VDH Plan for Equitable Distribution of COVID-19 Vaccine (February 2022)

Summary

The February 2022 Vaccine Equity Report of the Office of Health Equity in the Virginia Department of Health, a monthly report covering January 2022. It states that it provides an overview of vaccination equity in the Commonwealth of Virginia and compares Virginia with other states in Region 3 of the Federal Emergency Management Agency (FEMA). The executive summary covers the Omicron variant, average daily cases and impacts on children, and a dated list of equity announcements and critical updates for January follows. The report presents vaccination percentages by age group and by race and ethnicity, and its appendix quotes the charging statute from the 2020 Appropriation Act.

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VDH Plan
for
Equitable
Distribution
of COVID-19
Vaccine

FEBRUARY 2022

Office of Health Equity in the Virginia
Department of Health

Under the supervision of the
Commonwealth of Virginia’s Chief
Diversity, Equity, and Inclusion Officer
and the Equity Leadership Task Force
Contents

Executive Summary………………………………………………….……………………………………………………………2
1. Key Equity Announcements and Critical Updates…………………………………….………………………3
2. Vaccination Equity in Virginia…………………………………….……………………………………………………6
Vaccinations for 65+…………………………………….…………………………………………………………….…….6
Vaccinations for Under 45…………………………………….………………………………………………………….6
Race and Ethnicity…………………………………….…………………………………………………………….……….7
Rural Areas…………………………………….…………………………………………………………….………………….8
Infections and Deaths Since Vaccine Availability…………………………………….……..………………10
3. Vaccinations in FEMA Region 3
FEMA Region 3 and Race/Ethnicity………………………………………………………………………………..15
4. Trends Over Time…………………………………………………………………………………………………………..17
Racial Groups as a Share of Total Vaccinations in Virginia……………………………………………..17
Doses Administered……………………………………………………………………………………………………….17
5. Vaccine Hesitancy…………………………………………………………………………………………………………..18
Vaccination Mandates…………………………………………………………………………………………………….19
6. On the Horizon……………………………………………………………………………………………………………….19

Vaccine Equity Report | February 2022 1
Executive Summary

This monthly report is from the Office of Health Equity in the Virginia Department of Health. It
provides an overview of vaccination equity in the Commonwealth of Virginia, including key equity
accomplishments, for January 2022.

This report compares Virginia’s equitable vaccination progress with other states in Region 3 of
the Federal Emergency Management Agency (FEMA), namely Delaware, the District of Columbia,
Maryland, Pennsylvania, and West Virginia. This report explores vaccine trends over time,
vaccination hesitancy, and equity considerations for vaccine distribution. An overview of recent
legislative, executive, and administrative actions is also included. Key findings include:

Impact of the Omicron Variant
● VDH announces that it will no longer contact trace each case of COVID-19 but will instead
focus their efforts on outbreaks and cases in high-risk settings. This change is due to several
factors including the recent surge in cases and the shorter incubation period of the Omicron
variant. These factors make it harder to contact trace each case (Source).
● On January 20, Governor Youngkin issued an executive order that will continue to offer
hospitals, nursing homes, and other health care providers extra flexibility as they deal with
the latest COVID-19 surge. He also laid out the details for his “COVID Action Plan” that will
prioritize vaccine education, outreach, and distribution, and tackle testing supply shortages
(Source).

Increased Average Daily Cases
● Looking at the last 60 days, starting from the end of November 2021, Virginia saw the
highest number of average daily cases in the month of January (Source).
● On January 13, 2022, the average number of daily cases in Virginia peaked at 207.3 per
100,000. This is compared to 17.8 per 100,000 on November 27, 2021 (Source).

Vaccination Rates
● 70.7% of Virginia’s population was fully vaccinated and 83.3% had received one dose of the
vaccine (Source).

Impacts on Children
● On January 26, a child younger than ten died after contracting COVID-19. The child was the
eighth Virginia child under ten to die from the virus (Source).
● As of January 26, 18 individuals younger than 20 have died from COVID-19 in Virginia
(Source).

Vaccine Equity Report | February 2022 2
1. Key Equity Announcements and Critical Updates

This section details equity-related announcements regarding COVID-19 in the Commonwealth of
Virginia during the month. It also provides information on critical updates relevant to Virginia’s
responses to COVID-19. Equity announcements and critical updates from January include:

● January 3: The Virginia Beach Department of Public Health announces that it will host a free
COVID-19 testing event on Wednesday, January 5, 2022 (Source).
● January 3: The Rappahannock-Rapidan Health District partners with Culpeper County to
host free drive through COVID-19 testing on January 6th (Source).
● January 4: Virginia Beach City Public Schools and the Virginia Beach Department of Public
Health partnered to offer free COVID-19 and Flu vaccinations to students, faculty, staff, and
the general public, the week of January 3, 2022 at two schools (Source).
● January 4: After a period of inclement weather, VDH announces it will reopen all of its
Community Vaccination Centers (CVCs) on Wednesday, January 5, 2022 (Source).
● January 4: VDH’s Southside Health District announces that it will offer four COVID-19
testing events this month at two locations, one each in Mecklenburg and Halifax counties
(Source).
● January 5: VDH’s Pittsylvania-Danville Health District announces that it will offer free
COVID-19 testing on January 18th (Source).
● January 5: VDH’s Southside Health District announces that it is offering three weekly
COVID-19 vaccination clinics in the month of January (Source).
● January 5: The Roanoke City & Alleghany Health Districts issue guidance to help minimize
the risk of transmission in K-12 schools. The guidance includes recommendations for
vaccination, physical distancing when possible, and masking (Source).
● January 5: State Vaccination Coordinator Christy Gray releases a statement regarding the
CDC’s endorsement of strengthened Pfizer-BioNTech COVID-19 booster dose
recommendations for 12–17 year olds, all Pfizer boosters after five months, and third doses
for immunocompromised 5–11 year olds. VDH announces that it is immediately adopting
the recommendations from the CDC (Source).
● January 6: The Piedmont and Chesterfield Health Districts offer Pfizer booster shots for 12-
15 year olds (Source; Source).
● January 7: The Piedmont Health District announces that it will offer a free COVID-19 testing
event on January 12 from 9 a.m. to noon at the Victoria Railroad Park (Source).
● January 10: The Norfolk Health Department announces that a Community Testing Center
(CTC) will open on January 11 to provide free Polymerase Chain Reaction (PCR) testing for
COVID-19 to increase availability in response to public demand (Source).
● January 10: VDH’s Southside Health District announces that it will offer a free COVID-19
testing event on January 14 at the Brunswick County Conference Center (Source).
● January 11: The Pittsylvania-Danville Health District announces that it will host two
additional free COVID-19 vaccination clinics in January (Source).
● January 11: The Southside Health District announces that it will offer Pfizer BioNTech
booster shots for 12 to 15 year olds effective immediately (Source).

Vaccine Equity Report | February 2022 3
● January 11: In response to an increasing number of individuals seeking testing, the Crater
Health District announces that it is expanding testing efforts across the district by
increasing the number of Community Testing Events and adding Antigen Testing Kit
Distribution Event sites (Source).
● January 12: The Pittsylvania-Danville Health District announces that it will offer free COVID-
19 testing on January 15 at the Riceville/Java EMS Station (Source).
● January 13: The Piedmont Health District announces that it will offer two additional free
COVID-19 vaccination clinics on January 18 and 19. The clinics will offer first, second,
additional primary, and booster doses (Source).
● January 14: VDH’s award-winning COVIDWISE exposure notifications app hits a record level
of use. Over 2.5 million Virginians are using COVIDWISE (Source).
● January 14: The Lord Fairfax Health District announces that it will offer three free COVID-19
testing events in Front Royal on January 19, 26, and February 2 (Source).
● January 14: VDH announces closure of community testing centers on Sunday ahead of
inclement weather (Source).
● January 15: Glenn Youngkin is sworn in as Virginia’s governor (Source).
● January 16: Inclement weather continues to impact community testing availability. VDH
closes some vaccination and testing centers and delays the opening of others (Source).
● January 17: The Pittsylvania-Danville Health District cancels a Chatam COVID-19 testing
event on January 18 due to inclement weather. They announce that it will be rescheduled,
date to be determined (Source).
● January 18: The Chesterfield Health District opens a free community COVID-19 testing
center that will be open from Mondays to Thursdays from 9 a.m. to 6 p.m. (Source)
● January 18: The Pittsylvania-Danville Health District partners with a local McDonald's
restaurant to provide COVID-19 vaccinations on January 20 from 2 to 6 p.m. at the Chatham
McDonalds (Source).
● January 18: The Lord Fairfax Health District partners with a local Dollar General store to
provide COVID-19 vaccinations on January 21 from 8 a.m. to 5 p.m. (Source)
● January 19: Due to the ongoing surge in COVID-19 cases, the LENOWISCO and Cumberland
Plateau Health Districts change their COVID-19 case investigation and follow-up process.
They will no longer be providing individuals with clearance letters to return to work or
school following COVID-19 infection or exposure. They will also stop providing written
communications that exclude people from work or school due to illness or exposure. These
changes are due to the health districts being overwhelmed by the number of cases and not
being able to provide written letters for all individuals. They still recommend that
individuals infected with COVID-19 seek clearance letters from other healthcare providers
(Source).
● January 19: The Crater Health District offers free additional COVID-19 testing sites across
the district in response to the recent surge in COVID-19 cases (Source).
● January 19: VDH delays the opening of some vaccination and testing centers and closes all
centers early on Thursday and Friday ahead of a winter storm (Source).
● January 20: Loudoun County cancels an outdoor January 21 COVID-19 testing event ahead
of inclement weather (Source).

Vaccine Equity Report | February 2022 4
● January 20: The Southside Health District announces that it is canceling a COVID-19 testing
event scheduled for January 20 due to inclement weather and will reschedule it for a later
date, to be determined (Source).
● January 20: Loudon County posts information on their blog informing the public about
COVID-19 home tests, how to use them, and what to do with the results (Source).
● January 20: The Piedmont Health District announces that it will offer four additional COVID-
19 vaccination clinics the following week (Source).
● January 21: The Chesterfield Health District announces a delayed opening for the Rockwood
Vaccination Clinic on Saturday due to potential inclement weather (Source).
● January 25: Due to the surge in cases, VDH announces that it is refocusing its COVID-19
efforts to target congregate settings (Source).
● January 27: VDH announces that Southside Health District will offer a Moderna COVID-19
vaccination clinic on February 11 (Source).
● January 27: VDH’s Piedmont Health District announces that it will offer two COVID-19
vaccination clinics on February 3 and 5 (Source).
● January 27: VDH’s Chesterfield Health District announces that it will close its vaccination
clinic on Friday and Saturday due to potential inclement weather (Source).
● January 27: Richmond community vaccination centers and community testing centers will
close early on Friday and remain closed on Saturday and Sunday due to inclement weather
(Source).
● January 27: VDH announces its COVID-19 Community Vaccination and Testing Centers in
Norfolk (Military Circle) and Newport News (Sherwood) will be closed Saturday, January 29
and Sunday, January 30 due to expected inclement weather (Source).
● January 27: VDH’s LENOWISCO Health District partners with local Dollar General stores to
provide COVID-19 vaccinations (Source).
● January 28: Virginia Beach City Public Schools and the Virginia Beach Department of Public
Health partner to offer free COVID-19 and Flu vaccinations to students, faculty, staff, and the
general public, the week of January 31, 2022 at two schools (Source).
● January 28: VDH’s Lord Fairfax Health District partners with several local Dollar General
stores to provide free COVID-19 vaccinations throughout the month of February (Source).
● January 28: The Virginia Beach Department of Public Health cancels the vaccine and testing
clinics scheduled for Saturday January 29, 2022 due to potential inclement weather
(Source).
● January 28: Loudoun County schedules COVID-19 testing events for Tuesday, February 1,
and Friday, February 4, 2022 (Source).
● January 31: VDH’s Chesterfield Health District announces that its community testing center
at the Chesterfield Fairgrounds will begin accepting walk-ins (Source).

Vaccine Equity Report | February 2022 5
2. Vaccination Equity in Virginia

At the end of January, over 14 million COVID-19 vaccine doses have been administered
in Virginia, and over 17.4 million vaccines have been received (Source). With 70.57% of the
population fully vaccinated (over 6 million people), Virginia ranks 10th in the country for the
percentage of the population that has been fully vaccinated against COVID-19 (Source). At present,
79.1% of all Virginians have received at least one dose of a vaccine (Source), which is above the
75.3% national total vaccination rate receiving at least one dose (Source). Over 6 million Virginians
have been fully vaccinated, representing 70.57% of the population, which is above the 63.8%
national total fully vaccinated rate (Source). On average, Virginia is administering approximately
8,460 vaccinations per day (Source).

Figure 1: Vaccinations by Age (One Dose)

Source

Vaccinations for 65+

As seen in Figure 1, VDH reports the following age ranges: 65-74, 75-84, and 85+ (Source). At the
end of January, 96.9% of those ages 65+ were vaccinated (Source).

Vaccinations for Under 45

The reported age ranges in Virginia are: 5-11, 12-15, 16-17, 18-24, 25-34, and 35-44. As seen in
Figure 1, 54.1% of those younger than 18 have been vaccinated with at least one dose. 84.1% of

Vaccine Equity Report | February 2022 6
individuals older than 5 and 88.7% of individuals older than 12 have received at least one dose.
Furthermore, 90.2% of the population over the age of 18 have been vaccinated with at least one
dose. Data are also reported by each age group for percentages of the population vaccinated with at
least one dose: 37.3% of 5-11 year olds, 72.3% of 12-15 year olds, 75.3% of 16-17 year olds, 74.7%
of 18-24 year olds, 75.9% of 25-34 year olds, 83.4% of 35-44 year olds (Source).

Race and Ethnicity

Figure 2: Vaccination Count and Percent of Population Vaccinated by Race and Ethnicity
(One Dose)

As shown above in Figure 2, as of January 31st, the key race and ethnicity breakdowns for those
receiving at least one dose are as follows:
● First, Blacks have received 17.2% of all vaccinations and 62.7% have been vaccinated with
at least one dose.
● Second, Hispanics have received 10.4% of all vaccinations and 80.6% have been vaccinated
with at least one dose.
● Third, Asians or Pacific Islanders have received 9.3% of all vaccinations and 91.7% have
been vaccinated with at least one dose.
● Fourth, Whites have received 57.1% of all vaccinations and 65.8% have been vaccinated
with at least one dose (Source).

Vaccine Equity Report | February 2022 7
Figure 3: Cases by Race and Ethnicity

Source

As shown in Figure 3, cases continue to occur amongst Virginia’s population, making it more
important to focus efforts on vaccination. Also in Figure 3, 294,116 of the cases did not report a race
or ethnicity. Moving forward, continuing to collect data on race and ethnicity will be crucial to
making more progress on vaccine equity in Virginia. This is especially true given the spread of the
Omicron variant as well as the known increased and disproportional risks faced by historically
marginalized populations in experiencing the worst effects and outcomes of COVID-19, including
death.

Rural Areas
Figure 4 below displays the rural (non-metropolitan) areas in Virginia as defined by the Office of
Management and Budget (OMB) (Source). Areas in pink are rural localities while areas in beige
are considered non-rural (as defined by the OMB).

Figure 4: Rural and Non-Rural Areas in Virginia

Source

Vaccine Equity Report | February 2022 8
Rural areas, especially in south-central and southwest Virginia, continue to have lower
vaccination rates as compared to other areas of the state, although there are noted
improvements, primarily concentrated in the north-central, northeast, east, and southeast
portions of the state (Figure 5). Further, vaccination hesitancy continues to be an issue throughout
the Commonwealth. Throughout January, and as seen in Figure 6, Virginia saw a noted rise in highly
elevated risk levels across the Commonwealth, with all regions being at “high risk” (Source).

Figure 5: Vaccinations by Locality – Rate per 100,000 Population

Source

Vaccine Equity Report | February 2022 9
Infections and Deaths Since Vaccine Availability

VDH continues to note how the data reveal that vaccinations have saved lives (Source; Source).
Despite some progress in recent months, disparities remain in infections and deaths since the
availability of vaccines, especially concerning: 1) race; 2) age and sex; and 3) urban-rural divides.
As shown in Table 1, disparities detailed in earlier reports remain. Whites represent 61% of the
population, they represent 57% of cases (a rise of 6% from September) and 66% of deaths (a rise of
2% from September). Blacks represent 19% of the population yet 22% of cases (no change since
September) and 24% of deaths (1% less than September). Further, Hispanics are 10% of the
population yet 15% of cases. When comparing the percentages in the population, both Blacks and
Hispanics still disproportionately contract COVID-19, and Blacks disproportionately die from it.

Table 1: Comparisons of COVID-19 Cases, Deaths, and Population
% of Cases % of Deaths % of Total Population

White 57% 66% 61%

Black 22% 24% 19%

Hispanic 15% 6% 10%

Asian 4% 3% 7%
Source

Second, patterns concerning cases and deaths by age and sex remain similar in January as
they were in previous months. Concerning cases and age, those ages 20-29 continue to
comprise the group with the single largest number of cases. Concerning cases and sex, those
identifying as females tend to represent slightly more COVID-19 cases. Concerning deaths and
age, as expected, those ages 50+ comprise most of the deaths from COVID-19 with noted rises
in deaths for successive age groups and with the bulk of deaths occurring in the age 80+
category. Concerning deaths and sex, those identifying as male tend to die at a higher rate
than those identifying as female.

Vaccine Equity Report | February 2022 10
Figure 7: Cases of COVID-19 in Virginia: Demographics

Source

Vaccine Equity Report | February 2022 11
Figure 8: Deaths by COVID-19 in Virginia: Demographics

Source

Third, as shown in Figures 9 and 10, urban and rural disparities continue to be evident in terms of
cases as measured by rates per 100,000 people, which appear exacerbated as the Omicron
variant has led to a massive rise in risk. More rural counties continue to show disproportionate
cases, with notable concentrations in the southeast, south-central, and southwest portions of
the state. No area of Virginia has been immune to the rapid rise in risk levels. As was the case in
previous months, rural counties disproportionately experienced deaths related to COVID-19 in
January. Additionally, while there have not been any major changes in county-level divides on
deaths, there are noted spikes in the southwest, south-central, southeast, and northwest portions of
the state.

Vaccine Equity Report | February 2022 12
Figure 9: Cases of COVID-19 in Virginia: Urban and Rural

Source

Figure 10: Deaths from COVID-19 in Virginia: Urban and Rural

Source

Vaccine Equity Report | February 2022 13
3. Vaccinations in FEMA Region 3

Virginia is a part of FEMA Region 3, which includes Delaware, the District of Columbia,
Maryland, Pennsylvania, and West Virginia. In January, Virginia ranked second in the region
in terms of COVID-19 vaccine doses administered per 100 people (Source).

Regarding risk levels in January (Figure 11), all of Region 3 continues to see concerning risk levels.
Virginia is also seeing some concerning trends. The Commonwealth has 9,194.0 new daily cases, a
seven-day moving average at 107.7 new cases per 100,000 people. This places Virginia second out
of sixth in FEMA Region 3 in terms of COVID-19 risk level.

Figure 11: COVID-19 Risk Levels by County across FEMA Region 3

Source

Further, as seen in Figure 12 below, updated FEMA data are available concerning linkages
between vaccination coverage (low to high) and rankings on the social vulnerability index (SVI).
As shown below, Virginia particularly faces issues of high SVI and low vaccination coverage. In
Virginia, these issues especially affect the south-central and southwest portions of the state.

Vaccine Equity Report | February 2022 14
Figure 12: Percent of Population Fully Vaccinated by Social Vulnerability Index, FEMA
Region 3

Source

FEMA Region 3 and Race/Ethnicity
All areas in FEMA Region 3 continue to show racial disparities in the percentages of vaccines
administered in January. Both Blacks and Hispanics/Latinos continue to see some improvements in
vaccination percentages. Virginia remains a leader in working to close gaps between the percentage
of cases and the percentage of vaccinations for Blacks, Hispanics/Latinos, and Asians. Still,
comparing state vaccination rates by race and ethnicity is challenging because of reporting
inconsistency and missing data (Source). Kaiser Family Foundation data are current as of January
12, 2022.

Figure 13: Blacks as a Share of COVID-19 Trends, FEMA Region 3

Source

Vaccine Equity Report | February 2022 15
Figure 14: Hispanics as a Share of COVID-19 Trends, FEMA Region 3

Source

Figure 15: Asians as a Share of COVID-19 Trends, FEMA Region 3

Source

Vaccine Equity Report | February 2022 16
Source

4. Trends Over Time
Almost two years into the COVID-19 pandemic, there are still inequities in overall vaccination rates.
However, these inequities have declined over time. Overall, minorities have consistently had less
access to vaccinations, and lower overall vaccination rates, than whites. In addition, the 7-day
average increased during the winter due to the Omicron variant but began to decline at the end of
January. These are discussed further, with a focus on racial equity, in the sections that follow.

Racial Groups as a Share of Total Vaccinations in Virginia
In Virginia, Whites make up 61% of the total population and 57.1% of the population with reported
race and ethnicity that have been vaccinated with at least one dose. Blacks make up 19% of
Virginia’s total population but 17.2% of the vaccinated population (one dose). 10% of Virginia’s
population is Hispanic and 10.4% of the vaccinated population in Virginia is Latino. Asians make up
7% of Virginia’s total population while Asian and Pacific Islanders make up 9.4% of the vaccinated
population in the Commonwealth (Source; Source). While some progress has been made in closing
the disparity gap for vaccinations amongst racial groups, the Black population is notably behind
other minority groups in Virginia when it comes to vaccination percentages.

Furthermore, Blacks and Latinos carry an unequal burden of disease in Virginia when compared to
Whites and Asians, as shown in Figure 17. Vaccinations occur amongst Blacks at only 0.9 times the
rate of Whites. However, cases and deaths occur amongst Blacks at 1.3 and 1.6 times the rate of
Whites, respectively. Amongst Latinos, vaccinations occur at 1.1 times the rate of Whites. Cases and
deaths both occur amongst Latinos at 1.5 times the rate of Whites. VDH is currently working on
addressing these health disparities.

Vaccine Equity Report | February 2022 17
Figure 17: Racial and Ethnic Distribution of Burden of Disease in Virginia (according to
vaccinations, cases, deaths, and hospitalizations)

Source

Doses Administered
In Virginia, the 7-day average of doses administered has been on the rise since the month of
October 2021. The month of January saw a gradual decline. As of February 2, 2021, Virginia’s 7-day
average of vaccines administered was 3,705 (Source). The peak number of vaccines administered in
January was on January 11th at 29,391 (Source). These trends in Virginia generally match that of
the United States as a whole, which saw an increase in demand for vaccines during the winter
months when the Omicron variant was spreading and now has is seeing a decrease in demand from
the second half of January onward (Source).

Vaccine Equity Report | February 2022 18
Figure 18: Daily Number of Administered COVID-19 Vaccine Doses and 7-Day Average in
United States

(Blue bars represent daily numbers and red line shows 7-day average) Source

5. Vaccine Hesitancy
With over 14.8 million vaccination doses administered, and nearly 6.77 million people (78.8%)
vaccinated with at least one dose, Virginia’s vaccination rates surpass the national rate (75.1%)
(Source; Source). This includes those who have received at least one dose as well as those who are
fully vaccinated (63.6% of the U.S. population is fully vaccinated while 70.0% of Virginia’s
population is fully vaccinated). However, there is still 30% of Virginia’s population who
has not been fully vaccinated (Source). With the spread of the Omicron variant, working to
vaccinate a larger percentage of the population and reducing vaccine hesitancy are important
factors in combating the pandemic.

Looking at nationwide trends from Kaiser Family Foundation polling, there has not been much
change between July 2021 and January 2022 when it comes to individuals who say that
they will “definitely not” get vaccinated. Data indicate that, while 16% said that they would not get
vaccinated in October 2021, 14% said that they would not get vaccinated in January 2022 (Source).
However, there have been some changes in attitudes in Virginia. A May 2021 poll conducted by the
Research Institute for Social Equity (RISE) at VCU’s Wilder School found that 32% of those not
vaccinated (n = 84/259) said that they were “not at all likely” to get vaccinated. In June 2021, the
same poll found that 47% of those not vaccinated (n = 91/183) were “not at all likely” to get
vaccinated (Source). Between these polls, both the percentage and the total number of those who
were not at all likely to get vaccinated increased. More recent polls have either not been conducted
yet or the results have not yet been released.

To combat vaccine hesitancy, the Virginia Department of Health is working to communicate the
benefits of vaccination to the public. The VDH coronavirus dashboard now displays cases by

Vaccine Equity Report | February 2022 19
vaccination status, showing that the vast majority of those getting infected and those getting
hospitalized have not yet been vaccinated (Source).

More recent polling from the Kaiser Family Foundation indicated who remains unvaccinated. Of
those adults who have not gotten a vaccine:
● 62% are individuals under age 50
● 37% are between ages 30-49
● 49% have a high school education or less
● 62% identify as Republican
● 33% have annual incomes less than $40k
● 43% reside in suburban areas and 22% in rural areas
● 33% are White evangelicals (Source)

Vaccination Mandates
At the federal level, vaccination mandates are facing some pushback. On September 9, 2021,
President Biden unveiled an action plan to mandate vaccines for employers with 100 or more
personnel, federal workers, and healthcare providers (Source). VDH stated that it supports these
initiatives (Source). In January 2022, the Biden Administration withdrew its mandate following the
Supreme Court’s decision to block it.

Many states and counties have enforced mandates of their own. California and the state of New
York, for example, require state employees to be vaccinated. New York City and San Francisco
require proof of vaccination for inside dining, gyms and other indoor activities. All city workers in
New York City are required to be vaccinated with a $500 bonus for doing so. Los Angeles County
requires proof of vaccination to enter indoor bars, nightclubs, breweries and wineries and requires
people age 12 and older to be fully vaccinated before entering public indoor places (Source).

While vaccine hesitancy seems to be stagnating or even increasing in some areas, these
mandates may provide a solution to ensure that the hesitant will still get vaccinated. Even if
hesitancy remains, the mandates may be an effective alternative for getting the persistently
hesitant or adverse vaccinated.

6. On the Horizon
During January, Virginia saw COVID-19 cases being reported at levels higher than ever before.
Hospitalizations have been steadily increasing since the end of summer and started to fall at the
end of January after hitting two peaks during the winter. The number of deaths was lower in
January 2022 than it was in September 2021, indicating that vaccinations are very effective.
Vaccinations in children ages 12-17 and frequent testing are essential to keeping children and staff
healthy in schools.

Virginia’s vaccination rates are better than rates in many other states. However, nearly 30% of
Virginia’s population has not been fully vaccinated. Vaccination hesitancy remains of great concern.
Recent reports show those who were unwilling to be vaccinated in late 2020 were still unwilling to

Vaccine Equity Report | February 2022 20
be vaccinated in the fall of 2021. Mandates are an effective tool, but many are still unwilling to get
vaccinated and additional equity work remains. A continued effort to vaccinate a larger percentage
of the population and reducing vaccine hesitancy are important factors in combating the pandemic.

Despite much progress, a continued focus on vaccine equity remains critical. Fears of virus spread
and breakthrough infections require the critical need to bolster vaccination efforts across the
Commonwealth and center equity in policy and procedures. Given ongoing issues of inequities
concerning who gets infected, as well as who dies from COVID-19, equity must remain centered in
all government practice. Racial and ethnic disparities, as well as disparities between urban and
rural areas, remain a challenge.

Vaccine Equity Report | February 2022 21
Appendix
Charging Statutes

2020 Appropriation Act Item 299 I. The Department of Health shall convene a workgroup, which
shall include the Commonwealth's Chief Diversity, Equity, and Inclusion Officer and
representatives of the Office of Health Equity of the Department of Health, the Department of
Emergency Management, and such other stakeholders as the department shall deem
appropriate and which may be an existing workgroup or other entity previously convened for a
related purpose, to (i) evaluate the methods by which vaccines and other medications
necessary to treat or prevent the spread of COVID-19 are made available to the public; (ii)
identify and develop a plan to implement specific actions necessary to ensure such vaccines
and other medications are equitably distributed in the Commonwealth to ensure all residents of
the Commonwealth are able to access such vaccines and other medications; (iii) make
recommendations for any statutory, regulatory, or budgetary actions necessary to implement
such a plan.), including: a) statutes regarding plans; b) regulatory changes; c) budgetary
changes; d) changes needed to the any Virginia vaccination plan.

Vaccine Equity Report | February 2022 22

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