This monthly report is 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 (ELT). It provides an overview of vaccination equity in the Commonwealth of Virginia, including key equity accomplishments, for the month of June 2021.

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

→ Targeted Community Efforts

• VDH and VDEM are continuing to engage in promising practices to reduce inequities. These promising practices include: eliminating vaccination pre-registration requirements and increasing walk-up vaccination clinics; collaborating with trusted community leaders; creating targeted outreach efforts to at-risk communities; providing information in multiple languages; and removing ID requirements at registration and check-in during vaccination events.

• Virginia continues to operate mobile vaccination efforts in locations across the Commonwealth to reach vulnerable populations. Starting in mid-May, the Virginia Department of Health began regularly announcing information about opening mobile sites, especially in areas in which vaccine access is difficult, like rural and underserved locations. Community clinics are also helping to vaccinate underserved populations.

→ Trends Over Time

• Vaccination numbers continued to increase, but the pace of vaccinations has slowed. More Virginians are getting vaccinated. Over 9 million COVID-19 vaccine doses have been administered in Virginia. At present, 58.9% of Virginians have received at least one dose of a vaccine, up from 54.7% at the end of April. Over 4.3 million Virginians have been fully vaccinated, which represents 50.7% of the population.

• The State of Emergency brought on by the COVID-19 pandemic expired on June 30th in Virginia. This ended the last remaining public-health restrictions across the Commonwealth including, mandatory mask requirements for unvaccinated individuals and social distancing. Despite the state reaching the goal of 70% of adults having received one vaccine dose, many local vaccination rates are well below what public health experts consider safe for population health.

• Decrease in life expectancy in the US due to the COVID-19 pandemic, greatest loss in Hispanic/Latino and non-Hispanic Black populations. A new VCU study was released on the effects of the COVID-19 pandemic on life expectancy of showing the life expectancy loss of ~2 years for the average US adult, but the greatest loss was in the Black and Hispanic/Latino populations

• Vaccines have made significant and positive differences in the COVID-19 pandemic in that they are safe, effective, and overwhelmingly successful at reducing risk of severe illness. Moreover, both cases and deaths have been flattening out because of vaccines. The CDC now indicates that every COVID-19 death is largely preventable, and nearly all COVID-19 deaths now are in people who were not vaccinated.

• Racial disparities persist: Black and Hispanic/Latino populations continue to receive vaccinations at far lower rates than Whites in Virginia. Whites have the highest overall numbers and percentages of cases and deaths. Still, disparities are evident. While Whites represent 61% of the population, they represent 50% of cases and 64% of deaths. However, Blacks represent 19% of the population yet 21% of cases and 25% of deaths. When comparing the percentages in the population, Blacks still disproportionately contract COVID-19 and die from it. Similarly, Hispanics/Latinos represent 10% of the population and 19% of cases, yet 7% of deaths.

Table 1: Race, COVID Cases and Deaths, and Vaccinations in Virginia, as of 6/28/21

Source:  Kaiser Family Foundation

• Looking ahead, the actual vaccination rates of most racial/ethnic groups (Black, Hispanic/Latino, and White) are expected to fall behind July 4 projections. Only the vaccination rate for Asians is expected to meet the target. If this trend continues, chances increase that Black and Hispanic/Latino communities will remain at increased risk for contracting and dying from COVID-19.

• Virginia received additional CDC funding to help tackle health disparities. The CDC awarded $30.6 million to Virginia to address health inequities created and exacerbated in high-risk and underserved communities by the COVID-19 pandemic.

→ Vaccine Hesitancy

• Virginia reports a higher unvaccinated rate of Blacks and Hispanics/Latinos than the national average, but a far lower rate than the national average for Whites. This is an important equity point. Virginia is not doing well in vaccinating racial/ethnic minorities compared to the US generally, but is doing well compared to the US on almost all other factors.

• Vaccine hesitancy continues to decrease nationally and within the Commonwealth, yet hesitancy remains. Those who are still unvaccinated tend to be younger, people of color, less educated, Republican (or Republican-leaning), and the uninsured.

• In many instances, the reasons for vaccine hesitancy are decreasing. Concern over the rapid development, and the belief that the vaccine is not needed have remained steady. However, concern over side effects has dropped by 10% since last reported, and testing of vaccines and the desire to know more about how well the vaccines work has dropped by 7% points.

→ Reducing Hesitancy

• Vaccine hesitant individuals say several factors could decrease hesitancy. These factors include: the COVID-19 vaccine receiving full approval from the FDA, rather than the current Emergency Use Authorization; being able to get the COVID-19 vaccine at a place they normally go to for health care; and requiring vaccinations for certain activities.