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Among the things that Pearl Barry is excited to do once she’s fully vaccinated: hang out with friends, eat inside at restaurants and visit SkyZone, a sprawling indoor trampoline park.

“I mean, obviously,” said the eight-year-old from Bon Air. “Who wouldn’t be?” She got her first dose of Pfizer’s pediatric vaccine on Wednesday night, and besides the hour-long wait at her local Walgreens, the process went relatively smoothly. The shot itself felt like the smallest pinch ever, Pearl said — more like a mosquito bite. And her dad, Tim Barry, was equally relieved to see both Pearl and her 5-year-old sister, June, take their first steps toward full immunization.

“Pearl probably asks to go to SkyZone two or three times a week,” he said. “So we’re really excited to have this coincide with Christmas and be able to be more free about seeing friends and family.”

Across Virginia, other parents are feeling the same jubilation. In the first week after federal officials authorized Pfizer’s COVID-19 vaccine for 5 to 11-year-olds, more than 35,000 children received their first dose — close to 5 percent of the state’s total population in that age group, according to data from the Virginia Department of Health.

After months of anticipation from families, Pfizer’s COVID-19 vaccines for five to 11-year-olds were authorized Tuesday after a sign-off from Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention.

But doctors and local health officials are urging patience even as thousands of vaccines, specially formulated for pediatric patients, flow into Virginia. State vaccine coordinator Dr. Danny Avula said supply isn’t a concern for health officials. But the first shipment of doses will be divided across the state and, in many cases, redistributed to local providers, likely creating some backlogs when it comes to booking appointments.

“The availability is a little constrained because this is a new vial, it’s new packaging, it’s a new buffer,” said Breanne Forbes Hubbard, population health manager for the Mount Rogers Health District in southwestern Virginia. “So, we can’t just draw up from existing adult vials, unfortunately, because we have plenty of those ready to go.”

According to Avula, a total of 377,000 pediatric doses are expected to be delivered to Virginia in the first week of shipments — 252,000 of which will go to health departments, private practices and health systems. Another 125,000 will be delivered to pharmacies through a partnership with the federal government.

Fully vaccinated Virginians are receiving COVID-19 booster shots at more than double the rate of people getting their first dose, according to a Richmond Times-Dispatch analysis of Virginia Department of Health data.
Of the nearly 728,000 vaccinations recorded between Sept. 27 and Friday — a time frame that widened the eligibility for Pfizer, Moderna and Johnson & Johnson booster shots to millions of residents — the majority were third doses or boosters.
Less than a quarter were first jabs against the coronavirus.
The pattern is unsurprising, said Dr. Michael Stevens, interim hospital epidemiologist at VCU Health. But it’s widening the gulf between who faces the least and most severe risk of infection heading into the winter months.

“Every person who gets vaccinated sort of helps the overall population prevent COVID from spreading in the population, but until you get to that magic herd immunity number, which people talk about and no one knows quite exactly what that number is, no. We’re not going to stop seeing spread in the community,” Stevens said. “We’re not going to stop seeing surges.”

Virginia’s health secretary, who’s held a key role in the state government response to the COVID-19 pandemic, is leaving his job as Gov. Ralph Northam’s term soon closes to work for a nonprofit health system.

Dan Carey’s last day at the post will be Friday, Northam’s office told the Richmond Times-Dispatch. He will become chief medical officer for Providence Physician Enterprise, a collective of affiliated physicians and medical groups based in Washington, D.C.

Carey was named secretary of health and human resources shortly before Northam took office in 2018. He was a key adviser to the governor on pandemic restrictions and public messaging.

In a letter to the governor’s Cabinet, Carey said serving as secretary “has been the greatest privilege of my professional life,” and described the last two years as “immersive and all-consuming.”

Carey is the latest top official in the Northam administration to leave before his term ends in January. Others include finance secretary Aubrey Layne, chief counsel Rita Davis and natural resources secretary Matt Strickler.

Vanessa Walker Harris, the deputy health secretary, will be elevated to the secretary’s post.

RICHMOND, Va. — The health department reported 11,817 more people tested positive for COVID-19 out of the 234,604 total tests processed over the past week. That brings Virginia’s total number of coronavirus cases to 914,755.

As of Friday’s update, 38,269 (+502 from the Friday before) people had been hospitalized and 13,668 (+277) people had died as a result of COVID-19-related illnesses, according to updated Virginia Department of Health (VDH) data.

RELATED: 11,800+ new cases reported this week; 62.3% of Virginians now fully vaccinated

Scroll down for complete city/county-by-county breakdown of COVID-19 cases in Virginia

Nearly 18 months after Virginia’s first recorded case of COVID-19 — a period that’s seen the virus surge and retreat four different times — new infections are once again on the decline. Once again, many researchers are cautiously optimistic that we’re leaving behind the latest wave, driven by the highly infectious delta variant, which raised hospitalizations in some areas of the state higher than they were last winter.

That doesn’t mean we’ve beaten the virus.

“We still have a very high case rate, like most of the states in the country,” said Bryan Lewis, a computational epidemiologist with the University of Virginia’s Biocomplexity Institute. “We’ve been down for a few weeks, so everybody feels good, but there are still a lot of people going into the hospital.”

As of Friday, Virginia was still recording an average of more than 2,000 new infections a day. More than 1,500 patients are hospitalized with coronavirus in the average week, according to data from the Virginia Hospital and Healthcare Association. Those figures seem particularly stark compared to this summer, when daily new cases dropped below 150 and COVID hospitalizations reached an all-time low.

At least six pregnant Virginians have died of COVID-19, and 346 have been admitted to hospitals for serious illnesses.
It’s not known what happened to their babies — whether any were lost or if they got sick. Virginia Department of Health officials said they don’t have data on their outcomes.

Pregnant people are more likely to get severely ill if they contract the virus than those who aren’t, state epidemiologists said. If they have underlying health conditions, such as diabetes or obesity, they’re at even greater risk.
With the recent rise in cases, more pregnant patients ended up in the hospital earlier than planned. Lucy Vinson, a Sentara Norfolk General Hospital ICU nurse manager, said her team also has cared for a slew of pregnant coronavirus patients.

“More than we’ve ever treated in probably the history of our unit,” she said.
Virginia’s alarming rate of infections among pregnant people is a pattern throughout the country. The Centers for Disease Control and Prevention reported that COVID-19 deaths in pregnant individuals increased in August. The federal agency recommended urgent action Wednesday to increase vaccination among people who are pregnant, nursing or trying to get pregnant — stressing that data show the shots are safe and effective.

In mid-August, as the delta variant was surging across Virginia, hospitals reached out to Gov. Ralph Northam’s administration for help.

“This rise in infections is once again placing significant stress on general hospitals and nursing facilities within the commonwealth,” wrote Sean Connaughton, president of the Virginia Hospital and Healthcare Association, in a letter to Health Commissioner Dr. Norman Oliver and Health Secretary Dr. Dan Carey. At the time, the seven-day average for new hospitalizations mirrored that of March, when Virginia was still recovering from a massive holiday surge.

Connaughton asked the administration to reinstate emergency waivers that had given hospitals the ability to quickly add bed capacity and hire out-of-state providers, among other regulatory changes that could provide flexibility.

“Staffing levels at these facilities are severely strained by a shortage of health care workers and trained health care professionals, exacerbated by fatigue, personal illness and family needs stemming from this long-term pandemic event,” he wrote. “It is further anticipated that COVID-19 will continue to place increased demands on the commonwealth’s health professional workforce.”

It was far from the only communication between health systems and the Northam administration. Emails from Carey’s office, obtained through a Freedom of Information Act request, show multiple hospitals began raising concerns over increasing caseloads around the same time. An Aug. 13 email from James Moss, the state hospital coordinator with the Virginia Department of Health’s Office of Emergency Preparedness, noted that facilities in Eastern Virginia were already “getting close” to exhausting their bed space.

• “About a month into the school year, a clear majority of Virginia voters support coronavirus vaccine mandates in schools, while a smaller majority supports such requirements for in-person workers in the state, according to a Washington Post-Schar School poll.”—Washington Post

Last month, Gov. Ralph Northam gave state employees a choice: get vaccinated or submit to weekly testing for COVID-19.

Many, it appears, have chosen testing.

While comprehensive figures aren’t available yet, a survey of some of the largest state agencies reveals employee vaccination rates range from just over 50 percent at the Department of Corrections to 87 percent at the Virginia Department of Health.

Other agencies, including the Virginia Department of Transportation and the Virginia State Police, reported vaccination rates that roughly mirror the state’s overall vaccination rate of about 60 percent.

Northam wrote in his Aug. 5 executive directive that “vaccination is the only method to protect fully against the virus.” But unlike a similar order issued by President Joe Biden for the federal workforce, Northam’s directive did not actually require state employees to be vaccinated. Instead, it asked them to disclose their vaccination status and, if they are unvaccinated, submit to weekly testing at the state’s expense.

The directive does not require unvaccinated employees to request a formal exemption, but it does allow employees to opt out of the weekly testing if they lodge a religious rejection or have a medical reason — a step few state employees appear to have taken.

The testing required under the mandate has come at a cost to taxpayers.

Three Winchester Medical Center workers who refused to get vaccinated against the coronavirus unsuccessfully sued to keep their jobs.

The lawsuit was filed on Monday against Valley Health System, the six-hospital chain that includes WMC, on behalf of registered nurses Rebecca Ashworth and Kayla Cox and certified nursing assistant Lori Swartz. All Valley Health employees had until midnight Tuesday to get vaccinated or get fired unless they received medical or religious exemptions.

Judge William Warner Eldridge IV on Tuesday in Winchester Circuit Court dismissed the suit. He sided with Valley Health, whose attorneys argued the plaintiffs needed authorization from the Virginia Attorney General’s Office of Civil Rights to sue under the Virginia Human Rights Act.

“The VHRA does not permit a claimant to pursue temporary relief in court until ‘after a notice of a charge of discrimination is issued,’” attorney Andrew S. Baugher wrote, citing a June verdict in Norfolk Circuit Court that ruled in favor of the city of Norfolk. “And then, ‘the petition shall contain a certification by the Office that the particular matter presents exceptional circumstances and irreparable injury will result from unlawful discrimination in the absence of temporary relief.’”

Over the last week, health systems and emergency physicians across Virginia have sounded the alarm over a surge of COVID-19 hospitalizations threatening to overwhelm many emergency rooms.

But the rise of the delta variant, coupled with the start of the new school year, is also creating chaos for pediatricians, who are struggling to treat an unprecedented swell in patients. On Friday, the Virginia chapter of the American Academy of Pediatrics issued a “call for help,” saying practices have been unable to keep up with “surging demand” for office visits and COVID-19 testing.

“Our volumes are through the roof,” chapter president Dr. Michael Martin said in a phone interview on Friday. “I don’t know anyone who’s not over capacity. This is the worst I’ve seen it, and I’m in my 40s. When you talk to older physicians, they’ve never seen this either.”

According to Martin, a combination of factors have created a “perfect storm” for pediatricians over the last several weeks. First, the end of statewide restrictions and dramatic decline in cases over the spring and summer led more Virginians to return to life as normal. Many children returned to daycare and summer camp — often unmasked — leading to a rise in non-COVID-19 respiratory illnesses.

Over the last few weeks, hospital systems across Virginia have been sounding alarms over the latest coronavirus surge, largely driven by the highly infectious delta variant.

In Southwest Virginia, Ballad Health is facing its “worst-case scenario” with more than 700 COVID-19 patients. In Northern Virginia, hospitals already nearing capacity with COVID-19 cases have been overwhelmed by recently arrived Afghan refugees. And on Thursday, the Virginia Hospital and Healthcare Association issued a statement on behalf of more than three dozen medical groups, pleading for unvaccinated Virginians to get their shots.

“In just two months, hospitalizations have increased by 1,008 percent and new cases have jumped by 1,217 percent,” it read. “With hospital inpatient and ICU beds already filling ahead of a looming fall surge, it is imperative for unvaccinated Virginians to do their part to help save lives and slow the spread of this deadly virus by getting vaccinated.”

Nowhere has the latest spike in cases been more obvious than in Virginia’s beleaguered emergency rooms, where unvaccinated and often seriously ill COVID-19 patients are adding stress to an already maxed-out system. Dr. Todd Parker, president-elect of the Virginia College of Emergency Physicians, said almost every hospital across the state is struggling with overcrowding, widespread staffing shortages and difficulty transferring patients — who frequently require higher levels of care — to facilities experiencing the exact same challenges.

The Food and Drug Administration expanded emergency use authorization of the Pfizer-BioNTech COVID-19 vaccine to include adolescents 12 to 15 years of age on May 10. The Centers for Disease Control and Prevention followed with recommendations endorsing use in this age group after their advisory group meeting on May 12. The American Academy of Pediatrics also supports this decision.

Dr. Debbie-Ann Shirley is an associate professor of pediatrics at the University of Virginia specializing in pediatric infectious diseases. Here she addresses some of the concerns parents may have about their teen or preteen getting the COVID-19 vaccine.

1. Does the vaccine work in adolescents?
Yes, recently released data from Pfizer-BioNTech shows that the COVID-19 vaccine seems to work really well in this age group. The COVID-19 vaccine was found to be 100 percent efficacious in preventing symptomatic COVID-19 in an ongoing clinical trial of children in the U.S. aged 12 to 15. Adolescents made high levels of antibody in response to the vaccine, and their immune response was just as strong as what has been seen in older teens and young adults 16-25 years of age.

A COVID-19 vaccine mandate is not being ruled out in Virginia but it won’t happen in the near future, if at all. That’s according to the state’s Vaccine Coordinator Dr. Danny Avula, who spoke to 8News via Zoom on Thursday.

In the meantime, Dr. Avula said the use of so-called “vaccine passports” or certifications are a more likely solution for skepticism.

“If our ability to move forward as a society, to open back up businesses, to open back up schools, is contingent on this, then I think we find every way we can to incentivize it and potentially even get to a point where we require it, but I think we’re a long way from that,” Dr. Avula said.

Gov. Ralph Northam amended Virginia’s mask mandate to match recently issued guidance from the U.S. Centers for Disease Control and Prevention.

The changes, announced in a Thursday press release, went into effect immediately, according to Northam’s spokeswoman, Alena Yarmosky. They allow fully vaccinated Virginians to “participate in outdoor activities and recreation without a mask,” based on language from the CDC. Those include solo activities and small outside gatherings of fully vaccinated people.

People are considered fully vaccinated two weeks after receiving their second shot (or two weeks after their first, in the case of Johnson & Johnson’s one-dose vaccine). Neither the state nor the CDC has specified whether there’s an exact size limit for “small” outdoor gatherings, but Yarmosky said the administration is “asking folks to use their best judgement.”

Virginia universities plan a return to campuses in the fall, but there are questions if the COVID-19 vaccine can be mandated.

The U.S. Food and Drug Administration only authorized the vaccine for emergency purposes, according to Lisa Lee, professor of public health at Virginia Tech in Blacksburg. The vaccine does not yet have full FDA approval.

The vaccine was authorized for emergency use, so people have to be given the choice to take it and be informed of the consequences if they don’t, Lee said.

“Many legal scholars have interpreted that as saying that people cannot be required to take a vaccine that is under an emergency use authorization,” Lee said. “They can be when it has full approval, so that’s where the hitch is.”

Starting May 15, Virginia will significantly relax capacity restrictions on social gatherings and entertainment venues as COVID-19 numbers plateau across much of the state.

Gov. Ralph Northam announced the latest rollback in a video message on Thursday, citing the state’s continued progress in vaccinations. Data from the Virginia Department of Health indicates that more than 40 percent of the population has received at least one shot and more than 26 percent are fully vaccinated. Every Virginian 16 and older became eligible for the vaccine on Sunday.

“Vaccination numbers are up, and our COVID case numbers are substantially lower than they were earlier this year,” Northam said in a statement. “So, we have been able to begin easing some mitigation measures.”

Over the last month, state and federal officials have directed thousands of COVID-19 vaccines to large-scale clinics in vulnerable communities with high rates of coronavirus cases — all in areas with significant or majority Black and Latino populations.

The sites have been touted by leaders as a core strategy in expanding access to vaccines among communities of color, where immunization rates are consistently lower than they are for White Virginians. “We have done a very good job in the commonwealth in addressing this issue,” state Health Commissioner Dr. Norman Oliver said at a news briefing last month in response to questions over vaccine equity.

“We have brought on staff in our emergency support team that is doing outreach in these communities,” he added. “We’ve put boots on the ground in all 35 of our health districts and those teams are doing your basic sort of community organizing — door to door, working with faith leaders, community-based organizations to bring people from these vulnerable populations to our vaccination sites.”

National data is shedding new light on how the COVID-19 pandemic is affecting medical providers and their mental health as they balance the emotional and physical demands of a sometimes deadly virus. For frontline hospital workers, it’s often the visceral jolt — and exhausting work — of caring for critically ill patients. But primary care physicians are also reporting fears of infection and ongoing stress that comes from a radical shift in how their businesses operate.

In Virginia, there’s growing concern that burnout and extreme stress could lead more providers to leave the field or grapple with long-term mental health problems. On an individual level, it’s bad for doctors and their patients. But on a systemic level, there’s also worry that COVID-19 could make an existing physician shortage worse.

“One of the things we always talk about is physicians, nurses, support staff — they’re taking care of patients every day,” said Taylor Woody, the communications manager for the Medical Society of Virginia. “But who’s focusing on taking care of them?”

Virginia is one of a growing number of states exploring testing as a way to combat COVID-19 in K-12 schools.

Dr. Laurie Forlano, a deputy commissioner for the Virginia Department of Health, said the agency is launching a pilot program to provide rapid antigen tests to schools across the state. VDH is rolling out the program with Abbott BinaxNOW tests — portable kits, roughly the size of a credit card, that provide results in around 15 minutes.

“We agree that testing can be a layer of prevention,” said Forlano, who oversees population health for the department. The concept of screening students and staff isn’t a new one, and some colleges and private K-12 schools have been testing since the fall. But it’s taken on a new importance since Virginia — like many states across the country — began encouraging local school divisions to reopen for in-person instruction.

As of March 22, only three of Virginia’s 132 school districts were operating fully remotely. The U.S. Centers for Disease Control and Prevention have also issued interim guidance for K-12 testing, which is largely mirrored by VDH in its own reopening guidelines for schools.

Gov. Ralph Northam announced Thursday that the state will expand vaccine eligibility to all Virginians 16 and older by April 18.

The news puts Virginia nearly two weeks ahead of the May 1 deadline set by President Joe Biden earlier this month. In a news release, the administration said that nearly every high-risk Virginian who pre-registered for a vaccine has already received a shot, allowing the state to expand eligibility sooner than expected. Those still on the state’s pre-registration list will receive an appointment invitation within the next two weeks.

“Expanding vaccine eligibility to all adults marks an important milestone in our ongoing efforts to put this pandemic behind us,” Northam said in a statement. “I thank all of the public health staff, health care workers, vaccinators, and volunteers who have helped make this possible.”

In late September, when Virginia health officials launched a dashboard that detailed outbreaks in K-12 schools across the state, it was applauded as a long-needed step toward more transparency — and a relief for parents hesitant over the prospect of sending their children back to the classroom.

Six months later, the data on reopening has gained even more importance amid a state and nationwide push to return students to the classroom. But there are limits on what it can and can’t tell officials, parents and others looking for answers on the relative risks of in-person school.

In early February, Gov. Ralph Northam directed local divisions to begin offering in-person instruction by March 15. Three weeks later, the Virginia General Assembly passed legislation — with bipartisan support — that mandates a return to the classroom by July 1.

As a result, only three of the state’s 132 local school divisions were operating fully remotely as of March 22, according to data from the Virginia Department of Education. Thirty-eight are fully in-person — defined by the agency as providing at least four days of in-person instruction for all students.

Sam Kukich was initially excited to join a workgroup she thought would focus on improving staffing levels at Virginia nursing homes.

The director of Dignity for the Aged, a Poquoson-based nonprofit, Kukich had become an almost inadvertent advocate for reforming standards of care in the nursing home industry. She and her family had already made headlines across the state when they detailed a nearly five-year-long struggle to find care for her mother-in-law, who lost 65 pounds and suffered dozens of falls at multiple facilities in the Hampton Roads region.

When she started Dignity for the Aged in 2018, largely out of frustration, Kukich started hearing from “all sorts of people” about cases of abuse and neglect in Virginia nursing homes. Many of the cases, she said, were linked to understaffing — certified nursing assistants and other health care workers who were simply too overworked and overwhelmed to properly care for residents.

So Kukich was disappointed last year, when a Virginia Senate subcommittee rejected a bill from Sen. Jennifer Kiggans, R-Virginia Beach, that would set minimum staffing ratios for the industry. It was the 16th straight year similar legislation had died, but this time, legislators ordered the state Department of Health to organize a work group to “review and make recommendations” on increasing the nursing home workforce in Virginia.

With COVID-19 cases down after a winter surge, and with nearly a quarter of the population having received at least one dose of vaccine, Gov. Ralph Northam is again rolling back some of Virginia’s pandemic restrictions — cautiously.

At a Tuesday news briefing, the governor announced the expansion of the attendance cap on indoor social gatherings from 10 to 50 people. Outdoor gatherings, currently limited to 25 attendees, will be allowed up to 100.

Alena Yarmosky, the governor’s spokeswoman, said the new guidelines will offer slightly more flexibility to events-oriented businesses — including Virginia’s wedding industry, which has lobbed some of the harshest criticism at Northam’s health and safety guidelines (at least two venue owners have sued over the restrictions).

But the governor is still taking a moderate approach to reopening compared to some neighboring states, including Maryland, where Gov. Larry Hogan lifted all capacity restrictions for the vast majority of businesses earlier this month. Northam’s executive order requiring mask wearing in indoor public areas remains in effect.

More essential workers and Virginians with underlying medical conditions can now access COVID-19 vaccines through major pharmacies across the state, the Virginia Department of Health announced Wednesday.

There are currently eight large chains that offer vaccines through a partnership with the federal government, including CVS, Walgreens, Walmart, Kroger and Albertson’s, which owns Safeway grocery stores.

Some independent pharmacies are also included in the partnership, which provides doses to more than 300 locations across Virginia, according to Stephanie Wheawill, director of VDH’s Division of Pharmacy Services.

While the doses supplied to pharmacies are separate from Virginia’s overall allotment, Wheawill said locations are asked to follow the state’s distribution guidelines. Until this week, state health officials instructed pharmacies to limit doses to residents 65 and older, as well as certain essential worker categories.

More than 70 million Americans have received at least one dose of a COVID-19 vaccine — and along with that shot, a small paper card with the CDC’s label detailing the timing and manufacturer of the dose.

Those paper cards at the moment are the only proof readily available to Americans of their vaccination against a virus that has upended businesses, schools and most other aspects of daily life.

That could soon change, with multiple companies and nonprofit groups working to create “vaccine passports” — smartphone-based apps that would allow someone to certify that they’ve been vaccinated. The apps so far are aimed at travelers, who may be required to show proof of their vaccination status before boarding a plane or entering another country.

In early January, Gov. Ralph Northam warned that the worst of Virginia’s winter surge may not have happened yet.

“The virus is worse now than it’s ever been,” he said at a news briefing. At the time, the state had reached an all-time high in daily new cases and hospitalizations — a trend that threatened to overwhelm some hospital systems. Many local health departments were forced to suspend contact tracing programs amid the spike, warning residents that winter travel and holiday gatherings had made it impossible to keep up with cases.

“Case numbers are about four times higher than they were last spring, and we can expect them to go higher,” Northam continued. “In fact, the [University of Virginia] model shows cases could keep rising until Valentine’s Day or even later.”

The pandemic has made this past year unlike any other at Beth Sholom, a senior living center in Henrico.

In late February, it seemed we were facing a typical long-term care viral threat, but I could not shake the sinking feeling in the pit of my stomach that this was going to be much bigger. In the early, there was so little information available, making it difficult to anticipate and prepare for the reality of what was coming. We were one of the first senior living communities in our area to lock down, and like so many others in our industry, we faced extraordinary daily challenges and heartbreaking losses.

Here is our story.

Our frontline staff put themselves and their families at risk every day simply by coming to work. Once the March lockdown was in place, many of our staff found it difficult to meet the challenges of working and managing their families. When schools closed, they scrambled to find ways to address the needs of their children while continuing to work. Daily, our employees faced the fear of bringing the virus — which was not understood — home to their family.

As Virginia continues to combat the public health challenges of COVID-19, the distribution of vaccines in the commonwealth provides a long-needed glimmer of hope.

The complex COVID-19 vaccine distribution process underscores the importance of accurate immunization histories and records. While Virginia had the foresight years ago to invest in an immunization registry for individuals, families, medical providers and public health researchers, recent action by the General Assembly has strengthened the statewide database of vaccine history and distribution. To keep our communities healthy even after the pandemic, all health care providers that administer vaccines, starting in January 2022, will participate in the Virginia Immunization Information System.

VIIS is a free, statewide, digital immunization registry that records reported vaccination doses distributed by health care providers to individuals, thus increasing the ability to appropriately react to vaccine-preventable disease outbreaks. Vaccine registry systems like VIIS are incredibly helpful for improving the public health response to outbreaks of diseases like measles, Hepatitis A, H1N1, and now COVID-19. By sharing the data with the state, appropriate resources can be deployed to counteract outbreaks and help increase community immunization rates. Currently, the Virginia Department of Health reports that 2.1 million children are under-immunized.

For public health experts across Virginia, the Johnson & Johnson vaccine was a more-than-welcome addition to the state’s weekly allocation.

The one-dose shot boosted Virginia’s shipments by 69,000 this week, spurring a slew of new mass vaccination events. It doesn’t have the same cold storage requirements, making it easier to ship and redistribute. And at the national level, it’s prompting a new wave of optimism, with President Joe Biden promising a vaccine “for every adult in America by the end of May.”

But state health officials also worry the Johnson & Johnson vaccine has an image problem. When trial data was released, many reports honed in on the numbers: 72 percent effective against COVID-19 infections in the United States, 66 percent effective in South America and 57 percent effective in South Africa. Pfizer’s, by contrast, showed 95 percent effectiveness at preventing symptomatic COVID-19 after two doses. Moderna’s showed 94.1 percent.

President Joe Biden is urging states to prioritize teachers for COVID-19 vaccines, setting a goal of ensuring that every pre-kindergarten through 12th grade educator, school staff member and childcare worker is able to receive at least one shot this month.

At least 34 states and the District of Columbia have some or all teachers eligible to receive the coronavirus vaccine, according to tracking data from Education Week.

That tally has been growing in recent weeks, as many students across the country approach the one-year mark for switching to virtual classes due to the pandemic.

Biden’s latest directive to states is the latest step in his administration’s effort to aid schools in safely reopening their buildings to in-person classes. In a televised statement from the White House on Tuesday, Biden described teachers as “essential workers,” and said that accelerating vaccinations can help assuage anxieties about school reopenings.

Executives from five COVID-19 vaccine manufacturers told Congress Tuesday that they expect to significantly boost the number of shots delivered to states in the coming weeks.

Pfizer will increase weekly shipments to more than 13 million doses by mid-March, an increase from the 4 to 5 million doses shipped weekly in early February, the company’s chief business officer, John Young, told a U.S. House panel.

Moderna, the other vaccine that has received federal authorization for emergency use, expects to double its monthly vaccine deliveries by April to more than 40 million doses per month.

Fairfax County is ranked as one of the wealthiest communities in Virginia. It’s also one of the healthiest.

As of 2020, Fairfax led the state in measures including length of life, access to exercise opportunities and low rates of poor health indicators such as smoking and adult obesity, according to annual rankings by the Robert Wood Johnson Foundation. From 2015 to 2019, the county’s median household income was $124,831 (nationally, it’s around $68,703, according to the U.S. Census Bureau).

Currently, Fairfax County is also leading Virginia in vaccine distribution. In late January, health officials shifted the state’s strategy, routing doses through local health districts based on their percentage of the state’s population. As Virginia’s largest locality with more than 1.1 million residents, that left Fairfax with the largest share.

Even before then, the Fairfax County Health Department had requested — and received — more than eight times as many shots as other local health districts, according to data from the Virginia Department of Health. From Dec. 22 to Jan. 23, Fairfax received a total of 74,625 doses. Over the same time period, the Richmond-Henrico Health District, received a total of 19,550 doses for both localities, which have a combined population of nearly 560,000.

In the early weeks of Virginia’s COVID-19 vaccine rollout, hospital systems in five local health districts requested, and received, tens of thousands of doses — a disproportionately larger share than pharmacies, community health clinics and even the local health departments charged with overseeing the state’s immunization plan.

In Chesterfield, for example, HCA Virginia requested 27,775 first doses from Dec. 14 to Dec. 20 and ultimately received 18,275 — more than enough to vaccinate what Jeff Caldwell, the system’s vice president of communications, described as more than 17,000 total employees across the state. VCU Health in Richmond requested and received 20,050 first doses within the first three weeks of the state’s rollout — far more than its roughly 13,000 employees (spokeswoman Alex Nowak said the health system also has more than 10,000 “affiliated team members,” which include residents, medical students and food service workers, but not every direct or affiliated employee is involved in patient care.)

The Mercury obtained detailed distribution data for the Richmond, Henrico, Chesterfield, Fairfax and Central Shenandoah health districts from a reader, who noticed that the Virginia Department of Health’s public vaccine dashboard initially allowed the public to download spreadsheets showing how many doses were delivered to individual facilities.

States will see another increase in the COVID-19 vaccine doses they receive, with President Joe Biden’s administration announcing Tuesday that the federal government will distribute 11 million doses next week.

That’s an increase from 10.5 million doses this week, and 8.6 million during the week President Joe Biden took office last month. Those increases were attributed to boosted production by vaccine manufacturers.

The administration has not published a state-by-state breakdown on how many doses are distributed each week. Iowa Sens. Joni Ernst and Chuck Grassley, both Republicans, have questioned whether Iowa is receiving a fair share of doses under that formula, and wrote to the Centers for Disease Control and Prevention on Tuesday, asking CDC officials to release the weekly formula for allocating vaccines to states.

State officials say they’re confident that no COVID-19 vaccines are going to waste in Virginia.

But seven weeks into the state’s vaccine rollout, the Virginia Department of Health won’t release data on wastage, which vaccinators are required to report under a provider agreement distributed by the federal Centers for Disease Control and Prevention.

The document, which providers must fill out in order to administer vaccines, requires them to report the number of doses that were “unused, spoiled, expired, or wasted as required by the relevant jurisdiction.” In practice, that means hospitals, pharmacies and other administrators should be reporting the data to VDH, which then passes the information onto the CDC.

The Mercury first requested the data from VDH in late January, after Dr. Danny Avula, the state’s vaccine coordinator, stated in a telebriefing that the reporting was required but that he didn’t have information on wastage in Virginia.

Here we go again, Virginia, trailing the pack at yet another critical turn in combating the global coronavirus pandemic — the rollout of the lifesaving vaccine that could finally break the back of COVID-19. And if you’re a Democrat in Virginia, particularly one who’s seeking statewide office this fall, this isn’t what you had hoped to see.

It feels like last March, when the coronavirus caught the commonwealth flat-footed and plodding in its initial mobilization against the novel and then-mysterious plague, forcing Gov. Ralph Northam’s administration to play catch-up.

Yes, catch up Virginia did. Eventually. Northam, the only physician governor of any U.S. state, finally issued forceful and unambiguous orders to kick Virginia’s protective response into the same high gear that Maryland, Ohio, New York and other states had already hit. Schools closed, as did most businesses not deemed essential. Home sheltering, working and learning remotely, social distancing, hand washing and mask wearing were the order of the day. Literally.

City streets fell silent and abandoned. For weeks on end, springtime gusts whistled across sprawling, empty shopping mall parking lots. Small businesses — and even some large ones — took it in the neck, particularly mom-and-pop restaurants, bars, retailers, gyms and cinemas. A chilling number of those shops and offices and eateries died, in many cases taking family livelihoods and life savings with them, and they will never be resurrected. Those were lifesaving steps Virginia had to take and the government was justified in taking them.

Even then, just when Northam had emphatically laid down the law on requiring the use of face coverings, he undermined his own messaging when photographs of him laughing it up unmasked and huddled close with others for selfies on Virginia Beach’s Boardwalk began trending across social media.

By summer, Virginia had ramped up testing, plateaued its numbers of COVID-19 cases and related deaths, and driven down the percentages of positive coronavirus tests. Restrictions were eased. By autumn, ours was among the states faring the best with the coronavirus. But getting there was like pulling teeth.

For reasons still not clear, Northam’s Department of Health balked at making public the granular coronavirus testing data for extended care facilities that families of elderly, ailing and vulnerable people could use to make informed decisions about their loved ones. That was particularly galling after an outbreak at a Henrico County nursing home was among the nation’s deadliest in the early weeks of the pandemic. Eventually, faced with withering media coverage and public outrage, the administration relented and, without explanation, made the data available.

The VDH’s reluctance to provide specific, actionable guidance last summer to school districts on whether, when and how to reopen classrooms or continue virtual schooling created chaos and conflict among faculty, administrators and parents within school divisions and resulted in a crazy-quilt patchwork of differing regimens across the state.

And so it goes.

Last Thursday, with the respected Becker’s Hospital Review ranking Virginia’s vaccination effort the fifth least effective in the nation, Northam found himself promising to jump-start a torpid immunization effort one month after Virginia got the first of its nearly 846,000 vaccine doses. According to Becker’s, only about 218,000 — barely over one-fourth — of those doses have been injected into the arms of Virginians.

Compare that to West Virginia, which has dispensed nearly 70 percent of its approximately 161,000 doses — the nation’s best rate. Maryland and North Carolina have each dispensed about 32 percent of their vaccine allotments, while Kentucky and Tennessee have injected 43 percent and 44 percent, respectively, of their doses. Idaho, Hawaii, Alabama and Georgia (the nation’s worst at just under 20 percent) were the only four states that performed worse than Virginia.

At Thursday’s news conference, Dr. Danny Avula, Northam’s newly appointed vaccine czar, said that to achieve a pace that puts the commonwealth ahead of the virus and returns life to normal sooner rather than later, Virginia needs to dispense about 50,000 doses daily. Last week, the state was at about 30 percent of that pace. As of Friday, 88 of the state’s 133 localities remained mired in Phase 1A, the first phase of the vaccine rollout that includes frontline healthcare workers, first-responders and nursing home residents. Only one-third of the localities, clustered mostly in Southwest Virginia, the Eastern Shore and Northern Virginia, had advanced to Phase 1B, which includes people 65 and older, police and firefighters, teachers, grocery workers and essential government workers.

Northam said he was “pleased” with a pace in which only one out of every four doses the state received a month ago has been injected.

“Everyone will need to be patient. It’s going to happen as fast as it can be done and it’s moving faster every day,” he said Thursday. “Monday, we vaccinated more than 15,000 people. Tuesday, it was more than 17,000.”

When Virginia is the laggard behind every one of its contiguous neighbors, isn’t it fair to ask why? Two weeks ago in Tennessee, for instance, officials in Sullivan County opened a max vaccination site at the Bristol Motor Speedway Dragway, a 10-minute drive from the Virginia border. On its first day, Jan. 7, the site ran out of doses by noon. Vaccinations are scheduled for four days starting this week at Richmond’s enormous car-racing venue. The sprawling NASCAR stadium in Martinsville also volunteered to be a mass-vaccination venue if needed, but thus far has no takers.

Patience, your excellency, is in short supply. After a life-altering (and, in more than 5,600 cases in Virginia and nearly 400,000 nationally, life-ending) 11 months of pandemic, a searing summer of racial unrest, an election from hell and an even worse post-election in which a defeated president instigated the attempted violent overthrow of Congress in a vain effort to keep the victor from taking office, this might not be the most opportune time to prescribe a chill pill.

And, boy, did Virginia’s out-of-power, victory-starved Republicans notice.

Del. Kirk Cox, a conservative former House speaker and a declared GOP candidate for governor, assailed the Northam administration’s lethargic response in a statement.

“While … it’s good news that he’s trying to speed up vaccine distribution, the truth is ‘better late than never’ just doesn’t cut it,” Cox said, adding that he urged Northam “to take decisive action over a week ago.”

Northam could still turn around Virginia’s thus-far inauspicious vaccine deployment, just as his administration eventually energized Virginia’s leisurely initial response to the pandemic last spring. But if he doesn’t, it could hand Republicans another significant election-year bouquet.

This year, the GOP won’t run in the shadow of a president so polarizing that he just cost once-ruby-red Georgia both of its Republican U.S. senators, flipping control of the Senate to the Democrats. They’ll also have a raft of brochure issues courtesy of Virginia Democrats, including proposals to end the death penalty and legalize marijuana, plus last year’s parole board debacle. Those issues resonate among conservatives and many centrists and could buttress a GOP argument that Democrats have gone too far left for an electorate that traditionally rewards moderation.

That said, Republicans haven’t found an opportunity over the past dozen years they couldn’t squander. They could do it again by nominating Amanda Chase, a Trump-style nationalist who urged the president to declare martial law to stay in power and whose incendiary claims have gotten her suspended from Facebook and ostracized by her own party.

The vaccine issue is one that voters will remember in November. The vaccine represents a genuine human triumph, our deliverance from the pain and loss that the past year has inflicted upon us. Government must get this right, and those in charge of it should answer for the consequences if it doesn’t.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Gov. Ralph Northam’s latest message to local school systems is to start thinking about reopening — and soon.

“In the short term, all of our school divisions need to be making plans for how to reopen,” he said at a news briefing on Thursday. “It’s not going to happen next week. But I want our schools to come from this starting point: how do we get schools open safely?”

Some division leaders said the new directive — accompanied by interim guidance from the Virginia Department of Health and Department of Education — represented a significant departure from the state’s earlier messaging on in-person instruction. Virginia’s initial guidance, released in July, emphasized that the final decision on reopening laid “squarely in the hands of local school boards” amid uncertain evidence on the role of children in COVID-19 transmission.

But a new letter from Virginia Superintendent of Public Instruction James Lane and state Health Commissioner Dr. Norman Oliver assured superintendents, school leadership and local health departments that “data increasingly suggest that school reopenings are unlikely to contribute significantly to community transmission when rates of community transmission are low and schools have infection prevention measures in place.”

The accompanying guidance includes a decision-making matrix that elevates individual mitigation measures over levels of community transmission. In a separate briefing later on Thursday, Lane said many divisions have been basing their reopening decisions primarily on top indicators from the U.S. Centers for Disease Control and Prevention, which advise schools to consider community case rates and the percentage of positive tests over the last two weeks.

But Lane said heavier consideration should go to the ability of local schools to implement mitigation measures such as mask usage, sanitation and social distancing. Other main considerations include whether there’s evidence of spread within school buildings themselves, as well as the impact that school closures have had on the surrounding community.

“Even if they’re in the highest category of community transmission — and even more so for low and moderate — we recommend that they maximize in-person learning as much as possible,” Lane said.

The recommendations also call on schools to prioritize instruction for more vulnerable students, including young learners, students with disabilities and English language learners. And instead of making district-wide and long-term decisions — opting for remote learning over an entire quarter or semester, for example — officials say schools should have the flexibility to phase out decisions after a few weeks.

“If there’s low absenteeism, there’s no case transmission in buildings, your staff capacity isn’t strained — that school should have some in-person options,” Lane said. “If there’s an outbreak in a school, certainly think of closing for some time. But if there are no outbreaks and no transmission in the school community, we’re saying you should open as long as you can do mitigation strategies.”

However, as contact tracing resources have grown increasingly strained, most local health departments are prioritizing outbreaks and other cases that pose a significant public health risk. If multiple students or staff members test positive after close contact or sharing a potential exposure, health officials will likely investigate to determine if there was in-school transmission. But there’s little data on how most individual cases were contracted, and many local health officials have warned it’s become increasingly difficult to catch infected students or staff before they enter school buildings.

Reopening decisions have sparked fierce debate in local communities since Northam first announced a framework to bring students back to the classroom — four months after becoming one of the first governors in the country to close schools for the remainder of the spring semester.

Lane emphasized that the state never required schools to adopt remote instruction after releasing its first round of guidance in July. But those guidelines heavily emphasized CDC recommendations and asked schools to notify VDOE if they planned to deviate from the state’s framework.

By early September, the majority of local school divisions — 67 in total — had chosen to begin the fall semester remotely. As of Thursday, that number had dropped to 52. But Keith Perrigan, the superintendent for Bristol Public Schools in Southwest Virginia, said much of the ongoing caution stemmed from the original guidance, which took a more incremental approach to bringing students back to the classroom.

“This is a huge change,” he said. “The previous phase guidance, it was probably more of a recommendation to be cautious. And I think the new guidance is to try your very best to reopen. If you can mitigate appropriately, you ought to do what you can to get back in school.”

There’s still no mandate for school divisions to follow the state’s revised guidance. Lane said Thursday that the Virginia Constitution left the final decision with local school boards. But education officials also faced heavy criticism from some superintendents earlier this year for allowing local divisions to deviate from the original plan.

Some school systems have already made the decision to stay closed until at least the early spring — something Lane said he’d recommend reconsidering in light of the new guidance and the rollout of COVID-19 vaccines. But there are also continued debates even in districts that have prioritized in-person learning. In Chesterfield County, which announced plans to bring back elementary students next month, parents launched a petition calling on the school system to reverse the decision and keep schools mostly closed until teachers are fully vaccinated against COVID-19.

Both Northam and Lane faced significant questioning over the timing of the new guidelines, given that many schools have already announced reopening decisions for the spring. Virginia is also experiencing an ongoing surge of COVID-19 which some models suggest could continue until February. Rates of community transmission are consistently higher across Virginia than they’ve been at any other point during the pandemic. Daily new cases have risen in all five geographic regions throughout the early days of January, and hospitalizations are at an all-time high. Many health systems have voluntarily canceled elective surgeries or announced new surge plans to boost capacity for an ongoing influx of cases.

Lane said announcing the new guidance would give school districts the opportunity to prepare their plans in the coming weeks — even as Virginia contemplates longer-term changes such as year-round instruction to make up for learning loss during the pandemic. Northam also touted the arrival of COVID-19 vaccines as an important step in returning students safely to the classroom.

“While getting everyone vaccinated isn’t necessary to reopening schools, it will make it a lot easier,” he said. Eleven local health districts have begun vaccinating educators — or plan to start soon — after moving into Phase 1b of the state’s vaccine campaign.

But the timeline for the rest of the state remains unclear. As of Thursday, the U.S. Centers for Disease Control and Prevention ranked Virginia in the low bottom third of all U.S. states when it came to immunizing residents. The same day, VDH’s vaccine reporting dashboard showed that only about 25 percent of shots distributed across the state had made their way into patients’ arms.

And throughout November and December, some health districts advised in-person schools to again close their buildings, warning that the surging cases made it impossible for them to trace and investigate new infections. In Bristol, Perrigan said it was the first dose of vaccines — administered by the local health department earlier this week — that helped reassure teachers more than anything else.

“That’s what had the biggest impact — the availability of vaccines,” he said. “I think a lot of pressure was released once our staff was able to get that first round.”

Every Virginian vaccinated by early to mid-summer?

Many experts say it’s no longer likely. Gov. Ralph Northam has also readjusted earlier — and more optimistic — estimates from late November, when he spoke to NPR about the state’s COVID-19 vaccination plans.

“Phase three will be the general population and hopefully by, you know, early to midsummer have everybody in Virginia vaccinated,” he said at the time. But after a slower-than-expected rollout — both in Virginia and across the country — the administration has slightly revised its targets.

“The governor is still hopeful that everyone will have the opportunity to be vaccinated by mid-summer to fall,” spokeswoman Alena Yarmosky wrote in an email on Tuesday. The administration’s prospective timeline includes a few caveats, including the fact that children under 16 — or roughly 2 million Virginians — won’t be included in the overall total because a vaccine hasn’t yet been approved for them.

The goal also assumes that some of the state’s residents will decline the vaccine (“although we’re hopeful that is not a large percentage and will decrease further as this process continues,” Yarmosky wrote). And ultimately, it means Virginia will need to be administering at least 50,000 doses a day, which is contingent on new vaccines entering the market and an increase in federal shipments.

Yarmosky pointed to recent changes that have inspired optimism from state leaders across the country. One, announced Friday, is that the Biden administration plans to begin releasing available vaccines immediately, rather than holding back a second dose from shipments from Pfizer and Moderna.

But even with the change in administration, many experts say there needs to be a rapid shift in how COVID-19 vaccines are distributed and administered in order to meet a late-summer to fall target. Mark Capofari — who worked for Pfizer and spent more than a decade as the director of global logistics at Merck before becoming a full-time lecturer at Penn State — thinks vaccinations will be ongoing well into the third quarter of the year, which stretches from July to September.

Thomas Denny, the chief operating officer of the Duke Human Vaccine Institute, said it might take even longer for most of the public to get inoculated — possibly not until October or November.

“I got a bit more optimistic when it looked like vaccines were coming and we’d have a good number of doses to start out with,” he said. “But then in between late December and so far in January, just about every place has missed its mark with using the amount of doses they’ve gotten.”

“I’m now back to thinking that it’s not likely by the summer that we’ll achieve it,” he continued.

When the vaccine will be accessible to most Virginians has been a major question since the state received its first doses in mid-December. The Northam administration has tentatively predicted that Phase 1a — when vaccines are prioritized for health care providers and long-term care facilities — could conclude by the end of this month. But there’s already been some overlap with Phase 1b, which includes first responders, correction officers and teachers, followed by other frontline personnel such as grocery store clerks and mail carriers.

On Friday, the Virginia Department of Health announced that 11 local districts across the state were beginning Phase 1b early after vaccinating the majority of their medical workers and long-term care residents. Scheduling an appointment would “depend on the supply of vaccine available,” the department warned, and the phase is likely to take “several weeks to months” even with an early start.

But at a briefing last week, Northam also outlined prioritization plans for Phase 1c, the next step of the state’s vaccine campaign, which will include other essential workers in construction, transportation and utilities.

Providing a clear timeline for all the different subgroups can be complicated. VDH guidelines set a clear order for frontline workers in Phase 1b “because there is not sufficient supply at this time to vaccinate everyone at the same time.” But Virginians aged 75 and older are also included in Phase 1b, and it’s unclear where they fall in the order of prioritization.

Northam emphasized flexibility in his briefing last week, saying he’d rather see providers administer more doses than hew strictly to the state’s guidance. But given the state’s current pace, it’s unclear when the next two phases — which cover about half of the state’s roughly 8.5 million residents — will fully get underway.

As of Friday, the state had received 481,550 doses of vaccine and administered nearly 150,000, or about 30 percent of its total allocation. Health Commissioner Dr. Norman Oliver said Tuesday that the Virginia Department of Health’s vaccine reporting dashboard could be undercounting anywhere from 35,000 to 55,000, which would push the state’s total closer to 40 percent.

Bloomberg’s vaccine tracker ranks Virginia above nearby states including Pennsylvania, North Carolina and South Carolina, but below neighbors such as Maryland, Kentucky, Tennessee and West Virginia (which has an administration rate more than double the Old Dominion’s). And some experts, including Denny and Bruce Y. Lee, a professor at the CUNY Graduate School of Public Health and Health Policy, say the haphazard rollout of vaccines across the country is mainly attributable to poor federal planning.

“When it comes right down to it, very few states have the wherewithal or the resources for the kind of coordination that’s required,” said Lee, who also works as the executive director of CUNY’s Public Health Computational and Operations Research. “That needed to come from the federal government.”

But Capofari said that state planning also played a major role, pointing to sometimes drastically different vaccination rates across the country. Funding makes a major difference, as does intensive planning and coordination between different agencies and providers.

He pointed to hospitals and local health departments — two settings where the state has routed a significant number of vaccines, though the Virginia Department of Health still can’t say which vaccines went where. If hospitals are going to play a role in vaccinating groups other than their own employees, Capofari said they need clear guidance on who to prioritize and how to reach them. And if hospitals are expected to transport any surplus doses to other settings, there needs to be clear communication and a plan of action, from which facility is responsible for transporting the vaccine to the equipment they’ll use to preserve the doses to when the delivery will be made.

“I think there’s still a lot of uncertainty still as to what the plans are and even where to do the inoculations and how to go about it,” he said.

Brandon

Gov. Ralph Northam acknowledged Wednesday that Virginia needs to speed up the pace of its COVID-19 vaccinations, announcing a “you use it or you lose it policy” prodding health care providers to administer the shots to more residents.

“I want you to empty those freezers and get shots in arms,” he said. “When you have vials, give out shots until they’re gone. No one wants to see any supplies sitting unused.”

The governor’s news briefing — his first in nearly a month — came as Virginia experiences its worst COVID-19 caseload than at any other point in the pandemic. The statewide percent positivity rate rose to nearly 17 percent on Wednesday, and Northam pointed out that daily case numbers are currently four times higher than they were in the spring — an average of more than 4,700 new infections every day.

At the same time, Virginia has been grappling with a sluggish rollout of a vaccine described by the governor as “the most powerful tool — the one that’s going to literally change things.” Northam has not announced new restrictions since early December, but has described COVID-19 vaccines as a ray of hope in the ongoing pandemic.

Many states have struggled with administering the shots after the federal government shipped out early doses in mid-December. But until recently, Virginia ranked 46th in the country when it came to the percentage of vaccines administered among states, the Richmond Times-Dispatch reported. The state’s rating has improved, but thousands of vaccines still have yet to make their way into the arms of Virginians.

State health officials also elaborated on reporting issues that have prevented administered doses from appearing on the Virginia Department of Health’s vaccine reporting dashboard. Health Commissioner Dr. Norman Oliver said Wednesday that the department updated its internal immunization reporting system in anticipation of the COVID-19 vaccine, but that some providers, as a result, have struggled to enter data in a timely manner. There have also been technical glitches that have prevented some health systems’ vaccines from hitting the dashboard.

Northam’s spokeswoman, Alena Yarmosky, said that in some cases, providers are reporting vaccinations but the data is appearing inaccurately in the state’s system, requiring VDH employees to go back and verify the numbers. As a result of all the problems, Oliver said that the state’s totals could be undercounting anywhere from 35,000 to 55,000 doses.

“We’re actually doing better than we appear,” he said after the briefing. But even if 55,000 was added to the state’s total number of administered vaccines, it would mean that health providers have given out around 171,247 of the 481,550 doses delivered to the state — around 35 percent.

To address the slow rollout, Northam announced several steps the administration plans to take over the next several weeks.

New goals for administering the vaccine

Northam outlined new goals for giving out the vaccine as one of the first steps in his plan to ramp up administration. Currently, he said the state receives roughly 110,000 doses of Pfizer and Moderna vaccine a week, which equates to an immediate goal of delivering 14,000 shots a day to fully use up that supply.

On Wednesday, VDH reported that 2,695 doses had been administered in the last 24 hours. That daily increase has been as high as 12,000 in recent days, but Yarmosky said the large jump was the result of backlogged data. Current reporting delays make it difficult for the department to assess daily progress, which is why resolving those issues is an instrumental part of achieving the governor’s goal, she added.

Longer-term, Northam said he’d like to build up to 25,000 daily doses — a number that also depends on federal officials ramping up shipments to states. Oliver later said the goal was achievable if President-elect Joe Biden delivered on his promise to distribute 100 million shots within his first 100 days in office. Yarmosky also said the state’s daily goal would increase with the greater supply.

‘Lose it or lose it’

Northam’s newly announced policy is directed at health systems, local health departments and other clinical settings that receive doses of the vaccine. The governor said with the next shipment of Pfizer and Moderna doses, VDH would expand its reporting so Virginians can see where vaccines are delivered and how quickly they’re being used.

“Virginians, you deserve this transparency,” he said. State officials will also monitor usage, and sites that don’t fully use their allocated doses could face reduced shipments going forward.

“Don’t save anything,” Northam said. “You’re going to get every dose you need because more is coming. But if you’re not using what you receive, you must be getting too much.”

A plan for next phases

The governor also unveiled priority groups for Phase 1b and 1c,  the next stages in the state’s vaccination campaign. According to Yarmosky, the current phase — 1a, which includes medical workers and long-term care facilities — should be finished by late January. VDH spokeswoman Erin Beard told the Mercury yesterday that moving onto later phases is based on whether “vaccine supply significantly increases” and “if vaccine demand is less than supply.”

Phase 1b will include essential and frontline workers — “people who work in jobs that keep society functioning,” Northam said. That includes roughly 285,000 teachers and childcare providers, along with first responders, mail carriers, corrections officers and grocery store workers. Essential workers in manufacturing and food production will also be included, as will public transit employees.

All adults aged 75 or older will also be included in phase 1b.

Phase 1c will cover essential workers in construction, transportation, and food service, such as restaurant servers, as well as adults aged 65 or older and all Virginians between 16 and 65 with high-risk medical conditions. The two groups — phase 1b and 1c — cover about half of the state’s roughly 8.5 million residents, Northam said, before the vaccine will move to the general public.

But the logistics of moving onto different phases — and the details of how state officials will ensure quicker innoculation — are largely unclear. Northam appointed Dr. Danny Avula, the director of the Richmond-Henrico Health Department, to oversee and coordinate statewide vaccination efforts, saying more details would become available in the coming weeks.

But as the Mercury has reported, some large health systems are vaccinating non-clinical employees who have worked from home since the start of the pandemic — even as some community providers struggle to book appointments with their local health departments.

Northam emphasized Wednesday that distribution sites should err on the side of vaccinating Virginians rather than holding doses based on prioritization. But Oliver also said that sites should follow the state’s guidance whenever possible “because that’s been well thought through” (he later added that VDH advised against giving out doses to Virginians who aren’t frontline workers, including anyone who can work from home).

What’s not clear is how Virginians in phase 1b and 1c will be notified that they’re eligible for the vaccine and when it becomes available. It’s also still unclear how health systems will manage excess doses. Northam said his administration hasn’t heard of vaccines being wasted, but Oliver later said anecdotal data suggests that only 60 percent of EMS workers and nurses have opted for vaccination.

Whether health systems will assist in vaccinating other priority groups remains to be seen. Oliver said it would require close collaboration with local health departments so that hospitals could redistribute unused doses to other settings.

“Maybe they vaccinate, maybe they just provide the supplies,” he said. “And we would shift the allocations if they weren’t using them.”

Virginia State Sen. A. Benton “Ben” Chafin Jr., R-Russell, has died of COVID-19, the Senate Republican leadership announced Friday evening.

“Tonight, as the Senate of Virginia comes to grips with this tremendous and untimely loss caused by COVID-19, our sympathy and prayers are with Ben’s wife, Lora Lee, their children and grandchildren, and Ben’s mother and his sister, Justice Teresa Chafin,” Senate Republican Leader Tommy Norment, R-James City, said in a statement.

Chafin, 60, was born in Abingdon and was briefly a member of the House of Delegates before winning a special election to the Senate in 2014. He is the first Virginia lawmaker to die from the virus, though several have had bouts with COVID-19, as has Gov. Ralph Northam and his wife, Pam.

“Ben was deeply and wholeheartedly committed to the commonwealth, and especially to the people of Southwest Virginia. A community leader in Russell, Ben rose to prominence in the fields of law, banking and agriculture long before his neighbors elected him to the General Assembly,” Norment said.

“First as delegate and then senator, Ben relentlessly promoted and fought for the interests and values of Southwest. He put the interests of those he was entrusted to serve first, cherishing the people of the region he proudly called ‘home.’”

Northam, a Democrat and former state senator who also presided over the chamber as lieutenant governor, said Southwest Virginia had “lost a strong advocate — and we have all lost a good man.”

“I knew Ben as a lawmaker, an attorney, a banker, and a farmer raising beef cattle in Moccasin Valley, working the land just as generations of his family had done before him. He loved the outdoors, and he loved serving people even more. He pushed hard to bring jobs and investment to his district, and I will always be grateful for his courageous vote to expand health care for people who need it,” Northam said, referring to Chafin’s vote to expand Medicaid in 2018. Northam has ordered the state flag to be lowered to half-staff.

“Pam and I are praying for Lora and their children. … This is sad news to begin a new year with the loss of a kind and gracious man. May we all recommit to taking extra steps to care for one another,” Northam said.

The Roanoke Times reported that Chafin had tested positive for the virus in December but that his family kept the diagnosis private for weeks.

Democratic House Speaker Eileen Filler-Corn, D-Fairfax, said she was “deeply saddened” by Chafin’s death, which comes less than two weeks before the General Assembly is scheduled to convene on Jan. 13.

“I respected his commitment to the people of the 38th senatorial district and his strong advocacy on their behalf,” she said.

Democratic Senate Majority Leader Dick Saslaw, D-Fairfax, said Chafin “epitomized the Virginia gentleman — he was compassionate, thoughtful and cared deeply for his district and all Virginians. We will miss him dearly.”

Americans can be a selfish lot. Not everybody, of course. But too many people couldn’t care less about taking the necessary steps to keep deaths and infections from COVID-19 at bay.

It’s not that hard: Stay at home as much as possible. Wear a mask out in public and in buildings. Wash your hands. Avoid situations where you can’t stay at least 6 feet apart. Treat workers with respect and deference who must come into contact with consumers. Limit the number of people at social gatherings.

Folks, none of these are Herculean tasks. We’re not being asked to climb mountains, mine for ore or donate a kidney just to survive.

Yet several months into this raging pandemic, the “me-first” mentality is readily apparent, in the commonwealth and elsewhere:

• The Virginia Department of Health issued a news release last week noting COVID-19 cases were surging in Norton city and Lee, Scott and Wise counties. “Keep in mind that your behavior can help protect yourself and others — or put you and them at increased risk,” said Dr. Sue Cantrell, a director of health districts in the area. (I tried to interview Cantrell about whether resistance to mask-wearing contributed to the numbers, but I couldn’t reach her.)

• A mid-October wedding at Wintergreen Resort forced several employees to quarantine because of possible exposure to COVID-19, an official said. Some staffers tested positive. Weddings are special, but shouldn’t couples limit the number of guests because of the times we’re in? Even then, you don’t know if all the well-wishers had recent tests confirming they were free of the virus.

• Lynchburg General Hospital’s acute care facilities were “strained,” a top official said, because of an influx of coronavirus patients last week.

• Despite new restrictions imposed by Illinois Gov. J.B. Pritzker prohibiting indoor dining in specific communities, a throng of customers showed up and packed a restaurant in defiance of the guidelines, the Chicago Tribune reported. The restaurant’s social media post said it was opening “out of survival and to help our staff pay their bills.” Yet Pritzker this week warned “there seems to be a COVID storm coming.”

The United States has proved the days of exceptionalism are over — unless you’re talking about leading everybody else with more than 226,000 deaths. By mid-October, the United States had the highest numbers of COVID-19 infections and deaths, and officials said we’ve entered a third peak of cases in many states.

We don’t have a vaccine. So why is it so hard for Americans to do what medical experts advise to fight this thing?

University professors I interviewed and scholarly articles suggested several reasons: Partisanship, since many Republicans followed President Donald Trump’s lead in downplaying or even denying the coronavirus’ existence, and they resisted wearing masks. A rugged individualism — baked into the nation’s founding — over working for the common good. And pandemic fatigue, even as there’s no end in sight to the carnage.

“We are a country that values individualism, materialism and wealth over the well-being of our neighbors,” Tim Goler, assistant professor of sociology and urban affairs at Norfolk State University, told me. He’s one of the researchers overseeing a pandemic study of older adults.

Goler added that people are fed up with being at home, especially if they haven’t been directly affected by deaths or illnesses: “They’re willing to sacrifice people dying.” You saw indications of this even earlier this year, when protesters demanded states to reopen their economies — even as spikes of infections continued.

“The pandemic has exposed the extent to which we do not live in a ‘United States of America,’ ” said Ernestine Duncan, a psychology professor at NSU. She noted people in other nations have accepted strong restrictions on movements and behavior, and they’re faring better than the U.S.

Clearly, we’re an individualistic society, Duncan noted.

It made me wonder about the last time our sprawling, populous country really sacrificed as a whole for the common good. Historians might point to World War II, in which food, gasoline and clothes were rationed.

Officials and residents collected scrap metal and rubber for the war effort. Women entered defense plants to work because so many men had joined the military and people grew “Victory Gardens” in large numbers to supplement their meals.

The circumstances, though, aren’t totally analogous. Back then, Americans were forced into rationing because of governmental mandates; that hasn’t always been the case this time. Trump has hesitated to restrict the movements and actions of citizens in spite of the way the coronavirus is transmitted.

In the 21^st century, our rugged, go-it-alone mentality has horrific consequences. We shouldn’t be surprised by the ever-rising COVID-19 death toll if we continue to be more concerned about individual comfort rather than our collective safety.

It’s a self-fulfilling prophecy — an awful one.

Virginia Health Officials are warning about small gatherings. It’s part of the concern over rising numbers in southwest Virginia but the message goes to the entire state as we head into the holidays.

“Coming together as an extended family as if you are in one household does present risk,” said Dr. Daniel Carey, Virginia Secretary of Health and Human Resources.

During a COVID-19 briefing Wednesday, Governor Ralph Northam said those gatherings are the reason behind a percent positivity climb from 5% to 8% in southwest Virginia.

“I know that many people are tired of COVID restrictions. We are all tired of not having social get togethers, not going to see sports or shows, not having the regular interactions that we count on in our lives,” said Northam.

To understand the mind of a teacher, those of us who do other things for a living must attempt some mental gymnastics.

Let’s imagine a professional passion so acute that when the coronavirus shuttered classrooms, they pivoted with little warning or rehearsal to digitally link dozens of children from home and continue daily instruction remotely.

Close your eyes and comprehend a devotion to students so strong that you spend your personal money to supplement classroom supplies as eclectic as sanitizing wipes and Elmer’s glue, crepe paper and whiteboard markers.

Now, as days start shortening and summer bends toward autumn and a new academic calendar, imagine balancing your innate yearning for the classroom with a well-reasoned fear of a monstrously contagious, potentially deadly virus that medicine still can’t control and science doesn’t fully understand.

Finally, overlay that against the backdrop of political conflict and chaos that multiplies by the day.

The Virginia Department of Corrections says it’s down to 22 active cases of COVID-19 among inmates in the 40 prisons it operates around the state.

Gov. Ralph Northam’s secretary of public safety, Brian Moran, touted the figures Friday, which include six hospitalized prisoners and 16 still being held at various correctional facilities. He emphasized the latter number in a presentation to lawmakers.

“We have 16, let me repeat, 16 active cases in all of our correctional facilities,” he said during a joint meeting of the Senate’s judiciary and social services committees. “That’s out of 28,000 inmates, 40 correctional facilities. Sixteen — one six — active cases.”

Virginia is refusing to release information on COVID-19 outbreaks at poultry processing plants on the grounds of privacy concerns, despite a June decision to provide such data for long-term care facilities.

In response to a Freedom of Information Act request filed by the Mercury in June after Gov. Ralph Northam’s administration began releasing facility-specific data for nursing homes, the Virginia Department of Health said it would not provide the same information for poultry processing plants “in order to ensure that VDH is able to preserve the anonymity of individuals whose medical records have been examined during the investigation of COVID-19.”

“VDH is considering how to make the information you have requested available at the health district and/or regional level,” wrote VDH Deputy Commissioner for Governmental and Regulatory Affairs Joseph Hilbert in an email.

Neither a followup request to Hilbert nor an inquiry to the governor’s office about the justification for releasing such information for nursing homes but not poultry plants were answered.