Why Virginia is changing its approach to vaccine distribution

RICHMOND, Virginia – The Virginia State Vaccine Coordinator has said the Virginia Department of Health will change the way it allocates doses of the COVID-19 vaccine due to the current vaccine shortage and that if the supply was not increasing, it could take between two and three months to complete immunization of those eligible for phases 1A and 1B of the deployment.

“For now, most beneficiaries should know that they are going to, quite reliably, get what they get for the next four weeks or so,” Dr Danny Avula said in a telebriefing Friday. “We have to manage and temper expectations, because with only several hundred, or in some cases, a few thousand doses per community, there won’t be as many windows for people to get vaccinated. And so, the people who are. in 1B and we are looking to get vaccinated, we must realize that it will be likely, without a significant change in the vaccine supply, that we consider two to three months to work on this population. “

The Virginia Department of Health’s COVID-19 vaccine dashboard on Friday said 1,010,150 doses had been distributed in the state, with 424,857 doses administered, or just over 42%. According to Bloomberg’s National Immunization Tracker, the national average at the start of Saturday is 49.7%. The seven-day average of daily injections given in Virginia is 19,405.

During the briefing, Avula said his role, which he began two weeks ago, to improve vaccine deployment in Virginia, is organized into three phases: filling reporting gaps, processing the problem of supply and demand and establish the immunization infrastructure of the state. prepared for an increase in supply.

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Gaps in reporting

Avula said much of his job since the start of the work has been to report on the destination of vaccine shipments from Virginia and whether or not to be promptly reported when administered.

“Right now, if you look at the data, you see that there are just under 600,000 doses that are not being counted,” Avula said. “There’s a real need to understand why that is, where these doses are located and how the public understands the current state of the vaccine supply in Virginia.”

Avula reiterated what he and other state leaders had said in the past about the gap between distributed and administered fire and said they would never completely close that gap as shipments arrive each year. week. He said the difference would be between 170,000 and 200,000 depending on the number of first and second doses given each week.

“The second extra doses we get vary. Sometimes it’s 60,000. Sometimes a little more,” Avula added.

Avula had said Thursday that there were around 90,000 doses that were administered to Virginians, but not entered into the state’s database. He said a new ten-person team was deployed this week to help resolve this issue.

He also said the majority of the doses of Virginia reserved for the federal partnership with Walgreens and CVS pharmacies to vaccinate residents and staff of long-term care facilities have yet to be used.

“226,000 doses have been booked and set aside for CVS and Walgreens. Now not all of these doses have been delivered, not all of them are being reduced, but they are being set aside,” said Avula, who added that as of Thursday, they had administered about 66,000 doses. “There are a large number of cases, probably around 100,000 at this point, that have been distributed in Virginia, but have yet to be administered.”

Avula said they have spoken with state leaders of these two pharmacies and said they are working to speed up their vaccination rates and aim to get through all nursing homes and assisted living facilities by the end of the year. month of January. He said some of the challenges they face include outbreaks in facilities, which delay when vaccinators can enter, and that the willingness of people in those facilities to be vaccinated is low.

“We have heard different anecdotal figures that it seems that the residents, the elderly residents of these facilities have a higher turnout – 70-80%. But, the staff is lower. Down 30-40%,” he said. said Avula. He added that some staff would later be willing to be vaccinated after seeing their colleagues do so. Avula said they are also in discussions with CVS and Walgreens to reallocate some of those federally-reserved vaccines to other pharmacies to speed up the process. “They’re looking at their projections of how much vaccine they’ll need to get through their three phases… and that they’ll be willing to allow us to reallocate to other pharmacies. So I will probably know on Monday what that number is and how to go about achieving it. “

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Demand is greater than supply

Avula said Virginia received 105,000 doses last week, as it received statewide requests for nearly 300,000 doses and expects to face a similar discrepancy in the next few years. weeks, so VDH will start assigning doses based only on the percentage of the population. .

“So for each community, we know what percentage of the population they have and then we assign that percentage of that week’s allocation to them,” Avula said. “What we also did is that we really relied on our local health services like the ESF [Emergency Support Functions]… Lead in their community to coordinate the response. “

Avula said local health departments have been made aware of the amount of vaccine their districts will receive and are working with their partners to determine how the doses will be distributed across their districts.

“So it looks different from district to district. In some cases, health departments and hospitals are working hand in hand to achieve large-scale PODs. [point of dispensing]”Avula added.” In different areas you will have different vaccination channels. Some of this will happen through large-scale vaccinations, others through partnering with pharmacies that focus on segments of the population.

“Health services are working hard to determine how to prioritize this vaccine. We continue to prioritize 1A individuals who did not, who may not have been vaccinated in the first round and, therefore, they will be integrated into clinics as soon as possible, “says Avula.” And then we have this really big 1B group. And I think the challenge is you only get a few thousand doses a week to split between hospitals, health systems, health services, providers, and pharmacies – how do you do this in a way that even comes close to asking? And the answer is no. You can’t. And, naturally, that has led to a lot of confusion and frustration on the part of our audience who says, “Hey, I’m in 1B. Why can’t I find a place to get the vaccine? “”

Avula said health departments and their partners should provide capacity every week for the 65+ portion of 1B and, simultaneously, provide immunization opportunities for essential frontline workers.

Avula was asked whether in the future, due to limited vaccine supply, health districts should stop the practice of allowing people outside their jurisdiction to attend open POD events to obtain the vaccine. . Avula said he would watch to see how this problem emerges.

“If there are situations where it seems to be abused or creates great inequalities, because the inhabitants of a neighboring district have more capacity to cross the campaign line,” Avula said. “So we’ll have to revisit that and revisit… are we more restrictive on where we live?”

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Prepare for mass vaccination clinics

Finally, Avula said that the third phase of VDH’s planning is to build the infrastructure for the mass vaccination clinics that will be needed to meet Governor Ralph Northam’s goal of 50,000 vaccinations per day and inoculate 70% to 80 % of the population and achieve collective immunity.

Avula said there is also huge capacity in the state’s health systems and health departments, but they also have around 2,000 provider groups and 400 pharmacies that have been approved to provide vaccines.

“I have no concerns about our ability to get 50,000 doses per day,” Avula said. “Except we don’t have the vaccine.”

Precautions against covid19

Most patients with COVID-19 have mild to moderate symptoms. However, in a small proportion of patients, COVID-19 can lead to more serious illness, including death, especially in people who are older or have chronic illnesses.

COVID-19 is spread primarily through respiratory droplets produced when an infected person coughs or sneezes.

Symptoms include fever, cough, and difficulty breathing. Symptoms appear within 14 days of exposure to an infectious person.

Health officials in Virginia have urged the following precautions:

• Wash your hands often with soap and water for at least 20 seconds.
• Use an alcohol-based hand sanitizer only if there is no soap and water.
• Avoid touching your eyes, nose and mouth. Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze.
• Clean and disinfect frequently touched objects and surfaces.
• Stay home when you are sick.
• Avoid contact with sick people.
• Avoid non-essential travel.