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Frustration is building among Virginians who believe they qualify to receive a coronavirus vaccine because of their ages, jobs or health issues but can’t figure out how to get one.
Now Hampton Roads’ cities and counties have entered the state’s second phase for administering the vaccine, or are starting next week. Phase 1b opens immunizations to people ages 65 and older, front-line essential workers and adults with high-risk medical conditions.
But regardless of local leaders’ opening the floodgates to the next stage in the process, many eligible residents are still in for a wait.
Public health officials say supplies are not coming into the state at a rate that would support such drastic expansion to all who qualify, meaning local health leaders and vaccinators are still grappling with how to prioritize recipients among the eligible. State officials have estimated over 4 million people could be in the Phase 1b category.
Local health departments also are scrambling to build the infrastructure to hold mass vaccination events. They need scheduling tools, places to host the clinics — which they’re calling “points of dispensing,” or PODs — and staff to make them happen. All of these efforts are underway, but details from officials have been slow to emerge.
The Peninsula, Norfolk and Virginia Beach recently announced ways people in Phase 1b can sign up to be informed about their opportunity to get inoculated. But, perhaps confusingly, that “pre-registration” is only the first step in a process to eventually make an appointment.
Dr. Danny Avula, state vaccination coordinator, said Virginia had over 300,000 doses ordered from the federal government for this week, yet only 106,000 were fulfilled. State health department officials say they expect that pattern of receiving about 110,000 doses per week to continue for about a month, and a large ramp-up may not happen until March or April, when other pharmaceutical companies’ vaccines are anticipated to be ready.
Those 110,000 doses spread across the state won’t go very far. Public health officials are using a geographic and population-based calculation to distribute supplies. Chesapeake, for example, has about 3% of the state’s population, so they will be receiving about 3% of those doses. Do the math and that means a city of 250,000 people will get roughly 3,000 per week.
With so many differences in how cities and counties are facing the extraordinary demand, inconsistency is sowing confusion.
At a meeting Wednesday involving part of the Virginia Vaccine Advisory Workgroup, a panel that provides guidance for state health officials on the COVID-19 vaccine, members were concerned about transparency.
“If (public health officials) could just elucidate why they’re not able to give the shots right now. Is it because they don’t have enough doses? I mean people should be open about it. I think there’s a lot of people who get stressed, fearful, anxious, when they don’t have the information,” Dr. Stuart Henochowicz said. “We just got to say, ‘Well, we have this much dose of vaccine.’”
Some residents have even been upset to learn their health district has offered vaccines to portions of 1b, such as teachers, while lingering in Phase 1a — even though the state has given local health leaders the discretion to gradually move from one group to another.
The optics have caused some to question the fairness of the system. In actuality, state public health officials said they decided to give vaccinators more flexibility on how to approach Phase 1b because they felt the priority groups were so rigid, they were slowing the process down.
The new message for vaccine providers coming from the top: If in doubt, err on the side of giving shots.
Gov. Ralph Northam had expanded eligibility for Phase 1b on Jan. 14 to include people ages 65 and older and adults with high-risk medical conditions, which he said would allow about half of the state’s population to get the vaccine. But news reports Friday indicated the increase in supply expected from the federal government likely won’t be coming.
Virginia Health and Human Resources Sec. Dan Carey said Gen. Gustave Perna, who has led Operation Warp Speed, spoke to Virginia Health Commissioner Norman Oliver last week to “walk back” the expectation that so-called reserves of second doses were going to be released to help speed up states’ efforts.
“There is not a warehouse full of frozen vaccine to distribute,” Carey told reporters Saturday. “It’s all based on just-in-time production.”
But Virginians are skeptical of whether supplies are the prevailing issue. The Virginia Department of Health’s data show the state has received a little over 1 million doses from the federal government as of Friday, yet only about 40% has been put into people’s arms.
Public health officials say they believe many more shots actually have been given but not recorded, due to technology and reporting problems. About 226,000 of those doses were committed already for the CVS and Walgreens federal program that gives vaccines at nursing homes. The state has no control of that allotment, they said.
By their own admission, a lot of doses are “unaccounted for,” Carey said, with state officials trying to wrap their heads around the discrepancy between the amount of supplies distributed and those administered.
Avula said the 110,000 doses the state is receiving each week don’t include second doses, which are coming to Virginia on a separate track. This week Virginia received 61,000 second doses, he said. They went directly to the vaccinators who administered the first doses, timed to arrive three or four weeks after their shots.
Because of scarce resources, Avula said vaccinators should use all the doses they have. If people don’t schedule or show up for their second appointments, he said, vaccine providers are being advised to go ahead and use that stock up, even for other people’s first doses. Public health officials don’t want any vials of vaccine to sit in a freezer or thaw and expire.
“Right now, the imperative is really to use all of the doses you have,” he said.
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Virginia Vaccination Plan
Phase 1a: Health care workers, emergency medical technicians and long-term care residents and staff.
Where? Statewide.
Most health care workers are being vaccinated through their employers, and some others are getting it through local health departments. Long-term care residents and staff are receiving vaccines through a federal partnership program with CVS and Walgreens. The chains are providing vaccines directly at those facilities.
Phase 1b: Front-line essential workers, people ages 65 and up, incarcerated people, people in homeless shelters and people in migrant labor camps.
Where? Statewide as of Monday.
Front-line essential workers include police, firefighters, hazmat, homeless shelter workers, inmates in correctional facilities, child care workers, pre-K-12 teachers and staff, food and agriculture workers, veterinarians, manufacturers, grocery store workers, public transit workers, mail carriers, judges and other workers needed to maintain “continuity of government.”
Local health departments, pharmacies, hospital systems and employers are cooperating to vaccinate front-line essential workers. Many people over age 65 will be offered the vaccine through their health care providers. Others will be able to access shots through their local health department or through arrangements with health care systems and pharmacies. State, regional and local correctional facilities will handle vaccines on their sites.
Phase 1c: Other essential workers.
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Where? Nowhere yet.
The other essential workers include energy; waste, wastewater, and waste removal workers (includes recycling removal workers); housing construction; food service; transportation and logistics; institutions of higher education faculty and staff; finance; IT; media; legal services; public safety engineers; and other public health workers.
Many essential workers will get their vaccines from their employers. Local health departments, pharmacies and health care systems are working collaboratively to vaccinate them.
For more information on the state’s vaccine plan, visit https://www.vdh.virginia.gov/covid-19-vaccine.
To view the vaccine phase map, visit https://www.vdh.virginia.gov/covid-19-vaccine/phase-by-health-district.
To learn what vaccine priority group you’re in, visit https://vdh.jebbit.com/amkwk6m1?L=Owned+Web&JC=Vaccine.
Elisha Sauers, elisha.sauers@pilotonline.com, 757-222-3864