Block to block, cars lined up one after the other, jamming the streets of downtown’s Gaslamp Quarter. A parade of 42 tents in the parking lot adjacent to Petco suggested nothing so much as a massive tailgate party.

Into this scene walked Dr. Dianne Rosenberg, rain boots helping her navigate the nearby trolley tracks, a bag full of coats under one arm. She was already half-drenched, and she had an eight-hour volunteer shift waiting—eight hours, that is, of seeing to it that COVID-19 vaccines went into the arms of San Diego County residents.

“This is our World War II, and I want to help,” Rosenberg told me. “We’ve got to help the community. A little rain isn’t going to hold me back.”

If the U.S. vaccine rollout is to evolve from the chaotic mess it was under the prior administration to something approaching an effective process, it will be achieved in part on the shoulders of super stations like the one at Petco Park. There, in just its first two weeks, the county administered 57,961 doses, an average of 4,600 per day. The station is operating seven days per week, 12 hours per day.

“Vaccinating nearly 3.5 million San Diego County residents quickly is a monumental task,” San Diego Mayor Todd Gloria said in an email. “Opening the Petco Park site in a very short time as the first vaccination super station was critically important, and it wouldn’t have been possible without close collaboration among the city, the county, the Padres, and UCSD,” he said, referring to the University of California, San Diego.

Indeed, it took the logistical know-how of the Padres’ event operations teams, UCSD’s medical knowledge, and the county’s planning experience. All were combined into “a great opportunity and partnership, both public and private,” said Erik Greupner, the baseball team’s president of business operations, in a phone interview.

As one of the waves of volunteers, nurses, physicians, paramedics, and others working the lines at Petco, the enormity of the challenge is not lost on me. With new, more transmissible, and potentially more lethal viral variants on the scene, it’s imperative that vaccine initiatives gain speed rapidly. If we can reduce the amount of virus in circulation, we may not only prevent infection and save lives but also limit the opportunities the virus has to mutate. Yet time is of the essence.

At Petco’s Tailgate Park, cars line up and are brought into the super station area 12 at a time. Passengers are greeted by staff, screened for allergies or contraindications, and then given the vaccine. All patients are observed for at least 15 minutes afterward while remaining in their vehicles, and then the entire row of 12 cars departs together—to be quickly replaced with a new dozen. With generally eight rows of 12 cars each, turnover is constant. In the same way that a Ferris wheel continuously drops off and loads passengers, the vaccination process rolls on.

It does so under pressurized circumstances, yet the collegiality and commonness of purpose come through—and a sense of humor helps. “Are you a nurse?” a male visitor asked Rosenberg, who said she was not. “Oh,” the man replied. “I heard nurses give the best shots.” Rosenberg chuckled. “The good news for you is that I’m actually a gynecologist,” she said, “so my guess is, this is your first appointment with a gynecologist. It’s going to be special.”

Our teams are stacked. Often we have a nurse, a physician assistant, or a doctor, sometimes a pharmacist, and even a computer expert. There are supervisors, scribes, observers, vaccinators—a full roster, and well protected under layers of PPE. Medic crews are on standby, in the case of a serious adverse reaction to the vaccine. (In its first week of operation, a higher-than-usual number of apparent allergic reactions occurred with one of the lots of vaccines, which was swapped out in an abundance of caution.)

Education around vaccinations is important. People have many questions. They want to know about the vaccine and whether the Pfizer or Moderna one is better (at this time, the two appear to be similarly efficacious). They’re curious about common side effects, such as fatigue, fever, pain at the injection site, and headache. They want to know whether one can contract COVID-19 from the vaccine (no), whether it’s okay to take a shower after the shot (yes, please do), or how to make an appointment for the second shot. The super station has plenty of qualified people to address these concerns.

In my experience, one overwhelming reaction from patients is gratitude. Most are surprised to know their shot already was administered, saying they felt almost nothing. Smiles are found in abundance, and it is clear that along with the vaccines, some hope has arrived. 

Sometimes that hope goes too far. For some, it feels like a “get out of jail for free” card has finally been handed to them. In reality, while the first dose of the vaccine will provide some level of immunity, the full effect is not expected until approximately two weeks after the second dose. For the Moderna vaccine, which is being offered currently at Petco, that would mean approximately six weeks from the time of that first shot.

With the current eligibility criteria, most people getting the vaccine at the super station are older: in their seventies, eighties, or nineties. It’s a good thing. Many elders have been isolated from their friends, children, and grandchildren for nearly a year. Loneliness and depression in this group have been well-documented, and so anything that allows them to look forward optimistically is welcome. And considering that their mortality if infected with COVID is much higher, the shot will save many lives.

Currently, the super station is vaccinating not only health care workers but also anyone aged 65 or older. We see younger family members driving these patients through, waiting in line with them, encouraging them, helping them with online forms, and even taking photos. Many of these helpers have their phones in hand, asking mid-injection, “Wait, Grams, look this way. Smile.” Perhaps their vaccine shots will go viral. Would a pair of Bernie mittens help?

“I am so thankful for the city staff and volunteers working at the site, lately during some pretty harsh weather,” said Gloria. “The appreciative response from San Diegans receiving the vaccine there has been truly heartwarming.” 

That appreciation could get you fat. On a recent day at Tailgate Park, an older couple brought celebratory popcorn to share; a woman offered homemade chocolate chip cookies to the staff; one couple planned to send over a hot meal to Rosenberg from a restaurant they own; and another shared that it was her birthday—the shot and some lemon meringue pie were her way of celebrating 2021. She was promptly serenaded by the staff, out of tune but fully in the spirit of the moment.

San Diego’s strange “winter” weather interrupted operations for a bit, but from a boots-on-the-ground perspective, not much else is stopping them. A second super station recently opened in Chula Vista, in the area’s South Bay, and plans are in the works for stations in San Diego’s East County and North County. 

“The hope is that this will be a model both for the region and the country,” Greupner said. 

A few weeks into operation, this is very clearly a home run—and, perhaps, our best hope for achieving mass vaccinations throughout the U.S.

Carolyn Barber has been an emergency department physician for 25 years. She is cofounder of the homeless work program Wheels of Change and author of the book Runaway Medicine: What You Don’t Know May Kill You, which was a top-ranked Amazon bestseller in health care administration.