Virginia received approximately 285,725 doses of the COVID-19 vaccine in early December and hospitals and health care departments have been working to distribute them since. However, as of Saturday, less than 25 percent of those vaccines have been recorded as administered, and Virginia is ranked 41 out of 50 states when it comes to the percentage of the state’s population that has received the vaccine.
This lag in vaccine administration is primarily caused by two factors — the difficulties associated with coordinating the logistics of vaccinating large amounts of healthcare professionals and delays in reporting. However, healthcare workers at statewide facilities, including U.Va. Health, are steadily implementing quicker and more efficient vaccinations of front-line workers.
As part of executing Phase 1a in Virginia’s vaccine implementation plan, which was made by the Virginia Department of Health, healthcare workers and those in long-term care facilities are being given vaccination priority, followed by Group 1b which includes essential workers. Although many healthcare professionals — who are at greater risk of exposure to COVID-19 through direct engagement with patients — have been eager to receive the vaccine, a few setbacks have resulted in delays.
The nationwide goal of achieving vaccination of approximately 20 million individuals by the end of 2020 was not achieved largely due to the numerous considerations involved in safely administering a vaccine of unprecedented size, scope and complexity, as emphasized by Virginia Governor Ralph Northam.
“We are now three weeks into the most extensive public vaccination campaign in modern history,” Northam said at the Virginia COVID-19 briefing on Jan. 6.
Logistical challenges include having to allow time for healthcare workers to gain familiarity with the protocols for properly administering the vaccine and ensuring proper communication with healthcare workers working statewide at hospitals and clinics.
Brookie Crawford, public information officer for the Central Region of Virginia at VDH, agrees that vaccinating the 8.5 million residents of Virginia is a complex task. However, VDH continues to contact the priority workers in Phase 1a who have yet to receive vaccines in order to ensure that none of the distributed doses are left in storage, unadministered.
“Our health departments are coordinating with the providers in their districts to identify and vaccinate these healthcare personnel as quickly as possible,” Crawford said in an email to The Cavalier Daily.
Other reasons for lags in the vaccine rollout relate to the multidisciplinary effort required. The administration of the vaccine involves scientists, researchers and doctors working together to conduct quality control of the vaccine and oversee proper administration of both doses. The fact that the vaccine requires two doses given at specific times apart from each other — 21 days for Pfizer and 28 days for Moderna — presents another logistical consideration, as hospitals must ensure patients return for their second dose at the correct time and that the dose itself has been appropriately stored and is available to be administered then.
In addition, the vaccine made by Pfizer-BioNTech requires storage at 2 to 8 degrees Celsius for maximum efficacy, further adding possible impediments to efficiently rolling out the vaccines. Pfizer recommends facilities to purchase ultra-low-temperature freezers to extend vaccine shelf life, but if this is not an option, they must be stored in refrigerators, or temporarily use the Pfizer thermal shippers which the vials arrive in, replenishing with dry ice.
An additional reason the statewide vaccine administration rate is only about a quarter of distributed vaccines is because the number of vaccines that are shown to be administered on the official dashboard sometimes lags behind due to delays associated with entering information into the system. In addition, the new vaccines have required staff to go through hours of training on using the new Vaccine Administration Management System mandated by federal agencies. This system is intended to provide services to help all clinics plan and execute vaccination services with attempts to collect real-time data on early mass vaccine administration for Operation Warp Speed.
“The number of doses of COVID-19 vaccine administered, which are displayed on this dashboard, will always lag behind the actual number of doses administered,” Crawford said.
Though staff who were eager to receive the vaccine expressed some frustration regarding the lag in rollout, Dr. Costi Sifri, director of hospital epidemiology in the University Health System, notes that this is understandable and they are actively working to meet the demand.
“I think especially in the first week, week and a half of vaccine administration, we did hear frustration that it could not go more quickly and that’s understandable,” Sifri said. “There is a tremendous desire within the medical community to receive vaccines.”
Plans to expedite the administration of vaccines statewide by alleviating the logistical roadblocks are currently in motion.
One of the modifications to accelerate the Virginia vaccine rollout plan is potentially extending Phase 1b to include individuals 65 and up and those with preexisting conditions in addition to the front-line workers originally included in 1b. Northam notes that these adjustments would qualify approximately half of all Virginians to be eligible to receive the vaccine by the end of January.
Another one of the modifications includes encouraging hospitals and clinics to efficiently deplete the shipments of vaccines they receive and deter the practice of saving doses, with aims of vaccinating everyone eligible as quickly as possible. VDH is expected to receive around 100,000 doses per week, supposedly allowing for it to replenish stocks of statewide healthcare systems, according to Crawford.
Northam had a message for the healthcare staff conducting vaccinations, with the ultimate goal of expediting the vaccination process in coming weeks.
“Move quickly please, empty those freezers, clear those shelves, deploy those doses, show us shots in Virginians’ arms,” Northam said at the Jan. 6 briefing.
The U.Va. Health System understands the urge for efficiency and states that its plan is to maximize usage of the allotted supply. The first shipment consisted of 3,305 doses of the Pfizer vaccine and 2,500 doses of Moderna.
“We’re not going to be able to turn this pandemic around if we just let vaccines sit in a freezer, so that is why we have been using the vaccines we have been allocated as quickly as we can,” Sifri said.
The U.Va. Health System has been working to maximize vaccination capabilities within their eligible staff since the arrival of the first shipment, despite countless challenges which the pandemic has brought.
“As we have received more [vaccines], as we have expanded our efforts, we’ve been able to rapidly accelerate vaccine delivery at a very difficult time — in a time that we’re taking care of more patients with COVID than we’ve ever taken care of, at a time when our resources are stretched to a limit … and when we have a lot of team members who themselves have COVID,” Sifri said.
The U.Va. Health vaccination team was recently able to increase their rate of vaccinating staff to 900 to 1,000 people a day — a sharp increase from the 175 that were delivered Dec. 15, the first day vaccines were administered. Dr. Reid Adams, U.Va. Health’s chief medical officer, acknowledges the impact of staff’s flexibility to volunteer in accelerating vaccination in the community.
“The team effort that has been required to manage this has been tremendous,” Adams said. “Everyone has pitched in to help and been very flexible. That has allowed us to do this in a fashion that has been orderly and safe.”
Going forward, the timeframe in which the state will be transitioning to Phase 1b of vaccinations varies amongst health districts in the Commonwealth, but will likely be occurring in the next couple weeks.
“Some health districts … are ready to move forward with Phase 1b very soon and others have a lot more work in terms of vaccinating 1a,” Sifri said. “I think we will see that very soon, within the next week or two would be my prediction, depending on where in the Commonwealth.”
The Blue Ridge Health District — which includes Albemarle County and the City of Charlottesville — announced Friday that it will expand COVID-19 vaccination plans to include Phase 1b recipients starting Monday.
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