One week after the Blue Ridge Health District said it would open up the COVID-19 vaccine to more people, officials are cautioning that vaccinating all those currently eligible will take months and require patience from the community.
In a series of media briefings Friday, local and state public health officials sought to clear up confusion about the vaccination program thus far, outline plans moving forward and update the community about COVID case numbers. Although millions of people in Virginia are eligible to receive a shot, supply of the vaccine is limited. The state receives about 100,000 doses a week from the federal government.
The vaccination process thus far has confused and frustrated people as health districts across the state deal with limited supplies, quickly training vaccinators, technology issues and evolving guidance from the state. Earlier in the week, BRHD medical director Denise Bonds apologized for the roll-out thus far.
Bonds said Friday that health district staff are working to add more links and information to the website to help people understand the process.
“I think this press conference is really the start of us trying to be transparent about how we’re providing the vaccine, and to answer questions to the community,” she said. “We are working to make sure that everyone in the community who wants a vaccine gets a vaccine.”
As the Blue Ridge Health District works to roll-out the shot, the community is seeing a record number of cases, which has forced case investigators to triage who gets a phone call.
“Because of the surge and the large number of cases, I do want people to understand that not everybody who tests positive will get a call from a case investigator at this point in time,” said Bonds. “… Right now we are really trying to focus on those individuals who test positive who are in high-risk groups or high-risk settings.”
Before, case investigators sought to call everyone who tested positive to provide guidance and to determine if anyone else was potentially exposed to the virus who would then need to quarantine. That contact tracing has been key to containing the spread of virus.
The health district has reported 2,357 new cases this month — a record — as well as 55 new hospitalizations and 11 new deaths. Small gatherings have driven the surge, which started after the Thanksgiving holiday. The district’s seven-day average of new cases and positivity rate have dropped in recent days, signaling that the surge could be beginning to taper off.
The vaccine shortage means that the health district will receive 2,950 doses a week for the first round of shots. Although local officials didn’t say how many doses they have requested or recently received, BRHD policy director Ryan McKay said the new allocation falls “significantly short” of what the district could dispense in a week.
McKay and Bonds said the health district has spent the last several weeks building the infrastructure — from hiring and training to staff to working out other logistics — in order to vaccinate several hundred people a day. In fact, the district is now able to vaccinate 1,000 people a day at its site in the former Kmart parking lot, which opened Jan. 6, and has set up similar fixed locations in surrounding localities.
As of Friday evening, 35,000 people eligible for the vaccine in the 1b priority group have registered their interest via online surveys with the health district. That figure doesn’t include everyone who is eligible as people continue to fill out the surveys and call the hotline to provide their information.
In the district 19,371 doses have been administered since Dec. 15, and 2,128 people have been fully vaccinated, according to a state dashboard that officials have said is incomplete, and the University of Virginia Medical Center accounts for most of that total. The two vaccines approved for COVID-19 require two doses either three or four weeks apart.
“Would we like it to be moving faster? Absolutely,” Bonds said. “We needed some time to get all of the resources in place.”
Other health districts have struggled to update the state’s vaccine tracking system in a timely fashion, resulting in an apparent 585,000-dose gap between the doses distributed and those administered.
Bonds said the health district isn’t behind on that data entry, and that state has instructed local departments to catch up by this weekend.
On Friday, Dr. Costi Sifri, director of hospital epidemiology for UVa, said the medical center had received 25,075 and given out 17,321 doses, which includes the second shot. About 22,693 first doses have been scheduled or administered.
That includes about 4,200 people in the health district who are 75 and older. UVa is working with the health district to vaccinate that population, which includes up to 5,800 people. This week, 1,560 people 75 years or older received their first shot, officials said.
“We stand ready to provide vaccine to our patients, to members of the community, to whomever as the Blue Ridge Health District wants us to,” Sifri said.
That pilot program kicked off with a system failure that resulted in several people not receiving confirmation emails telling them where to go for their shot. In fact, several of the confirmation emails were sent to one individual while others were blocked by spam filters. That issue was later resolved.
The district opened up the vaccine to the 1b priority group on Monday, weeks earlier than originally planned after urging from federal and state officials. The group includes people who are 65 and older, those with underlying health conditions and a range of essential workers.
Bonds said the move to 1b was made before she fully understood the severity of the vaccine shortage and how allocations would be limited moving forward.
“But we feel like that’s still the right decision because that is the group that is the highest risk of dying,” she said. “We are prioritizing, particularly within 1b, those individuals over the age of 75 that really have the highest risk.”
As they figure out how to distribute the 2,950 doses, Bonds said that the district is taking into consideration the fact COVID-19 has disproportionately affected people of color.
“And we said, it’s going to take months,” she said. “Please be patient. We’re going to try to use appropriate medical prioritization and equity as we develop all of our plans.”
The state has not yet released a complete breakdown of how many doses each health district is getting moving forward or how many they have received since the vaccine was first distributed in mid-December. That’s one of several data issues that have hindered the state’s vaccination program.
The appointment scheduling system known as the Vaccine Administration Management System has been challenging for users and the health district. The system is from the Centers for Disease Control and Prevention and adopted by the state. It doesn’t give individuals at the local level much control. To fix that issue, the state is piloting a new registration system, which the district is piloting now.
Currently, all appointments posted through February are full and the health district staff held off opening up more slots until they knew more about the availability of the vaccine.
Bonds said that individuals who have secured an appointment over the next two weeks will still receive a shot.
The state dashboard doesn’t show how many people in the first priority group — frontline healthcare workers and long-term care facilities — have received the vaccine, but Bonds said they are continuing to prioritize that group despite the expansion to 1b.
The health district is working with Sentara Martha Jefferson Hospital to vaccinate those left in the 1a group. The hospital will reach out to providers who are registered with the health district and schedule appointments.
After the hospital has exhausted its vaccine stock, Bonds said the district will hold vaccine clinics just for 1a providers.
All of these plans, however, are contingent on supply of the vaccine.
To ensure doses of the vaccine aren’t wasted, Bonds said the district has a list of people in 1a as well as people who are high-risk and in 1b that they use if someone doesn’t show up to an appointment.
“We do have the rare no-show,” she said.
Eventually, people will receive an email telling them how to sign up for an appointment, but that notification could take months as district staff members work through the list.
A mix of 1a and 1b individuals are receiving shots at the Kmart site, and the health district is looking to host vaccine clinics for specific organizations and employers who fall in 1b such as schools, day cares, migrant farm workers, homeless shelters and correctional facilities.
That will free up space at the Kmart site when more vaccine doses are available.
For people 65 and older and as well as those with high-risk medical conditions, the district is planning to allocate specific days at clinics when they can get vaccinated.
The district is continuing to ask people in either priority group to fill out an online survey, which is the first step to getting the vaccine. Those surveys are available at vdh.virginia.gov/blue-ridge/covid-19-vaccination. Individuals can also provide their information via the district’s COVID-19 hotline, (434) 972-6261.