolutions.
Of what event or achievement are you most proud?
PM: Increasing Coast Guard readiness and saving lives through vaccination. As the nation’s premiere maritime first responder, Coast Guard operational readiness is vital to keeping our waters, coasts, and shipping ports safe and secure. The Coast Guard remains committed to protecting our service members, civilian employees, and families; safeguarding our national security capabilities; and supporting the whole-of-nation response to the pandemic. This action is essential to sustaining Coast Guard military readiness.
The health of our workforce and families is vital to a mission-ready Coast Guard. Vaccination will protect our people, maintain readiness, and support the national COVID-19 response. The Coast Guard continues its campaign to vaccinate the entire workforce to sustain mission readiness, and ensure we are protecting ourselves, our shipmates, our families, and our communities against COVID-19. This included fully vaccinating over 70% of our active duty workforce prior to the July 4 holiday.
The Coast Guard has people throughout the United States and internationally. What lessons can you share regarding remote and mobile access?
PM: The Coast Guard followed the CDC/FDA/DoD tiered approach. This required teamwork and coordination from the IC; senior leadership; the Health, Safety, Work-Life Service Center; and commanding officers to assist with the logistical challenges of delivering vaccine to the remote areas of our population. In addition, we leveraged our volunteer service called the Coast Guard Auxiliary to assist with transportation of vaccine to some of our more remote locations.
What insight did you gain regarding the pharmaceutical supply chain when overseeing a strategic national stockpile?
PM: Coast Guard pharmacists routinely oversee a strategic national stockpile, so we were prepared to manage this evolution. We hold training events to test closed points of dispensing annually. The Coast Guard pharmacy and medical community were prepared to manage this vaccination effort. Forward-leaning pharmacy leaders procured ultra-low [temperature] freezers that allowed us to store initial tranches of vaccine for the Coast Guard, DoD, and other government agencies throughout the [vaccination process].
What do you see as the single greatest change in pharmacy practice to have come from COVID-19?
PM: The single greatest change in pharmacy practice was the expansion of the pharmacy technician role in vaccinations. The Coast Guard motto is “Semper Paratus,” which means “Always Ready,” and we were better prepared than most due to our corpsmen. They fill the role of a pharmacy technician, nurse, and laboratory technician. We have a highly skilled and trained workforce ready to administer vaccines daily, but the civilian sector needed legislative change to support the pharmacies, pharmacists, and the general public by expanding the role of the pharmacy technician.
What advice would you give to someone looking at a career in pharmacy?
PM: Don’t put limitations on what you can do in the field of pharmacy. Continue to progress and grow the profession beyond what it is today. “There’s no growth in the comfort zone and there’s no comfort in the growth zone” is a mantra that has stayed with me since attending a Coast Guard senior leadership training. Look for opportunities to better yourself as a leader, professional, and friend. Those in school now are the future leaders of this great profession, so I challenge them to expand what pharmacists can achieve.