Covid-19 demanded new ways of working. In this paper, we present the experience of the Vaxi Taxi, a community-orientated model of care developed when Emergency Medical Services (EMS) pivoted in response to the Covid-19 pandemic, converting its ambulances into mobile vaccination units in the Western Cape, South Africa. Using a five-year long embedded research approach, we drew on traditions of organizational ethnography and critical action research. Data collection included documenting observations and reflections in a research diary during implementation. In addition, in-depth interviews, focus group discussions and a series of sensemaking discussions with academic research team members were done. Our analysis draws on the Everyday Health Systems Resilience framework (EHSR) which understands resilience as an emergent process underpinned by system capacities (cognitive, behavioral and contextual) that can be nurtured through response to stress and shock. Responses take the form of absorptive, adaptive or transformative strategies. We consider the Vaxi Taxi as adaptive resilience strategy that nurtured system capacities which may have transformative potential in future. For health practitioners, it highlights the value of creative problem-solving to generate ‘slack in the system’ and creating ‘spaces of unlearning’ in supporting adaptive strategies. However, the experience also highlighted that the relational work to support meaningful community relationships that enable trust take time. Routine EMS operations don’t support this trust building, and this requires alternative approaches. Finally, the paper represents a rare empirical example of an adaptive response to crisis tracked over time, and thus offers globally relevant lessons to the still-small EHSR literature.