This monthly report is the first from the Office of Health Equity in the Virginia Department of Health under the supervision of the Governor’s Chief Diversity, Equity, and Inclusion Officer and the Equity Leadership Task Force. It provides an overview of vaccination equity in the Commonwealth, including key equity accomplishments.

COVID-19 infection rates, hospitalizations, and deaths have disproportionately impacted individuals in long-term care facilities, the elderly, and Black and Hispanic populations. Additionally, individuals in rural communities are at higher risk for serious illness if they contract COVID-19 due to fewer hospitals, ICU units, and infectious disease physicians.

In addition to reporting equity distribution of the COVID-19 vaccine, this report also compares Virginia to other states in Region 3 of the Federal Emergency Management Agency (FEMA), namely Delaware, the District of Columbia, Maryland, Pennsylvania, and West Virginia. It also presents an overview of recent legislative and executive activities at both the federal and state levels, as well as equity considerations for future vaccine distribution.

Summary key equity findings include:

• Virginia is doing relatively well in vaccinating individuals in long-term care facilities and the elderly. At present, 217,426 COVID-19 vaccine doses have been administered at long-term care facilities (Source). Additionally, 1,140,940 Virginians have received at least one vaccine dose. Those age 60-69 (216,488) make up 19% of those receiving at least one dose, and those age 70+ (390,306) comprise 34.2% of those receiving at least one dose.

• Black and Hispanic populations are receiving vaccinations at far lower rates than whites. This is particularly concerning because Blacks and Hispanics are disproportionately infected and die from COVID-19, but whites are disproportionately receiving vaccinations.

• Rural counties have lower vaccination rates: More rural counties experience a higher risk due to COVID-19, yet rural counties have lower vaccination rates, per 100,000 population. Some of the challenges facing rural areas include limited supply based on population per capita, limited broadband access for a high technology driven enrollment process, and limited regional health care centers and vaccinators.

• Within FEMA Region 3, Virginia is currently ranked third in terms of COVID-19 vaccine doses administered. West Virginia and the District of Columbia rank higher than Virginia. Delaware, Maryland, and Pennsylvania rank lower.

• To address inequities in vaccinations in Virginia, vaccine allocations and vaccination strategies should be targeted at vulnerable populations. This includes prioritizing equity in mass vaccinations plans, community vaccination plans, and most importantly, including monitoring and accountability of vaccination equity outcomes.