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COVID-19 vaccine distribution continues across the BRHD despite challenges

Blue Ridge Health District faces limited supply of vaccines despite high demand for the key component that will return communities to their normal routines

COVID-19 vaccination efforts are underway across the Blue Ridge Health District, which includes Charlottesville and Albemarle County, and eligible individuals are receiving FDA-approved doses of the Pfizer and Moderna vaccines. Additionally, U.Va. Health began a collaborative effort with BRHD to vaccinate community members. However, limited supply has affected the speed of vaccine delivery, which is essential in returning to normal routines. 

The COVID-19 vaccine is an mRNA vaccine that provides cells with instructions for the production of a harmless protein found on the surface of the COVID-19 virus. The immune system then identifies the protein as foreign material and produces antibodies that can be used to fight off the virus in the event of future infection. 

The Food and Drug Administration has authorized the Pfizer-BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine for emergency use. Both intramuscular injections require two doses — Pfizer’s vaccine doses are administered three weeks while Moderna’s are administered a month apart. 

In a COVID-19 media briefing Jan. 14, Governor Ralph Northam emphasized the importance of the state’s vaccination efforts. He suggested that it is the way to return to pre-pandemic routines and urged Virginians to get vaccinated if they are eligible. 

“The vaccines are really our way out of this pandemic,” Northam said. “This is how we reopen our schools and rebuild our economy through the vaccine. It is the light at the end of a long and dark tunnel.” 

The Virginia Department of Health reports that 742,733 individuals have received at least their first dose of the vaccine as of Feb. 2, which constitutes 8.7 percent of Virginia’s population. Virginia is tied for sixth — alongside Vermont and North Dakota — in rankings of states by the percentage of the state population that has received one shot. 

VDH has laid out several phases for vaccine distribution, and health districts across the Commonwealth are slowly vaccinating eligible individuals based on local rates of vaccine distribution. BRHD is currently vaccinating individuals in phases 1a and 1b. Phase 1a includes healthcare personnel and residents of long-term care facilities. Phase 1b includes frontline essential workers, individuals over the age of 65, individuals 16-64 year-olds with underlying health conditions and those living in correctional facilities, homeless shelters and migrant labor camps.

BRHD officials expect completion of phase 1b to take months. Afterward, phase 1c, which includes other essential workers, will begin. There is no set date for the start of this phase. 

Vaccination efforts have already been happening for over 6 weeks in the BRHD. As of Jan. 27, at least 26,330 of the health district’s 256,000 residents have received at least one vaccine shot. 

Costi Sifri, director of hospital epidemiology at U.Va., mentioned that over the next four weeks, BRHD will receive a weekly shipment of 2,950 COVID-19 vaccines, not including second doses. This number is lower than originally anticipated because of a shift in distribution plans across the Commonwealth. Originally, distribution was partially based on requests from health districts, but it will now be distributed based on each district’s relative population. 

Vaccination efforts are also taking place at U.Va. Health. Sifri said 17,321 first doses have been administered out of the 25,075 first doses received as of Jan. 22 and that the health system vaccinated up to 1,400 individuals on a single day. These doses were administered by U.Va. Health’s 600-member vaccination team, which is composed of nurses, physicians, EMTs, nurse practitioners, faculty in the Schools of Nursing and Medicine and others who vaccinate within their scope of practice. Despite the hospital’s success vaccinating thus far, Sifri notes that the limited vaccination supply has been the greatest challenge to current efforts. 

“Our vaccine efforts initially [vaccinated] 175 people a day, and we're now able to do over 1,000 people a day,” Sifri said. “The efficiency of providing vaccines has been learned by many of us who are involved in that work, and really the limitation is going to be vaccine supply for the near future.” 

U.Va. Health has collaborated with BRDH to establish community vaccination sites, including one on Hydraulic Road to vaccinate community members over the age of 75 and a second site at Seminole Square to serve essential workers. 

Furthermore, despite the drastic health benefits of the vaccine, Sifri emphasizes that vaccinated individuals should continue to social distance and follow guidelines. He notes that the duration of immunity and possibility of asymptomatic spread of the virus after vaccination is unknown. 

“The data shows that [the vaccine is] highly efficacious and your chances of developing COVID are greatly reduced more than 90 percent,” Sifri said. “You still need to practice those personal health and safety measures that we've become accustomed to over the last months and last year, [even after vaccination].” 

Additionally, there is recent concern regarding new strains of the COVID-19 virus, which researchers suggest could spread more easily and quickly. The CDC reports that there have been 2 reported cases of the United Kingdom variant in Virginia as of Wednesday. 

Sifri notes that the vaccines have been effective on new strains in the laboratory setting. While some studies indicate that the vaccine is slightly reduced but still effective against new forms of the virus, there is still not enough research to conclude their effectiveness given all new variants. This emphasizes the need for continued social distancing and adherence to CDC guidelines. 

“If we practice [infection prevention measures] and also continue to work on vaccination then the strain can be effectively prevented,” Sifri said. 

Furthermore, during a briefing on Jan. 14, Dr. Danny Avula, director of the Richmond City and Henrico County Health Department, detailed the requirement of 50,000 doses a day in order to attain herd immunity in the Commonwealth. Herd immunity occurs when most of a population is immune to a disease providing indirect protection to those who are not immune. Immunity among the population ranges from 50 percent to 90 percent depending on the transmissibility of the virus.

Avula detailed plans to expand vaccination efforts and infrastructure across the state that would account for daily requirements to develop herd immunity. 

“Part of what doing more looks like is [setting] up fixed-site mass vaccination centers across the Commonwealth,” Avula said. “Places that will be six to seven day a week operations that initially will be planned and partnered with health departments, with Medical Reserve Corps, with health systems. Eventually, our goal is to get this staffed by the National Guard and by contracted vaccinators who will be able to provide this service [at a] large scale.” 

Residents who are interested in receiving a vaccine should continue to monitor the Virginia Department of Health’s COVID-19 Vaccination Response website to stay informed on the status of their health district.