Virginia Changes Approach Of Vaccine Distribution To Localities

VIRGINIA — The distribution strategy for the COVID-19 vaccine has changed in Virginia as requests for doses were higher than the weekly supply being allocated by the federal government.

Dr. Danny Avula, who was chosen by the governor as Virginia's vaccination coordinator, provided the vaccine update on Friday, Jan. 22 to reporters. During that week, he said Virginia changed the approach from allocating doses to any place that requested it to a geographically, population-based distribution. Doses are given to local health departments, who then work with partners to determine where the vaccine goes for each distribution.

"The population density or the population distribution is what defines that number, that percentage of the total allocation for the state," Avula told reporters. "And then the health department works with their local partners, their health systems and other pharmacies and providers to determine, where do we want this vaccine to go? Where should it be prioritized for this week?"

As local health districts advanced to phase 1b of vaccinations, eligibility opened up to a greater share of the population. Phase 1b originally included residents 75 and older, certain essential workers and people in correctional facilities and homeless shelters. That was expanded to any residents 65 and older and people 16 to 64 with underlying medical conditions.

That has led to more requests for appointments than available doses. For instance, the Fairfax Health District last week reported a wait list of approximately 115,000 people preregistered for the first dose. The state as a whole receives about 105,000 doses per week from the federal government.

"Up until last week, we were able to...allocate the vaccine to everybody who wanted it," said Avula, referring to providers who administer the vaccine. "But last week, we had over almost 300,000 dose requests and only 105,000 doses to allocate."

For Fairfax County, the state's distribution change will have an impact on the allocation. Fairfax County Board of Supervisors Chairman Jeff McKay said in a letter to residents that the health department and Inova Health System will have to roll back vaccination operations due to changes at the state and federal levels. In addition, Inova canceled all first dose appointments as of Jan. 26 and will prioritize people who need the second dose.

The state has a goal of providing 50,000 doses per day and has the capacity to administer more doses once vaccine availability ramps up. Avula noted that there is "tremendous capacity" in place with health systems and health departments, along with 2,000 different provider groups that have been approved as vaccinators. The state is also planned mass vaccination sites, where the National Guard will be deployed starting in February. Those are anticipated to be daily large-scale operations once vaccine supply increases to the needed level.

" I don't have any concerns about us being able to get to 50,000 doses a day, except that we don't have the vaccine," said Avula.

As people in the phase 1b group waiting on vaccine appointments, Avula said it could take two to three months to work through this population — if there isn't a significant chance in the vaccine supply.

"I think the challenge of this is, when you're only getting a couple thousand new doses a week to be distributed between hospitals, health systems, health departments, providers, and pharmacies, how do you do that in a way that even comes close to meeting demand? And the answer is you don't," said Avula. "And understandably, that has led to a great deal of confusion and frustration on the part of our public, who says, hey, I'm in 1b. Why can't I find a place to get vaccinated? So really the approach that health departments and partners are taking on the ground, is to provide some capacity each week for the 65 and up and underlying condition population."

As of Tuesday, 497,581 people in Virginia have received at least the first vaccine dose, and 71,459 people are fully vaccinated. There have been 1,156,500 doses distributed to date.

Becker's Hospital Review ranks Virginia 49th for vaccines administered. Virginia has 45.15 percent of distributed vaccines reported as administered, ranking behind all states but Kansas based on the percentage. An average of 24,790 doses are being administered each day, according to VDH data.

Update on numbers

Virginia's cases and hospitalizations have shown signs of declining after record highs in January. But the appearance of a more contagious variant of the virus has experts at the University of Virginia Biocomplexity Institute projecting weekly cases above 65,000 for 10 weeks in the latest COVID-19 model.

On Monday, the Virginia Department of Health confirmed the first case of the B.1.1.7 variant identified in December in the United Kingdom. Evidence has shown the variant is more easily spread than other SARS-CoV-2 variants, and the Centers for Disease Control and Prevention believes it could be the predominant variant in March in the U.S. However, early data does show the vaccines authorized in the U.S. are effective against the variant.

The Virginia Department of Health reports daily COVID-19 data and trends of cases, hospitalizations, deaths and more. On Tuesday, there were 4,707 new cases and 93 new deaths reported statewide. Northern Virginia accounted for 1,174 cases and 15 deaths.

Current hospitalizations stand at 2,843 after numbers were in the 3,000s for two weeks in January. The total includes 539 patients in the intensive care units and 316 on ventilators.

The 2,843 COVID-19 patients represent about 21 percent of the 13,355 occupied hospital beds in Virginia. There are 16,476 total staffed hospital beds in the state. Ventilator use among all Virginia hospital patients stands at 35 percent, and intensive care unit occupancy is at 83 percent, according to the Virginia Hospital and Healthcare Association.

The seven-day positive average of PCR tests is on the decline since Jan. 7. As of Jan. 22, the average is 12.5 percent, while Northern Virginia's average stands at 11.8 percent. On a statewide level, there is a seven-day average of 29,722 daily PCR testing encounters. Northern Virginia alone has an average of 7,230 daily testing encounters.

Below are the latest coronavirus data updates for our coverage area from Monday to Tuesday.

• Alexandria: 9,190 cases, 484 hospitalizations, 101 deaths; increase of 69 cases
• Arlington County: 11,341 cases, 715 hospitalizations, 197 deaths; increase of 72 cases
• Fairfax County: 57,559 cases, 3,214 hospitalizations, 760 hospitalizations; increase of 395 cases, five hospitalizations and eight deaths
• Fairfax City: 402 cases, 27 hospitalizations and 10 deaths; increase of seven cases
• Falls Church: 276 cases, 18 hospitalizations, six deaths; increase of two cases
• Loudoun County: 19,161 cases, 725 hospitalizations, 171 deaths; increase of 313 cases and two hospitalizations
• Manassas: 3,587 cases, 153 hospitalizations, 33 deaths; increase of 17 cases and one death
• Manassas Park: 1,062 cases, 66 hospitalizations, eight deaths; increase of two cases
• Prince William County: 34,036 cases, 1,298 hospitalizations, 291 deaths; increase of 297 cases, two hospitalizations, and six deaths
• Fredericksburg: 1,446 cases, 72 hospitalizations, 14 deaths; increase of 28 cases
• Spotsylvania County: 6,820 cases, 236 hospitalizations, 79 deaths; increase of 123 cases, one hospitalization and one death
• Stafford County: 7,489 cases, 264 hospitalizations, 44 deaths; increase of 148 cases, two hospitalizations and two deaths