Exhausted vaccine reserve could unravel plans for Phase 1b expansion in Virginia

News that the federal government has already exhausted its supply of “reserve” COVID-19 vaccines sent Virginia officials scrambling on Friday — less than 24 hours after Gov. Ralph Northam outlined plans to expand vaccine eligibility.

The Washington Post reported Friday that there was no federal stockpile of additional vaccines, despite an announcement earlier this week by Health and Human Services Secretary Alex Azar, who told states the Trump administration would begin distributing those doses immediately. Previously, the administration said it was holding back the vaccines to ensure a second dose for everyone who had already received a first shot. 

Both the Pfizer and Moderna vaccines — the only ones currently approved by the U.S. Food and Drug Administration — require a two-shot schedule.

Northam, along with multiple other Democratic governors, first asked HHS to begin releasing the reserve doses earlier this month. Virginia, like other states, has attributed its slower-than-expected vaccine rollout in part to the limited supply coming from the federal government.

HHS initially appeared unwilling to acquiesce to the request, according to reporting from Politico. But the administration’s Operation Warp Speed reversed that stance soon after President-elect Joe Biden announced he would begin releasing reserve doses to states after taking office. 

Northam was one of many public officials to celebrate the arrival of additional vaccines. In his State of the Commonwealth address Wednesday, the governor announced that Virginia would begin vaccinating residents aged 65 and older — a direct response to Azar, who told states to expand their vaccination eligibility to speed up the pace of administration.

At a news briefing the next day, Northam announced that Virginians aged 65 and older, and those 65 and under with underlying medical conditions (including asthma, heart conditions and obesity, according to the Centers for Disease Control and Prevention), would be moved into Phase 1b of the state’s vaccination plan — the second stage of prioritization after health care providers and long-term care residents.

“This means about half of Virginia is now eligible to receive the vaccine,” he said Thursday. “That’s a major logistical effort, and it’s not going to happen overnight.”

But with Friday’s report, the timeline — and whether those expanded populations will still be eligible for Phase 1b — is even more unclear. Last week, the Virginia Department of Health announced that 11 local districts were moving into the second stage of the state’s campaign (two more — Pittsylvania-Danville and Southside — later this week). At his briefing, Northam said the rest of Virginia would move into Phase 1b by the end of January, and some local health districts have already announced plans for delivering vaccines to the expanded population.

The governor’s office couldn’t immediately confirm whether the reported lack of reserve vaccines would affect plans to expand 1b. “Honestly, right now we’re just trying to get clear answers from the federal government,” spokeswoman Alena Yarmosky wrote in an email on Friday.

But the Post reported that vaccine shipments, for all states, would likely stay flat if no additional doses had been held in stockpile. For Virginia, that’s roughly 110,000 doses of Pfizer and Moderna vaccine a week.

If that distribution remained the same, it would take around 39 weeks to vaccinate roughly half of all Virginians who fall into the expanded 1b category — which also includes teachers, first responders, and other essential workers. That’s a rough estimate, not accounting for new vaccines that may enter the supply chain and assuming that the state was also administering 110,000 doses a week. 

At the same time, Virginia is still struggling to administer the vaccine doses it does have available. As of Friday, the state had only administered about 28 percent of the 943,400 total doses distributed to hospitals, local health departments and other medical facilities, according to date from the Virginia Department of Health’s vaccine reporting dashboard.

State health officials have said the dashboard is undercounting vaccines, partially due to lags or glitches in its electronic reporting system. But the CDC currently ranks Virginia 43 out of 50 states and Washington, D.C., when it comes to the number of doses administered per 100,000 people.

Dr. Danny Avula, the director of the Richmond-Henrico Health District who was recently appointed to head the state’s vaccine efforts, said officials were actively working to speed up the pace of vaccinations — including plans to establish large, free-standing vaccine clinics across the state.

But any mass immunization efforts will be hindered if vaccine supply remains low. Yarmosky said it was just one more frustration in trying to coordinate a COVID-19 response with the federal government.

“Once again, the Trump administration cannot seem to provide basic facts and truths,” she wrote Friday. “On Tuesday, governors were told explicitly that we would be provided additional doses — Virginia immediately pivoted and we moved quickly to expand eligibility and increase access.

“Now, the news media is reporting that the exact opposite may be true,” she said. “We’re frankly trying to gather as much information as possible right now — like every American, we need to understand what is going on, so we can plan accordingly. While astonishing, this is hardly surprising. What we’re seeing is fully in line with the dysfunction that has characterized the Trump administration’s entire response to COVID-19. President-elect Biden cannot be sworn in fast enough.”