State health officials say they’re working to reconfigure vaccine distribution to match geographic demand after a walk-in clinic in Danville, which has already moved into phase 1c, was swamped by out-of-towners.
It’s the latest wrinkle in the state’s vaccine distribution effort, which after a rocky roll-out has dramatically ramped up distribution.
The Danville site started to attract widespread attention on Wednesday, when the Blue Ridge Health District — which covers Charlottesville and surrounding counties — issued a warning to residents on Twitter.
“We have heard of many people who live in BRHD driving to Danville’s Community Vaccination Center to get a COVID-19 vaccine,” they wrote, warning that residents who made the drive wouldn’t be allowed to receive a second dose in their home district. “We have a limited supply of vaccines, despite requesting more supply, and simply cannot meet the current demand.”
The Danville site first opened last week along with community vaccination centers in three other areas of the state — Portsmouth, Petersburg and Prince William. The Virginia Department of Health emphasized that the sites were still appointment-only clinics for eligible residents. On Wednesday, the department issued a related release, urging all Virginians not to travel to a community vaccination site without an official appointment or invitation.
But as it turns out, people were traveling to Danville because the site had temporarily opened for walk-in appointments. Kathryn Goodman, a spokeswoman for the Blue Ridge Health District, said Thursday that the clinic had attracted UVA students along with “a lot of different community members.” And the news spurred dozens of posts on vaccine Facebook groups in Richmond and Northern Virginia, with many members reporting they had also made the drive.
It ties back to varying geographic demand for the vaccine — a new challenge the state is facing as its rollout continues to pick up steam. In some ways, it’s a good problem to have. Over the last three months, Virginia has significantly improved its rate of administering vaccines and eased early bottlenecks in its distribution process. As a result, more than a quarter of the state has received at least one dose, according to VDH data.
As more and more people are vaccinated, some health districts have moved through their pre-registration lists and into Phase 1c — another broad category that includes hairstylists, lawyers and restaurant workers. It’s the last phase of prioritization before a district can move to vaccinating all adults.
But progress still differs by region. While the Eastern Shore has moved into Phase 1c, for example, the Blue Ridge Health District just expanded eligibility to essential workers in the 1b category. More than 35,000 people are still on the waitlist to be vaccinated.
“We have a lot of people in that category,” Dr. Denise Bonds, the district’s director, said at a news briefing on Thursday. “We’re a very desirable area to retire to, so we have lots of people in that over 65 category that we need to work through to get their vaccine.”
Danville, on the other hand, expanded to 1c in mid-March — a day after its community vaccination center opened with an allocation of 3,000 doses a day. That played a role in the decision to open the site for walk-in appointments, according to Dena Potter, who’s leading vaccine communications for VDH.
“We learned that 3,000 doses per day outpaces the current demand in Danville,” she wrote in an email. So far, just over 12,000 people have been vaccinated at the site, though Potter couldn’t provide data on how many have been walk-ins and how many were community members with appointments.
Extra vaccines are now being reallocated “to parts of Virginia where there remain many people who are eligible to receive the vaccine,” Potter said. But the clinic temporarily opened for walk-up appointments to use up extra doses as the state was “working through” its redistribution strategy.
The state’s four mass vaccination sites are run by AshBritt and IEM, two emergency management contractors that have also been used in other states. Potter said the companies had protocols in place to avoid wasting vaccine, including end-of-day wait lists and vaccinating “clinic staff, emergency responders or other predetermined groups.”
But the Danville site highlights the challenges facing state officials as they choose where to allocate doses. As the rollout continues, many localities — including large, densely populated areas — have grown increasingly frustrated by their share of the state’s shipments. Last week, leaders in Northern Virginia urged Northam to distribute more doses to the region so local health departments could move through their 1b population.
“Each of our health districts have waiting lists for vaccines … that far outstrip the supply we have received to date,” reads the letter, signed by officials in Alexandria, Arlington, Fairfax, Loudoun and Prince William. “We stand ready to meet your expectation that everyone, even those who have not registered, will have a place in line six weeks from now, but we will need more doses immediately to make that reality.”
Bonds said almost every district has faced “vaccine tourism,” but it makes managing supply more difficult. That’s especially true for the Pfizer and Moderna vaccines, which both require two doses for full immunity. In many cases, residents who drive long distances for their first dose end up turning to their local health departments to receive a second.
“If we have a large number of individuals who get their first dose elsewhere and come to us for their second dose, it’s going to reduce the number of first doses we have for that period of time,” she said. “Additionally, the state will have sent that individual’s second dose back to where they got their first dose. That’s how the system works.”
State officials, though, are also trying to balance demand with concerns over equity. Danville was selected for a community vaccination clinic, along with the three other sites, based on an “equity analysis” that considered burden of disease, rates of vaccination and “communities with the largest number of vulnerable populations,” according to VDH.
The city of roughly 40,000 has a majority Black population and significant community of Hispanic residents. But VDH data indicates that most residents still haven’t been vaccinated. And while demographic data is missing for just over 4,000 shots, it also indicates that fewer Black residents are getting vaccinated than White residents.
It’s still unclear why the clinic didn’t command more appointments from the local community. Vaccine hesitancy is an often-cited concern, but Dr. Danny Avula, the state’s vaccine czar, pointed out that there’s “inequity baked into” the online-heavy registration system.
As the Mercury reported earlier this month, the process favors those with reliable internet access — along with the knowledge, and time, to search for appointments. And Danville isn’t the only place that’s become a hub for vaccines. Valley Health, a hospital system in Winchester, was overwhelmed by out-of-town visitors when it opened appointments on a first-come, first-served basis earlier this month.
The system eventually closed its appointment slots and began working from the state’s pre-registration list. Dr. Jeffrey Feit, its vice president of population health, said the overarching goal in Winchester and across the state is to vaccinate as many people as possible, as quickly as possible. But it’s also difficult to attract more community buy-in if the shots are going to other people.
“If I don’t have it to give out, I can’t sell it,” he said. “That’s the problem.”