Youngkin’s anti-mandate approach fails to boost Virginia vaccination rates

Days after taking office, Virginia Gov. Glenn Youngkin released a new COVID-19 action plan that pledged to boost vaccine uptake without mandating the shots.

“My administration’s campaign to increase vaccination rates is taking a different approach than in the past,” the governor wrote in an editorial published by the Bristol Herald Courier a few weeks later. Youngkin had repealed a directive from former Gov. Ralph Northam that mandated vaccines for executive branch employees, and was hoping that an individual-choice approach — coupled with his own support for the shots themselves — could sway skeptical Virginians. 

“We are going to empower the individual with information, provide facts to counter misinformation and increase access to vaccinations to give each Virginian the ability to decide whether the vaccine is right for them,” he added. “We will not rely on the government mandating individuals what they shall do, using the power of laws, regulations or executive orders.”

At least some local health officials, particularly those in rural districts, hoped the messaging from Virginia’s first Republican governor since 2014 might make a difference when it came to vaccine acceptance. The Kaiser Family Foundation has repeatedly found gaps in uptake between counties that voted for President Joe Biden and counties that voted for Donald Trump, and rates in many of Virginia’s deep-red localities remain far lower than the statewide average.

State data, though, indicates that the Youngkin administration’s approach has failed to boost the state’s stagnating vaccination rates. The average number of shots administered each day has steadily declined since mid-January and now — at well below 1,000 — is lower than at any other point since the vaccines were released. 

Even the recent authorization of doses for children under five has failed to boost statewide demand. According to the Virginia Department of Health, 16,207 so-called “baby vaccines” have been administered since the shots were authorized by the Food and Drug Administration last month — roughly 3.6 percent of the state’s total population of zero to five-year-olds.

Despite the declining numbers, The New York Times currently rates Virginia 12th in the country for its percentage of fully vaccinated residents — still defined as those who have received both shots of a two-dose vaccine series or a single one-dose vaccine. Just over 73 percent of the state’s total population is fully vaccinated, according to VDH data, and 83 percent of adults have received their primary series.

Those numbers have steadily increased since the start of the year, when just over 65 percent of the state’s total population was fully vaccinated. But with demand plummeting, health experts say they’re still concerned by the more than 25 percent of Virginians who aren’t protected against the virus. Also troubling is the state’s low uptake of third-dose shots, with just half of fully vaccinated Virginians choosing to get boosted.

“I would say that being fully vaccinated at this point should mean receiving three shots of the mRNA vaccines,” said Dr. Bill Petri, an infectious disease specialist at the University of Virginia. “If you haven’t had a booster, you’re partially but not completely vaccinated.”

“I think we need to start thinking about this, if we haven’t already, like influenza,” he continued. “Each year, it’s going to be likely that everyone who’s six months of age or older should get a new shot.”

The widespread success of an ongoing vaccination campaign, though, is still an open question. Given the tepid response to third doses by many Virginians, some health officials anticipate limited enthusiasm for updated shots, including an omicron-specific booster expected this fall. 

And a Republican governor in Virginia is unlikely to change things, many say. While Youngkin has pushed for a “return to normalcy” after two years of COVID-19 precautions — including a successful effort to end masking requirements in Virginia schools — health officials say they’ve seen no interference in local or state efforts to boost vaccination rates. 

Since Jan. 15, the state’s Department of Health has spent more than $33.2 million to support FEMA vaccination projects, including 532 mobile clinics throughout the state. Local health departments have taken increasingly granular efforts to reach unvaccinated Virginians, including Medicaid enrollees. And officials have tried new approaches to outreach, including texts to remind people of their eligibility for booster shots.

Even Youngkin has tried direct appeals. In February, the governor released two public service announcements promoting the shots, saying that he and his family had chosen to get vaccinated. And he’s held two round tables with community leaders in Abingdon and Petersburg, aimed at discussing ways to increase the local vaccination rate.

In Petersburg, leaders shared how an ongoing lack of medical providers had eroded trust in the health care system. In Abingdon, officials asked Youngkin to do even more to encourage vaccination, pushing back on the state’s common refrain that Virginians should reach out to their doctor with any questions or concerns.

“The idea of ‘Talk to your doctor’ is great if you have a doctor and you have the time to do that,’” said Breanne Forbes-Hubbard, who attended the discussion as population health manager for the Mount Rogers Health District in Southwest Virginia. “But doctors are busy, it’s hard to get a call back, and it’s hard to take time out of the day to do that, let alone if you don’t have a trusted provider.”

Youngkin was engaged during the meeting, Forbes-Hubbard said, but she didn’t notice much of a difference in community demand for vaccines after the round table or the launch of the governor’s public service campaign. Her experience matched that of many other local health leaders, who say they’ve struggled to convince residents who still haven’t chosen to get vaccinated.

“I do think Gov. Youngkin’s appeal helped some, but by January 2022, a large percentage of the population was essentially done with COVID and even he wasn’t going to change their minds,” Dr. Noelle Bissell, director of the New River Health District and acting leader of three other local health departments in Southwest Virginia, wrote in an email this week.

“The few people that we do get to accept the vaccine after refusing it for so long are those who we interact with about all health department services,” she added. “COVID comes up as part of the conversation, but not the sole focus.”