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‘The queen of vaccination’: a nurse practitioner carries Covid injections from house to house in Puerto Rico

MAYAGÜEZ, PUERTO RICO – Abigail Matos-Pagán walked into a bright blue house in Mayagüez earlier this summer and was greeted by Beatriz Gastón, who quietly led the way to her mother’s small room. Matos-Pagán had come to provide a covid-19 vaccine for Wildelma Gastón, 88, whose arthritis and other health problems confine her to bed.

Wildelma Gastón asked to have the rosary placed on his chest and pointed to his “good arm”, where Matos-Pagán injected him with a first dose of the Moderna vaccine. The Gastón household, made up of five family members, breathed a collective sigh of relief. Although the vaccine had been available for months, Wildelma had not been able to reach a vaccination site. According to the COVID data tracker from the Centers for Disease Control and Prevention, Puerto Rico’s vaccination rate in March was one of the lowest among US states and territories, despite receiving more than 1.3 million doses of vaccines. The launch highlighted disparities in access to medical services and the challenges of tracking and reaching remote citizens, such as Wildelma.

With every trip to school or work, family members worried about bringing the virus home and threatening Wildelma’s life. Matos-Pagán also vaccinated two of Beatriz’s children, who are students at the University of Puerto Rico-Mayaqüez, during her visit.

“We have been waiting for this moment for a long time,” said Beatriz Gastón, saying goodbye to Matos-Pagán with a hug and thanks for the home visit. For her, the vaccine is more than protection against the coronavirus: it paves the way for the family to be with her mother.

For Matos-Pagán, it is his last calling. The nurse practitioner, who has guided relief efforts after hurricanes and earthquakes in Puerto Rico and elsewhere, has made her mission on the US territory to vaccinate as many people as possible against covid. Some residents of Mayagüez, a city on the west coast of the main island, frankly call her “The Queen of Vaccination” and show up at her home asking for help getting vaccinated.

According to The New York Times case tracker, as of Friday, Puerto Rico has had more than 182,000 covid cases and at least 2,594 deaths. About 57% of the population is fully vaccinated, but many of the unvaccinated are difficult to reach because they live in remote mountain communities or suffer from chronic diseases that confine them to their homes. Matos-Pagán has vaccinated about 1,800 people in Puerto Rico so far, including 1,000 who are chronically ill or bedridden.

In the early days of the pandemic, Carmen Blas’s health deteriorated and she began to use a wheelchair. Blas, 78, was confined to her home, on the third floor of an apartment building, which kept her safe from contracting covid, but was later unable to find transportation to a vaccination site. In June, her two children, Lisette and Raymond, visited from Wisconsin to help and immediately called public health officials to have Blas vaccinated.

“Usually I go back every year and this was the longest I’ve been away. It was especially difficult because my mother’s health worsened and I was worried that I would never see her again, ”said Raymond, who planned to extend his visit for as long as necessary.

Matos-Pagán came to Blas’s home in Aguadilla, Puerto Rico, to give him the vaccine. The family applauded the moment the vaccination ended.

“It has been really special having intimate moments at someone’s home during vaccinations. You can tell how much he means to his whole family, ”Matos-Pagán said later.

Mobilizing during a crisis is nothing new for Matos-Pagán. In the wake of Hurricane María, which cut off water and electricity to the entire island and claimed more than 3,000 lives, Matos-Pagán conducted initial community assessments in the most remote and most affected cities in Puerto Rico. Floods and debris made many roads inaccessible, preventing these communities from having basic needs such as food, water, prescription drugs, and transportation. Then, after a series of earthquakes in 2020 shook the island, leaving even more people homeless or in substandard structures, Matos-Pagán organized local nurse practitioners to provide community health care. They supplied drugs to at-risk populations when pharmacies closed, and teams set up mobile medical tents near crowded hospitals.

“I am hyperactive and busy in my daily life, but when there is a crisis, I am calm and still. Grounded. I feel like I am where I belong, ”he said.

Abigail Matos-Pagán gives Wildelma Gastón a covid vaccine at her home in Mayagüez, Puerto Rico. Gastón is confined to bed due to arthritis and other health problems.(Alicia Carter)

Matos-Pagán was born in New York City. He became interested in medicine after seeing nurses support his mother, who died of complications from an aneurysm when Matos-Pagán was 9 years old. Her mother’s death taught her that “nothing is permanent,” she said, which has inspired her to act when disaster strikes and Support people through tragedy and personal loss.

Matos-Pagán returned to Puerto Rico to study nursing and later obtained a master’s degree and a doctorate from the University of Puerto Rico-Mayagüez. Through her work, she holds several titles: first commander of the Puerto Rican Disaster Response Team and director and founder of the Nurses Coalition for Communities in Disaster.

Her experience in managing resources and medical professionals during hurricanes has taken her to locations on the Atlantic coast of the US and the Caribbean. During the covid pandemic, she was recruited to assist in classification leadership for a poorly resourced ICU floor in El Paso, Texas, and a senior facility in Maryland.

“Not everyone is cut out for this. It’s a really sad and depressing job, ”said Matos-Pagán. “But even when there are large numbers of victims, lives can be saved and people’s basic needs met. I have seen communities come together in the most incredible ways. It’s challenging, but that’s what keeps me going. “

And, even as he’s quickly trying to get more shots in the Puerto Rican arms, Matos-Pagán is bracing himself for the next crisis. The hurricane season officially began in June and will be ready for disasters until the end of November.

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