VDH Plan for Equitable Distribution of the COVID-19 Vaccine, Vaccine Equity Report (October 2022)
Summary
This is the Vaccine Equity Report for October 2022 from the Office of Health Equity in the Virginia Department of Health, titled VDH Plan for Equitable Distribution of the COVID-19 Vaccine. The monthly report gives an overview of vaccination equity in the Commonwealth of Virginia for September 2022 and compares Virginia with the other states in Region 3 of the Federal Emergency Management Agency (FEMA). Its key findings state that at the end of September 2022, 72.6% of Virginia's population was fully vaccinated and 82.7% had received one dose, and that as of September 29th, 2022, 31 individuals younger than 20 have died from COVID-19 in Virginia. It also says the BA.5 variant was responsible for over half of all cases in Virginia at the end of July and August, according to CDC estimates.
Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used
Cite this document
“VDH Plan for Equitable Distribution of the COVID-19 Vaccine, Vaccine Equity Report (October 2022).”
Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/2022-rd627-8229d2ff06/
, SHA-256 3cdd0e2a9b8c66b3ce4a1476219f16decf6427108050237dc0ab88b557d7668e.Full text
VDH Plan
for
Equitable
Distribution
of the
COVID-19
Vaccine
October 2022
Office of Health Equity in the Virginia
Department of Health
fJ. HVIRCilNIA
D
fl DEPARTMEr,..'T
OF HEALTH
l'roltttintl Yoe, a(ttl Your Enwvnmrnt
w..wvdll. rgln1ag>v
Contents
Executive Summary ................................................................................................................................2
1. Key Equity Announcements and Critical Updates .......................................................... ...... ......3
2. Vaccination Equit:y"in Virginia ........................................................................................................6
Vaccinations for 65+.........................................................................................................................6
Vaccinations for Under 45 ....................................................... .......................................................7
Race and Ethnicity 7
1,1.,1 .,1,1••1•••• 1•• 1,, •••• ,1,1•1••••1 •••• •,1,,1 ,1,1,, 1,, 1,, 1•• 11, 1,,.,1.,1,1, •••••• , •••••••••••••••••••• ••••••••••••• ••••
Rural Areas .............................. ......................................... ,............................................... ......... ... ....9
Infections and Deaths Since Vaccine Availability.....................................................................12
31 Vaccinations in FEMA Region 3 ............................................................................................. ......15
FEMA Region 3 and Race/Ethnicity................................................... .........................................16
41 Trends OverTime ... 19
1•••••••1,,1,,, ,1,,1,1,,1,, ,,1,1,,,, ••, ••1,,.... ................. .......................................................
Racial Groups as a Share of Total Vaccinations in Virginia .....................................................19
Doses Administered ......................................................................................................................20
51 Vaccine 21
Hesitancy1,,,,1,,1,1,,1 , ,1,1,,1,,1,,,,1,,.,1 ,1,,,,1,,, ,1,1,, •••••••••••••••••••••••••••••••••••••••••• •••••• •••••••••••• ••• ••• •••••
Vaccination Mandates ....................................................................................... ............................22
6. On the Horizon ........................ ... ......................................................... ...........................................23
Vaccine Equity Report I October 2022 1
Executive Summary
This monthly report is from the Office Qf Health Equjty jn the Yirgjnia Depanmenr of lteaJtb. It
provides an overview of vaccination equity in the Commonwealth of Virginia, including key equity
accomplishments, for September 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. Additionally, 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 BA.5
• At the end of July and August, the BA.5 variant was responsible for over half ofall cases in
Virginia, according to CDC estimates (Source; Source}.
Trends in Average Daily Cases
• As of September 28th, the highest average number of daily cases in Virginia for the month was
28.9 cases per 100,000 people on September 1.11 (Source).
Vaccination Rates
• At the end of September 2022, 72.6% of Virginia's population was fully vaccinated and 82.7%
had received one dose of the vaccine (Source).
Impacts on Children
• As of September 29th, 2022, 31 individuals younger than 20 have died from COVID-19 in
Virginia (Source).
• CDC data shows that three out of every four kids in Virginia has had COVID-19 (Source}.
• Statewide rates for Virginia show that students have fallen behind on their routine school
immunizations during the pandemic. It is yet another grim reminder of how the pandemic has
indirectly and directly impacted life for Virginians (Sgurce}.
• Ahead of the start of the 2022-2023 academic year, Governor Youngkin announced updated
guidance on quarantine recommendations for people exposed to COVID-19 in K-12 schools,
child care, and camp settings. The revised guidance was released on July 14th and states that
quarantine is no longer recommended for asymptomatic individuals who were exposed to
COVID-19-infected individuals in these settings().
Vaccine Equity Report I October 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 September include:
• September 1: The Richmond and Henrico County health districts announced that they will
offer testing at the Fulton Neighborhood Resource Center, 1519 Williamsburg Road, from
3:30 p.m. to 5:30 p.m. on Thursday, September 1st (Source).
• September 2: Less than a month into the school year, school staff and students continue to
be affected by COVID-19. Since starting on August 9th, Washington County Virginia Public
Schools (WCS) reported 485 new cases amongst its students and staff (S.frl.ltce).
• September 2: The Virginia Beach Department of Public Health announced that it will host a
free COVID-19 vaccination clinic on Wednesday, September 7th. The clinic will be held from
4:30 p.m. to 6:30 p.m. at the New Light Full Gospel Baptist Church, located at 5549 Indian
River Road (Source).
• September 4: Recent data by the Virginia Hospital and Healthcare Association (VHHA)
showed that COVID-19 cases and hospitalizations have started to plateau, indicating that
COVID-19 may be transitioning from pandemic to endemic. Still, experts say it is hard to
predict what might happen in the upcoming months, since COVID-19 tends to spread more
in the fall. "If there's one thing we've learned from this pandemic, it's that COVID-19 is hard
to predict," said Dr. Elaine Perry, director of the Richmond and Henrico Health Districts
(Source:).
• September 5: VD H's Chief Deputy Commissioner for Community Health Services, Dr.
Parham Jaberi, announced that new COVID booster shots are available to the public starting
this week. The CDC recommends that teens and adults get updated booster shots from
Pfizer or Moderna (Pfizer for those aged twelve and up and Moderna for those aged 18 and
up). "We will get access increasingly over the course of the month," Dr. Jaberi said. "The goal
with these [boosters] is to give additional protection, specifically against the Omicron
subvariant b.4 and b.S. That's what's new in these vaccines. They're going to give you
additional and better protection against the common circulating strains of COVID right now
in the community." (Source)
• September 6: The Prince William Health District's mobile vaccine clinic announced that it
will offer the new Pfizer BioNTech 'bivalent' COVID-19 booster for the first time on
September 6th and 8th. The new booster shot has been formulated to combat both the
original strain of the coronavirus as well as the Omicron variant and subvariants BA.4 and
BAS (Source).
• September 7: Starting on September 7th, eligible Virginia residents were able to schedule
appointments with their healthcare providers to receive the new, free COVI D-19 bivalent
booster vaccinations, manufactured by Pfizer-BioNTech and Moderna. The new updated
boosters are targeted specifically at the BA.4 and BAS subvariants of the Omicron variant
that initially emerged in the United States in November 2021 (Source).
Vaccine Equity Report I October 2022 3
•September 8: The Richmond and Henrico County health districts announced that they are
offering free community testing for COVID-19. The testing will be held on September 8th and
15th at the Fulton Neighborhood Resource Center from 3:30 p.m. to 5:30 p.m. and on
September 14th from 8:00 to 10:00 a.m. at the East Henrico Recreation Center (Source).
• September 9: COVID-19 modeling by the University of Virginia (UVA) indicates that new
bivalent boosters could have a significant impact on COVID-19, potentially preventing
225,000 cases, 9,000 hospitalizations, and 850 deaths (Sou).
• Septem ber 10: VDH announced that it is reopening its Community Vaccination Clinic at
Military Circle Mall in Norfolk on September 12th. On specific days and times, the
monkeypox and COVID-19 vaccines (including the new bivalent booster) will be provided
(Smtrce).
• September 12: In the last seven days period, Virginia averaged 1,739 newly reported cases a
day. In the prior seven-day period, Virginia averaged 2,310 newly reported cases a day.
Since March 2020, Virginia has reported 2,062,984 cases of COVID-19 to date (Source).
• September 13: According to the CDC's weekly updates of community COVID-19 levels,
community transmission levels remain high but stable in the Roanoke City and Alleghany
Health Districts (Source).
• September 14: The past week's average daily newly reported cases are 11.89% lower than
the previous seven-day period (Source).
• September 15: The Rappahannock County Public Schools (RCPS) Superintendent Dr.
Shannon Grimsley presented the school board with new COVID-19 guidance from VDH on
Tuesday. For children that experience COVI D-19 symptoms and test positive, VDH
recommends that they should quarantine at home for five days, and can return to school
once their symptoms have improved and there is no fever. On days 6 through 10, VDH is
advising the child to wear a mask. RCPS is no longer conducting contact tracing, data
gathering, or daily health screenings for staff (Source).
• September 16: The seven-day positivity rate for COVID-19 in Virginia dropped to 16.7% and
new cases were down this last week by 12% (Source).
• Sept e mber 17: Within the past week, VDH reported that 11,600 more people tested positive
for COVID-19 out of the 63,316 PCR tests that VDH processed (Source).
• September 20: The CDC announced on September 20th that it granted five-year awards to
five state public health systems. The awards is part of the Pathogen Genomics Centers of
Excellence (PGCoE) network. The PGCoE network is intended to foster and improve
innovation and technical capacity in pathogen genomics, molecular epidemiology, and
bioinformatics to better prevent, control, and respond to microbial threats of public health
importance. One of the awardees is the Virginia Division of Consolidated Laboratory
Services, who will partner with VDH, the Virginia Commonwealth University, and the
University of Virginia. Combined, the PGCOEs will serve as a network to: perform a
landscape analysis of gaps, needs, and opportunities for genomics in the United States
public health system; pilot and implement genomics technologies and applications for
public health; and prepare for and respond to infectious disease threats (Source).
Vaccine Equity Report I October 2022 4
• Septem ber 21: In the last week, Virginia reported 10,239 new cases. In the last seven days,
Virginia has averaged 1,463 newly reported cases a day. In the prior seven-day period,
Virginia averaged 1,778 newly reported cases a day (Source).
• September 22: The Richmond and Henrico County health districts announced that they are
offering free community testing at the following locations:
o Thursday, Sept. 22, 3:30 to 5:30 p.m. - Fulton Neighborhood Resource Center, 1519
Williamsburg Road.
o Thursday, Sept. 22 & Sept. 29, 1:00 to 4:00 p.m. - Richmond Henrico Health District,
400 E. Cary St., Pfizer for ages 6 months and older, Moderna for ages 6 months to 5
years old and ages 18 years and older.
o Wednesday, Sept. 28, 1:00 to 4:00 p.m. - Henrico Health District West Headquarters,
8600 Dixon Powers Drive, Pfizer for ages 6 months and older, Moderna for ages 6
months to 5 years old and ages 18 years and older (Source).
• September 23: According to data from the Virginia Hospital & Healthcare Association
(VHHA), more than 550 additional COVID-19 patients were discharged from Virginia
hospitals over the past week. As of Friday, there were 605 hospitalized patients confirmed
positive for COVID-19, which is down from 657 (-52) last Friday (Source).
• September 25: In the last seven days, Virginia's COVI D-19 positivity rate dropped to 13.1%
and new cases were down by 13% (Source).
• Septem ber 26: For the second week in a row, COVID-19 community levels have been low in
the Rappahannock-Rapidan Health District. "COVID remains in our communities. Although
reported COVID-19 cases and hospitalizations are declining, an average of 400 Americans
continue to die from COVID every day," stated the weekly Friday update on Sept. 23 from
the Rappahannock-Rapidan Health District (So.utce).
• September 28: Shannan Green, M.D., the new medical director of University Student Health
Services at Virginia Commonwealth University, discussed challenges that the student body
faces regarding COVID-19, monkeypox, and mental health. "One of the biggest issues l see
facing the campus as we transition through the COVID-19 pandemic is addressing the
mental health needs of our community in a way that is inclusive," she said (Source).
Vaccine Equity Report I October 2022 5
2. Vaccination Equity in Virginia
At the end of September, over 16.9 million COVID-19 vaccine doses have been administered in
Virginia (Source). With 72.6% of the population fully vaccinated, Virginia ranks 11th in the country
for the percentage of the population that has been fully vaccinated against COVID-19 (Souref;
Source). At present, 82. 7% of all Virginians have received at least one dose of a vaccine (Source),
which is above the 79.5% national total vaccination rate receiving at least one dose (Source).
Virginia's fully vaccinated rate, 72.6%, is higher than the 67.8% national total fully vaccinated rate
(Source). On average, Virginia is administering approximately 15,021 vaccination doses per day
(Source).
Figure 1: Vaccinations by Age (One Dose)
Vaccination Count Percent of the Population Vaccinated with At
By Age Group Least One Dose - By Age Group
0-4148,076 0-4 .106,-
5-11 - 337, 087 5-11
12·15 - 325,911 12-15
16-17 • 166,581 16·17
18·24 18·24
25-34 25·34
35-44 35-44
45-54 45.54
55-64 1,026,l!liS 55-64
65·7" 65-74 97. 71.
75-34 - 399, 667 75·84
85+ • 137,721
Not Reported 373,511
Source
Vaccinations for 65+
As seen in Figure 1, VDH reports the following age ranges: 65-74, 75-84, and 85+ (SQUr). At the
end of September, 96.1% of those ages 65+ were vaccinated (Source).
Vaccine Equity Report I October 2022 6
Vaccinations for Under 45
The reported age ranges in Virginia are: 0-4, 5-11, 12-15, 16-17, 18-24, 25·34, and 35-44. As seen
on VD H's COVID-19 dashboard, 60.9% ofthose aged 5-17 years have been vaccinated with at least
one dose, up by 0.3% from last month. 87.3% ofindividuals older than 5, up by 0.2% since last
month, have been vaccinated with at least one dose. Furthermore, 92.6% of the population over the
age of 18 have been vaccinated with at least one dose, up by 0.1% from last month. Data are also
reported by each age group for percentages ofthe population vaccinated with at least one dose:
10.6% of0-4 year olds (up from 9.0% last month), 46.5% of5-11 year olds (up from 46.1%), 76.4%
of 12-15 year olds (up from 76.3%), 78.6% of16-17 year olds (up from 78.4%), 78.9% of 18-24
year olds (up from 78.8%), 79.3% of25-34 year olds (up from 79.2%), and 84.9% of 35-44 year
olds (no change since last month) (Source).
Race and Ethnicity
Figure 2: Vaccination Count and Percent of Population Vaccinated by Race and Ethnicity
(One Dose)
Vaccination Count Percent of the Eligible Population Vaccinated
By Race and Ethnicity with At Least One Dose - By Race and Ethnicity*
Asmu;r Pacific Islander 11576,765 Asian or Pacific lsla11i:ter
Black - 1. 062, 393
Back
Lanno 11657,332
Native American I 29,543
117 8%
Wh.te 3.448 661
Olller Race
1331.909
Whte
OM 1M 2M 3M 4M 50.0 1000%
Peop:e Vaccinated Percent 1/acclnated
Not Reported 999.131
Source
*This data source does not include population estimates for the Other Race category. No population
estimates are available for out-ofstate individuals or those without a reported locality. More
information about population estimates can be found at this link:
httn.;L/www.oic,gpvLncbs,Ln vsslbricJ.ued r:ace.h tm
The percentage of Native Americans that are vaccinated can be above 100% for two reasons.
1. There are small numbers of vaccinations and small population estimates for Native Americans
at the city/county level in Virginia. VDH gets population estimates from the National Center
for Health Statistics (NCHS). For example, there were 3 Native American vaccinations in a
Vaccine Equity Report I October 2022 7
county. Population estimates say there were only 2 people who identify as Native American in
that same county. This means that the data would say there were 3 vaccinations over 2 people
in the population. This would equal 150%, or a percentage over 100%.
2. Some people may identify that they are Native American and multi-race when they are getting
their vaccine. They will be categorized as Native American only in the data system. This is
because population estimates from NCHS do not include multi-race as an option. I/there was a
multi-race option, a person who identified as Native American and multi-race would be in the
multi-race population estimates.
Table 1: Vaccination Distribution by Race and Ethnicity
Race and ethnicity Percent of people with at least one dose with
reported race and ethnicity
Black 17.4%
Latino 10.8%
Asian or Pacific Islander 9.4%
White 56.5%
Source
According to Figure 2 and Table 1, as of September 28th, the key race and ethnicity breakdowns for
those receiving at least one dose are as follows (with little change since last month):
• First, Blacks have received 17.4% of all vaccinations and 65.8% of Blacks have been
vaccinated with at least one dose.
• Second, Latinos have received 10.8% of all vaccinations and 84.3% of Latinos have been
vaccinated with at least one dose.
• Third, Asians or Pacific Islanders have received 9.4% of all vaccinations and 93.4% of Asians
or Pacific Islanders have been vaccinated with at least one dose.
• Fourth, Whites have received 56.5% of all vaccinations and 67.6% of Whites have been
vaccinated with at least one dose (Source.).
Figure 3: Cases by Race and Ethnicity
Cases by Race and Ethnicity"
All Health Districts - Past 13 Weeks
As.•n"' Poclfi< l,..nde, I 9,045
Block-41,148
l.>nno. 14,742
N•DW Am.. i<.,.1169
White 97.714
01hef R,aice I 9,044
Two or more ra.ce'5o 12,647
No, Reported
Source
Vaccine Equity Report I October 2022 8
"For more information on how VDH is presenting data on race and ethnicity, visit:
https;/fwww.vdh,vJrgfnia,90yj£amnavirusj2D2JU0.Rl16/rnce-and-ethnicit;rrwortin9-updqwL
Case counts continue to occur amongst Virginia's population, making it more important to focus
efforts on vaccination. 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
known increased and disproportional risks faced by historically marginalized populations in
experiencing the worst effects and outcomes of COVID-19, including death. Likely explanations for
the unequal burden of disease on these populations include social vulnerability, social determinants
of health, and a pattern of historical disparity. It will be crucial to pay attention to these disparities
as the cooler months begin, possibly bringing another wave of COVID-19 cases.
Rural Areas
Figure 4 below displays the rural (non-metropolitan) areas in Virginia as defined by the Office of
Management and Budget (0MB) (Source;). Areas in pink are rural localities while areas in beige
are considered non-rural (as defined by the 0MB).
Figure 4: Rural and Non-Rural Areas in Virginia
D Rural Looalllles
D Non-Rural Localities
Source
Another way to examine rural and urban disparities is to examine rural, urban, suburban and
exurban areas. The lsserman Classification system (shown in Table 2 below) uses a combination of
urban area population and population density to identify counties as urban, rural, or mixed.
Table 2: Percent Population Vaccinated by Urban and Rural Jurisdictions (by Age Groups)
2013 SRHP lsserman Classlflcatlon Stoll Uto17 16to 17 18to30 31 to50 Slto64 65+ Grand Total
Mixed Urban OJ% 69% 3% 68% 69% 8t'i\ 88% 72%
Urban 38% 69% 15,'11, 60% 72% 82% 86% 70%
Mixed Rural 2S% 49% 56% S4% 60% 73% 82% 62%
Rural 17% 41% 47% 48% 54% 69% 78% 58%
Grand Total 34" 62" 67" 59" 67" 78" 84" 67"
Source
Vaccine Equity Report I October 2022 9
Rural areas, especially in south-central and southwest Virginia, continue to have lower vaccination
rates as compared to other areas of the state. There have been some improvements, primarily
concentrated in the north-central and northern regions (Figure 5). Vaccination hesitancy continues
to be an issue throughout the Commonwealth. As seen in Figure 6, counties across Virginia are
experiencing medium to high risk levels. Risk levels have improved this month in comparison to
August when almost the entire Commonwealth was experiencing highly elevated risk levels
(Source). As the winter draws nearer, increasing vaccination rates will be crucial to maintaining
lower risk levels.
Figure 5: Vaccinations by Locality - Rate per 100,000 Population - As of September 30th,
2022
At Least One Dose Rate per
100,000 Population
43911 • 47263
47264 - 50871
• 50872 - 54755
• 54756 - 58935
• 58936 - 63435
• 63436 · 68277
• 68278+
Prople Not Mapped: l 057 ,805
Source
Vaccine Equity Report I October 2022 10
Figure 6: COVID-19 Risk Levels by Locality in September
Risk levels. Gte.en Ytltow Orange
Source
Third, as shown in Figures 7 and 8, some urban and rural disparities remain in terms of cases as
measured by rates per 100,000 people. Some rural counties continue to show slightly higher rates
of cases throughout the Commonwealth.
Figure 7: Cases of COVID-19 Over the Last 13 Weeks in Virginia: Urban and Rural
Rates mat are oas e on counts le;.s
Rates per 100,000 of than 15 stwxM be ilcrl)rct with
Cases by Report Date caunon
C' < 250
0 500.1 • 900.0
• 900.1 · 1600.0
• 1600.1 · 2900.0
• 2900.1 5400.C
• 5400 1 • 10000.0
Source
Vaccine Equity Report I October 2022 11
Figure 8: Deaths from COVID- 19 Over the Last 13 Weeks in Virginia: Urban and Rural
Rates tna1 are based on counts iess
Rates per 100,000 of tM 15 sl'IOult:l i,e ,ntel'J)rete<:i >;"th
Deaths by Date of Death cunon
0<6
D6.0-10.0
D 10.1-20.0
• 20.1- 50.0
• 50.1-100.0
Source
Infections and Deaths Since Vaccine Availability
VD H's data reveal that vaccinations have saved lives (So.urce; 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 3,
disparities detailed in previous vaccine equity reports remain. Whites represent 61 % of the
population, 56% of cases, and 67% of deaths. Blacks represent only 19% of the population yet 23%
of cases and 23% of deaths. Further, Hispanics make up 10% of the population yet 14% of cases
and 6% of deaths. When comparing the percentages in the population, both Blacks and Hispanics
still disproportionately contract COVID-19, and Blacks disproportionately die from it.
Table 3: Comparisons ofCOVID-19 Cases, Deaths, and Population
%of Cases %ofDeaths % of Total Population
White 56% 67% 61%
Black 23% 23% 19%
Hispanic 14% 6% 10%
Asian 4% 3% 7%
Other 3% 1% 3%
Source
Secondly, as shown below in Figures 9 and 10, patterns concerning cases and deaths by age and sex
remain similar in September as they were in previous months. Concerning cases and age, those
Vaccine Equity Report I October 2022 12
aged between 30-39 continue to comprise the segment of the population with the single largest
number of cases. Regarding cases and sex, those identifying as females tend to represent more
COVID-19 cases. Concerning deaths and age, those ages SO+ 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. Regarding deaths and sex, those identifying as male tend to die at
a slightly higher rate than those identifying as female.
Figure 9: Cases of COVID-19 in Virginia: Demographics
Cases by Age Group -
All Health Districts - Past 13 Weeks
Ace Group
0.9
l(H9
20.29
30-39 36,970
40-49
S0-S9
60-69
70.79
80+-11,070
j
Nol Repo<ted 176
Cases by Race and Ethnicity" •
All Health Districts - Past 13 Weeks
Asian or Pacihc 1,lander I 9.045
Bk-41,148
lino • 14,742
Ha- it.merican 1369
97,714
Othe, Race I 9.044
Two or more races 12,647
Not Reported 60.862
Cases by Sex -
All Health Districts - Past 13 Weeks
FemAle 131,134
Male
Source
Afor more information on how VDH is presenting data on race and ethnicity, visit:
https:IJwww.vdh. vir9inia.ooll/cnronavirus/202Q/(l6/16/rac;e-and-ethnici-rwortin9·update.(
Vaccine Equity Report I October 2022 13
Figure 10: Deaths by COVID-19 in Virginia: Demographics
Deaths by Age Group -
All Health Districts - Past 13 Weeks
A,:e Group
0,913
10.19 Io
20,29 2 I
30,39. 14
40.49 I 25
50.59 .52
6().69-114
70.79
80+ 451
Not Reported O I
Deaths by Race and Ethnicity" -
All Health Districts - Past 13 Weeks
Asian or Pacific Islander I 10
Black-156
Latino I 13
NIDU! Amerkan 2 I
White 644
Other Race 1 I
Two or more races 13
Not Reported 16
Deaths by Sex -
All Health Districts - Past 13 Weeks
female
Male
Source
"For more information on how VDH is presenting data on race and ethnicity, visit:
https:L/www.vdh. virg{nia.govlcoronavfrus/2020106!16!race-and·ethnicity·reuoning-updatel
Vaccine Equity Report I October 2022 14
3. Vaccinations in FEMA Region 3
Regarding COVID-19 risk levels in September (Figure 11), most of Region 3 is currently
experiencing medium or high risk levels. The risk levels for Virginia in September were lower than
what they were in August. At present, West Virginia is the most at-risk in FEMA Region 3. Virginia
has 1,330.6 new daily cases, a seven-day moving average of 15.6 new cases per 100,000 people
(last month, Virginia saw 2,682.9 new daily cases with a seven-day moving average of 31.4 new
cases per 100,000 people). These numbers place Virginia fourth out of sixth in FEMA Region 3 in
terms of COVID-19 risk level, meaning that this month was better for Virginia's rankings than last
month when Virginia came in second. To compare, in the month of January 2022, Virginia had
9,194.0 new daily cases with a seven-day moving average of107.7 new cases per 100,000 people.
Figure 11: COVID-19 Risk Levels in September by County across FEMA Region 3
i
State/County Rank Daily new Daily new
cases per cases(7d
..it!
100k people moving
t7d moving avg.I
avg.I
A
.,
B West Virginia 22.9 411.1
·-
El Delaware 22.D 214.0
B Pennsylvania 19.5 2.501. 4
B Virginia
B Maryland
t.
5
15.6
14.2
1.3306
859.J •
B D1stnct of I, 13.2 93.1
..
Columbia
""'' • O..ur -:.-, "
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 parts of the state.
Vaccine Equity Report I October 2022 15
Figure 12: Percent of Population Fully Vaccinated by Social Vulnerability Index, FEMA
Region 3
•counrJa with 1-r rponln6 rMSS
for IIOCdnarJon COYMJ8': Should W inlu,lrff«I with coufJon.
1.DwSVI i.--ModSVI
LowVC LowVC
CMJ.2S 0.2501-0.50 0.5001-CI, 75 0.7501+1.0
Social Vulnerabmty Index (SVI}
Source
FEMA Region 3 and Race/Ethnicity
All areas in FEMA Region 3 continue to show racial disparities in the percentages of vaccines
administered. Both Blacks and Hispanics/Latinos continue to see some improvements in
vaccination percentages, but Blacks are still behind in vaccinations. The vaccination disparity for
the Latino population reversed as of July 11, 2022, with 82% of Latinos vaccinated compared to
68% of Whites (Source). 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 on race and ethnicity (Source). Data shown below in Figures 13-16
are current as of April 4, 2022.
Figure 13: Blacks as a Share of COVID-19 Trends, FEMA Region 3
Black ' Black% of
% of · Total
I Location ; Cases ! Population !
Delaware 24% 22%
District of Columbia 57% 45%
Maryland 33% 30%
Pennsylvania 8% 10%
Virginia 23% 19%
West Virginia 5% 3%
Source
Vaccine Equity Report I October 2022 16
I % of % of
. Vaccinations Vaccinations
' Black% of with Known with Known
Loc,H,on ; Vacc1nat1ons : Race : Ethnicity
Delaware 20% 97% 78%
01stnct of Columbia 46% 88% 92%
Maryland 28% 97% 96%
Pennsylvania t 7% 91% 78%
Virgma 17',I; 85% 85%
West V1rgL,i1a l 4, 97% NR
Source
Figure 14: Hispanics as a Share of COVID-19 Trends, FEMA Region 3
Hispanic Hispanic%
I % of of Total
Location ; Cases Population
Delaware 18% 10%
District of Columbia 14% 11%
Maryland 17% 11%
Pennsylvania 14% 8%
Virginia 14% 10%
West Virginia 3% I'll,
Source
I %of % of
Hispanic% Vaccinations Vaccinations
of with Known I with Known
lorntion ; Vaccinations Race : Ethnicity :
Oefaw.ire 11% 97% 78%
District of Columbia 15% 88% 92%
Maryl.ind 11% 97% 96%
Pennsylvania 1 7% 91% 78%
Virginia 11% 85% 85%
West Virginia 2 NR 97% NR
Soutee
Vaccine Equity Report I October 2022 17
Figure 1S: Asians as a Share of COVID-19 Trends, FEMA Region 3
, Asian Asian % of
% of Total
Location ; Cases : Population
1
Delaware 2% 4%
District of Columbia 2% 4%
Maryland 3% 6%
Pennsylvania 2% 4%
Virginia 4% 7%
West Virginia <1% 1%
Source
% of % of
!
Vacc1nc1t1ons Vaccinations
Asian% of with Known with Known
Loc .. 110n ; Vaccinations : Race Ethnicity ;
DelawJre 6'l6 97% 78%
D,srnct of Columbia 6% 88% 92%
Maryland 8% 97% 96%
PennsylvJ,ma 1 3% 91% 78%
v,,gm1a 9% 85% 85%
West Virgi111J 1 NR 97% NR
Source
Figure 16: Whites as a Share of COVJD-19 Trends, FEMA Region 3
White White% of
% of Total
Location Cases : Population :
Delaware 47% 61%
District of Columbia 21% 37%
Maryland 43% 50%
Pennsylvania 74% 76%
Virgmia 56% 61%
West Virginia 91% 93%
Source
Vaccine Equity Report I October 2022 18
1
%of %of
I Vaccinations Vaccinations
I
1 White% of with Known with Known
Locllon ; i Vaccinations ; · Race : Ethnicity :
lx!lawJre 70% 97% 78%
D1str ct of Columbia 47% 88% 92%
Maryland 53% 97% 96%
Pennsylll,mkl 1 74% 91% 78%
Virgm•a 57% 85% 85%
West Vu-g ma 2' 92% 97% NR
Source
Notes:
1. Data does not include Philadelphia County due to differences in reporting data. As of 6/21, PA
total population data was updated to exclude Philadelphia; data should not be compared to
earlier periods due to these data changes or corrections.
2. Data prior to 4/12 will not reflect people receiving the single dose ofthe Janssen vaccine
because the data reflects people receiving the first dose oftwo-dose vaccinations.
4. Trends Over Time
A little over two years into the COVID-19 pandemic, there are still inequities in overall vaccination
rates. However, these inequities have declined over time in Virginia. Overall, minorities have
consistently had less access to vaccinations, and lower overall vaccination rates, than Whites.
Recently, those gaps have begun to narrow and VDH is working to further dispel disparities. In
addition, the 7-day average number of cases increased last winter due to the Omicron variant,
declined significantly during the spring, and started to climb again in late spring and summer. As
part of its efforts to address inequities, VDH has transitioned its community testing centers to a
mobile clinic model in order to be able to reach areas that have low access to testing. Moving
forward, particular attention should be given to the Black population as they still suffer the worse
vaccination disparity out of all other racial and ethnic groups. These items 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 56.5% of the population with reported
race and ethnicity that have been vaccinated with at least one dose (no change since last month).
Blacks make up 19% of Virginia's total population and 17.4% of the one-dose vaccinated population
(no change). 10% of Virginia's population is Hispanic and 10.8% of the vaccinated population in
Virginia is reported to be Latino (no change). 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
(no change) (Smu:re; Source). Looking at vaccination coverage data since the start of the vaccine
rollout, vaccinations occurred amongst Blacks at only 0.9 times the rate of Whites. Cases and deaths
occurred amongst Blacks at 1.2 and 1.5 times the rate of Whites, respectively, when looking at
Vaccine Equity Report I October 2022 19
cumulative data across the entire pandemic. 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.
Blacks especially carry an unequal burden of disease in Virginia when compared to Whites and
Asians, as shown in Figure 17. Amongst Latinos, when analyzing data from the start of the vaccine
rollout, vaccinations occurred at 1.1 times the rate of Whites while cases and deaths each occurred
at 1.3 times the rate of Whites. VDH has been working throughout the pandemic to address these
health disparities. Fortunately, some notable progress occurred in the last three months. As shown
in Figure 17, rate ratios within the time period of the last three months reveal that, when compared
to the cumulative rate ratios discussed above, the disparity gaps in vaccination status amongst
Blacks and Latinos have disappeared. While Blacks continued to experience a disproportionately
higher burden of cases, deaths, and hospitalizations in the last three months when compared to
Whites, the rate ratio gaps are still smaller than what they were cumulatively, indicating some
recent progress in health equity. The data in Figure 17 used to be publicly available on VD H's
Health Equity dashboard, but is now stored internally.
Figure 17: Racial and Ethnic Distribution of Burden of Disease in Virginia Over the Last
Three Months (according to vaccinations, cases, deaths, and hospitalizations)
Select Helth Oistriict Time Period • Rate Category
(Affects all charts on page) (Affects bar chert only} • Case vacdnated
------------ "] !3month•
F: "I .Death
• Hospita1izea
Asian or Pacific 0.8
Islander
0.6
0.4
2.1
1.1
1.3
18
.o
08
Doses Administered
Between October 2021 and March 2022, Virginia saw a spike in the 7-day average of doses
administered. In general, the number of vaccines administered decreased as the winter Omicron
surge subsided. As of September 29th, the peak average number of vaccines administered in
September occurred on September 24th, with 15,021 doses (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 first Omicron variant was spreading, then a general decrease in
demand from the second half of January onward, and a slight uptake in vaccinations again as the
Vaccine Equity Report I October 2022 20
BAS subvariant began to spread (Source; Source). As the fall season begins, the daily number of
vaccines administered is starting to rise again statewide and nationally, as shown below.
Figure 18: Daily Number of Administered COVID-19 Vaccine Doses and 7-Day Average in the
United States
Daily Count of Doses by Date of Vaccine Administration, United States
,U.01'--------,1-1--------------------------
t------+ti-tfJt.at+-------------------------
(Blue bars represent daily numbers and red line shows 7-day average) Source
5. Vaccine Hesitancy
With close to 17 million vaccination doses administered, and a little over 7 million people (82.7%)
vaccinated with at least one dose, Virginia's vaccination rates surpass the national rate of 79.5%
( ; Source). This percentage includes those who have received at least one dose as well as
those who are fully vaccinated (67.8% of the U.S. population is fully vaccinated while 72.6% of
Virginia's population is fully vaccinated). However, there is still nearly 30% of Virginia's population
who has not been fully vaccinated (Source). Working to vaccinate a larger percentage of the
population and reducing vaccine hesitancy are important factors in combating the pandemic,
especially with the school year now underway across Virginia [Source).
Looking at nationwide trends from Kaiser Family Foundation polling, there has been some change
over time between December 2020 and July 2022 when it comes to individuals who say that they
will "definitely not" get vaccinated. Data indicate that, while 14% said that they would not get
vaccinated in January 2022, 19% said the same in the latest poll from July 2022 (£oun;,e:).
Throughout 2021, there were some changes in attitudes in Virginia as well. 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 (Sou). Between these polls, both the percentage and the total number of those
Vaccine Equity Report I October 2022 21
who were not at all likely to get vaccinated increased. More recent polls by RISE regarding attitudes
towards vaccination have either not been conducted yet or the results have not yet been released.
According to a statewide survey conducted by Mason-Dixon Polling & Strategy, 87% of
unvaccinated adults in Virginia say they do not plan on getting vaccinated for COVID-19 (Soorce).
Their reasons for not getting vaccinated included:
• Concerns that the vaccine could cause other health problems (28% of respondents)
• Doubts about the health threat posed by COVID-19 (22%)
• Doubts about vaccines in general
• Feeling that the vaccine is unnecessary for individuals who have already contracted
coronavirus (17%)
• Skepticism about the federal government's role in vaccine development (13%). (Source)
In order to combat vaccine hesitancy, VDH is working to communicate the benefits of vaccination to
the public. VDH experts regularly communicate with local media to answer questions and offer
information about COVID-19 vaccines in Virginia (for example, and).
More recent polling from the Kaiser Family Foundation indicates who remains unvaccinated. The
most recent poll is from July 2022. Of those adults who have not gotten a vaccine:
• 58% are individuals between the ages of 18-49
• 28% are between the ages of 30-49
• 31% have a high school education or less
• 31% identify as Republican
• 32% have annual incomes less than $40k
• 21% reside in suburban areas and 33% reside in rural areas (Source)
Vaccination Mandates
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). In January 2022,
the Biden Administration withdrew its mandate following the Supreme Court's decision to block it.
On January 15, 2022, the Governor of Virginia issued Executive Director Number Two (2022),
rescinding Executive Directive Number 18 (2021), and with it the vaccine mandate for state
employees (S.o:un:e). On January 26, 2022, Virginia's Attorney General issued an advisory opinion
concluding that Virginia colleges and universities did not have the authority to require COVID-19
vaccinations as a condition of enrollment or in-person attendance, superseding a prior opinion
(Ke). These actions effectively ended vaccine mandates in Virginia.
On January 20, 2022, the Governor of Virginia announced the COVID-19 Action Plan with three key
activities: (1) COVID-19 Vaccine Marshall Plan for Virginia, (2) Expanded Healthcare Flexibility &
Support, and (3) Prioritized Testing Guidelines (S:ource). His plan was updated on February 21,
2022 to include Treatment in activity (2) and to replace activity (3) with Charting a Path to
Normalcy. The White House released its March 2022 National COVID-19 Preparedness Plan with
an outline of its four key goals: (1) Protect against and treat COVID-19, (2) Prepare for new
Vaccine Equity Report I October 2022 22
variants, (3) Prevent economic and educational shutdowns, and (4) Continue to lead the effort to
vaccinate the world and save lives (Source). These plans signaled a new phase in the pandemic
response for Virginia and the nation. On July 14th, Governor Youngkin announced updated
guidance on quarantine recommendations for people exposed to COVID-19 in K-12 schools, child
care, and camp settings. The revised guidance states that quarantine is no longer recommended
for asymptomatic individuals who were exposed to COVID-19-infected individuals in these
settings (SJwr.ce).
6. On the Horizon
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 that those who were unwilling to be vaccinated in late 2020 were
still unwilling to be vaccinated in the fall of 2021. Vaccinations in children under the age of 18
(including now infants) and frequent testing are essential to keeping children and staff healthy in
schools, daycares, and summer camps. These protocol will be especially critical since the school
year has begun and as Virginia gets ready to enter the winter months. Risks of reinfection and
experiencing more severe symptoms seem to be higher with the BAS variant. Continued efforts
to encourage vaccination, including booster shots when eligible, and reducing vaccine hesitancy
are important factors to ensure Virginia remains on the path to normalcy. Therapeutics, testing,
prevention, outbreak control, and public health information are also important factors.
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 remains an important
factor in controlling COVID-19 and maintaining the path to normalcy. Racial and ethnic disparities,
as well as disparities between urban and rural areas, remain a challenge.
Vaccine Equity Report I October 2022 23
Appendix
Charging Statutes
2.022 App:ropdation Act IJem 291 t The Department of Health shall convene a work group, 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 work group 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, and (iii) make recommendations for any statutory, regulatory, or budgetary
actions necessary to implement such plan. The Department shall make an initial report on its
activities and any findings to the Chairs of the House Committee on Health, Welfare and Institutions
and the Senate Committee on Education and Health by December 1, 2020, and shall report monthly
thereaf ter htt;//budgetljs.yirginia,gov/itern/2022/2/H B30,L.Chap.ter/1/29l/
Vaccine Equity Report I October 2022 24
File and source
- File
- 2022-RD627.pdf
- Size
- 4,250,674 bytes
- SHA-256
- 3cdd0e2a9b8c66b3ce4a1476219f16decf6427108050237dc0ab88b557d7668e
- Our copy
- 2022-RD627.pdf
- Original
- No public link identified.