Emily Boucher, a nurse in Abingdon, became the first person in Virginia's Appalachian region to get the COVID-19 vaccine. Photo courtesy of Ballad Health. Vaccine Distributed in Abingdon
Emily Boucher, a nurse in Abingdon, became the first person in Virginia's Appalachian region to get the COVID-19 vaccine. Photo courtesy of Ballad Health.

Operation Warp Speed’s vaccination plans were just ‘too optimistic’, Health Dept. officials say.

RICHMOND-It’s going to take longer than expected to fully vaccinate everyone in Virginia’s Phase I plan. Christy Gray, immunization division director for Virginia’s Department of Health, gave that update Wednesday.

Gray faced a litany of questions from concerned reporters during the department’s press conference Dec. 30. The press conference was called to discuss vaccine rollout and response efforts. Gray defended the work of regional health department staff and healthcare workers across the state. “Administering 47,000 doses in two weeks is not a small number,” Gray said. “We are proud of Virginia providers for accomplishing that.” 

That said, Virginia is lagging behind federal targets for vaccination. The state received nearly 100,000 fewer doses of vaccine in its initial allocation than expected. Data on vaccine administration is being reported slowly too, meaning the actual number of vaccinated people is relatively unknown. This makes it difficult to track vaccination progress by locality or to ensure the vaccine is being provided equitably to racial and ethnic minorities. 

RELATED: Virginia Won’t Get Its Full Vaccine Shipment This Month.

What’s The Vaccination Holdup? 

Reporters asked Gray repeatedly about logistical hurdles to vaccination. Why had Virginia received a much smaller allotment of vaccine than initially promised? The federal government initially projected that 20 million people would be vaccinated by the end of the year. So why have only 2 million people received a dose just 24 hours before New Year’s Eve?

On Dec. 3, the federal government told Virginia officials to expect 480,000 doses of vaccine from two manufacturers: Pfizer and Moderna. So far, about 286,000 doses have been distributed. The health department expects that number will reach 370,000 by next week. 

Ultimately, Gray said, the numbers initially provided by Operation Warp Speed were simply too optimistic. Now, the Virginia Department of Health must adjust its distribution and administration plans accordingly.

“We just had less doses that we could hand out to the different facilities, and so…we had to scale down,” Gray said. 

Distribution Questions

Gray declined to comment directly on the efficiency of the federal government. She said vaccination schedules are dependent on how quickly the vaccine can be manufactured.

Gray described actual numbers for vaccine distribution as a “moving target” and the project overall as a “fluid situation.” As health department officials learn more, she said, they’ll get better.

“We are pleased with our progress, but we have a long way to go,” Gray said. “I think we will continue to get more efficient.”

She pointed out that vaccination efforts began two weeks ago and said the holiday season presented some logistical difficulties to ramping up the program. 

Speaking to Dogwood on Dec. 18, Pfizer officials said the problem isn’t theirs. The company provided a detailed statement, saying they met every requested goal. 

“Pfizer is not having any production issues with our COVID-19 vaccine. No shipments containing the vaccine are on hold or delayed,” the statement says. “This week, we successfully shipped all 2.9 million doses that we were asked to ship by the U.S. Government to the locations specified by them.” 

Pfizer officials added that they have more supplies ready to be delivered. But they need to know where to send them.  

“We have millions more doses sitting in our warehouse but, as of now, we have not received any shipment instructions for additional doses,” the statement said. 

Concerns About Vaccination Equity

It’s also important to pay attention to who specifically has access to the vaccine. 

Gray addressed concerns about several groups of people having equitable access to a vaccine in the coming weeks: frontline workers, racial and ethnic minorities and folks living in rural areas. 

According to guidelines VDH is following for vaccine administration in Phase 1a., healthcare personnel and residents of long-term care facilities should be prioritized. 

However, some healthcare workers protested the current process. People who face little risk of exposure to COVID-positive patients are getting vaccinated prior to those on the frontlines. Healthcare administrators who do not physically interact with patients shouldn’t be protected prior to doctors and nurses, they argue.

Gray explained that a “prioritization document” was distributed to all vaccination partners. However, she conceded that “there is no way to confirm” if somebody is a frontline worker before they’re vaccinated. She said vaccinators are “asking careful questions, but there is no background check.”

VDH has asked that the prioritization document be followed as closely as possible, “with the understanding that we don’t want to waste vaccine,” Gray said. If a facility has thawed or prepared more vaccine than it can use before it expires, she said, it does greater good to vaccinate someone “early” than to waste the vaccine. 

Addressing Missing Data 

At least 54,000 people have received the first dose of their respective vaccine in Virginia. Gray repeatedly emphasized that this number isn’t entirely reliable and said folks shouldn’t reference it to make judgements about vaccination equity.

Vaccination data is lagging real-time progress because health departments across the state have to report vaccinations to a central hub, and then the state office has to do a data quality review. More than likely, many more people have been vaccinated than are reported on the dashboard, Gray said. 

Still, it’s notable that of the 54,000 people we know received the vaccine, more than 40,000 failed to report their race or ethnicity. That means the state is lacking demographic data for nearly 75% of people vaccinated so far. Gray said because of the incompleteness of the data set and how early Virginia is in its vaccination efforts, that data isn’t very meaningful yet. However, she admitted that one reason we don’t have more demographic data is because it’s not required that facilities record it. The pandemic has disproportionately affected marginalized communities, which also have historically faced unequal treatment by the healthcare system. So tracking whether these communities have equal access to the vaccine is an essential facet of the rollout. 

When Can I Get Vaccinated? 

Virginia plans to have 370,000 doses of vaccine by next week. However, public officials estimate that there are more than 500,000 people who qualify for a vaccine in Phase 1a. So when can folks in later phases expect to get vaccinated?
Again, VDH didn’t have clear answers on Wednesday. While so far Virginia has elected to follow CDC guidelines for which people will be eligible for each phase of vaccination, the state hasn’t decided on final guidance for phases 1b and 1c yet, Gray said. 

Public health officials also haven’t finalized plans for when to move from Phase 1a to future phases. That is to say, they have not decided what percentage of Phase 1a participants have to be vaccinated before Phase 1b can start.

“We don’t have a specific number in mind right now,” said Gray. “We are also considerate that one area of Virginia might hit that (target) before another area of Virginia, so we are balancing the different districts and what their needs are.” 

Gray said by Phase 2, which includes the general public, she hopes that getting a COVID-19 vaccine is as simple as getting a flu shot. “Wherever you are typically getting your flu vaccine, that’s how we see rolling this out. COVID has a tendency to give us some curveballs along the way, so I don’t want to say we absolutely know what’s going to happen,” she said. “We still have vaccines that are in the pipeline of approval process,” she added. As more vaccines are approved, that will increase the supply of the vaccine, and administration will speed up. 

Ashley Spinks Dugan is a freelance reporter for Dogwood. You can reach her at info@vadogwood.com.