Decentralized planning between state and federal governments left chronically underfunded public health departments to organize mass testing efforts when there were few supplies in the first few months of the pandemic.
Nearly a year and half a million COVID-deaths in the U.S. later, communication among the entities remains fractured and marked by confusion as the largest vaccination campaign in history depends on a coordinated approach.
Virginia public health officials, hospital leaders and politicians have scrutinized the inconsistent messaging that has disjointed a rollout meant to beat back the virus.
Among the latest were Reps. Abigail Spanberger and Elaine Luria in a letter on Monday to Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.
Luria, D-2nd, and Spanberger, D-7th, called on the CDC to sync its immunization response with states to ensure efficiency and honor prioritization guidelines, which has largely been left up to states and local health districts to carry out.
The Federal Retail Pharmacy Program expands its vaccination reach in Virginia through Walgreens, Walmart and Kroger this week, but the allocation is separate from the state’s and beyond Virginia’s control — a factor that has resulted in frustration, wrote the Congresswomen.
“The varied eligibility requirements and appointment-making procedures favor the technologically savvy and well-resourced who can navigate the different systems,” said Luria and Spanberger. “Retail pharmacy partners have been reluctant to coordinate their outreach and appointments with state public health officials’ priorities, meaning vulnerable individuals patiently waiting their turn according to health department guidelines could be passed over.”
Lags in information and link sharing opened the possibility for duplicate appointments to be made and various outlets for residents to sign up for a dose, which the Congresswomen runs the risk of vaccines going to waste.
CVS Health, which is part of the federal push, launched its 36 locations for in-store vaccinations on Feb. 9 to chaos after opening its online portal early and residents grabbed slots they weren’t eligible for.
Dr. Danny Avula, the state’s vaccine coordinator, called the premature release “a core fundamental issue with how this was rolled out” that benefitted “people who get up super early” and were “trolling the internet.”
The pharmacy chain also had not accounted for the hundreds of thousands already on pre-registered waiting lists through local health departments. In a statement Monday, CVS spokeswoman Amy Thibault said Virginia is the only state to ask its pharmacies to accommodate pre-registered residents.
President Joe Biden’s administration sought to channel vaccines to underserved communities through retail pharmacies to increase vaccine supply and expand access.
But states were largely shut out of that process.
On Friday afternoon, Avula said the VDH saw a White House news release last Wednesday announcing how Walgreens would start vaccinating Virginians.
Logistics regarding how its immunizations would work with the state’s system was still unclear on Tuesday, the first day eligible Virginians were able to schedule appointments on walgreens.com/schedulevaccine.
In-store vaccinations start Wednesday. Walgreens has 3,510 doses for the state this week.
Nine governors, not including Gov. Ralph Northam, wrote to Biden last Monday outlining similar dissatisfaction before calling on the administration to be transparent and include state governments in the decision-making.
Although the CDC acknowledged the existing racial and ethnic disparities of the pandemic when developing guidelines, none exist for how states can close the gap when administering vaccines.
As of Tuesday, 72% — or nearly 750,000 — of Virginians vaccinated were white. Less than 18% were Black or Latino, despite high rates of hospitalizations and deaths among those groups.
The VDH is finalizing plans to allocate more vaccines to localities seeing that disproportionate impact among Black and Latino residents ages 65 and up in the coming weeks to help offset these disparities.
This prioritization shift has not been outlined by the federal government and currently relies on local health departments to decide for themselves, as they did with registration systems in January.
As of Tuesday, nearly half a million Virginians are fully vaccinated. At least 1.1 million have received one dose, which is 13.3% of the state population.
Of the more than 2.1 million vaccines received, Virginia has administered 77%.
The national average, according to the Centers for Disease Control and Prevention, was 79% on Tuesday.
For shipments allotted to first doses, the state’s percentage jumps to 92%.
By the numbers
Virginia is averaging 1,962 new COVID-19 cases over a seven-day period, which falls back to numbers last seen in mid-November. While a decline from the record case average of 6,161 in January, these numbers are higher than the first 8 months of the pandemic.
Prior to Oct. 31, the state had yet to pass a 1,200 case average.
On Tuesday, 1,769 new infections were recorded, bringing the state’s total caseload is at 567,039. The number of Virginians who have died from the virus reached 7,658.
Nearly 1,200 were reported in February, which the VDH said is high due to the processing of post-holiday spike death certificates.
Hospitalizations increased slightly on Tuesday by 81 patients, according to the Virginia Hospital and Healthcare Association. This is a total of 1,621 people currently hospitalized and the seven-day average of hospitalizations is at 1,661.
Last month, the average was at 3,026.
Richmond has had 14,577 cases, 670 hospitalizations and 164 deaths. Chesterfield County has had 23,172 cases, 774 hospitalizations and 260 deaths.
Henrico County has had 21,040 cases, 843 hospitalizations and 403 deaths. Hanover County has had 6,545 cases, 251 hospitalizations and 116 deaths.