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By H. Robert Nash 

Piedmont Health District Director

The safe and effective COVID-19 vaccines are a great achievement and cause for hope. But doses are limited and public health resources stretched thin, so the vaccination effort is an unprecedented challenge.

Here in Piedmont Health District, we’re building a system as we go along. I want to share with you what we’re doing and try to answer some questions I know citizens have.

In stage 1, we’ve had to quickly build resources to organize and administer shots. The shortage has been entities with licensed and qualified providers who can handle vaccine storage, organize scheduling and administer shots – all on top of their regular duties that haven’t stopped.

We’ve been working tirelessly and are making progress: in addition to our local VDH office, there are 27 community partners in our region now eligible to administer. We are now working to get them supply as it comes in. Centra has just begun vaccinating some people in priority groups who have a Centra primary care physician. Longwood nursing faculty and students are serving as a force multiplier, administering shots and supporting Centra and VDH efforts. The pace has picked up – the cumulative number of doses administered in Prince Edward County roughly tripled last week, and is increasing elsewhere too.

But now we’re in a new phase nationally. The bottleneck is becoming less about people to administer vaccinations, and more about supply of doses. These vaccines are hard to manufacture and Virginia is only receiving about 110,000 a week. That’s about the pace we’ve sped up to vaccinating people, so the problem from now on will be dose supply.

Here in Piedmont, I have requested 5,000 doses per week for our region. I’ve been told to expect about 1,200. I know this will be frustrating and require patience, and I hope soon other vaccines will be approved. But I’m committed to getting every dose administered within days of arrival. Remember, for each dose there must be a second dose in either three or four weeks, depending on which of the two approved vaccines you receive.

Who are the priority groups?

Our district and the whole commonwealth as of this week are prioritizing health care workers, long-term care residents and staff, first-responders and essential personnel including teachers, and those over 65, especially over 75. However, the commonwealth has also directed us to be flexible and use judgment to take advantage of opportunities to get as many doses administered as quickly as possible.

I’m in a priority group based on my job, age group, or underlying health condition. Where and when will I get vaccinated?

For those who qualify as essential personnel, we are working directly with employers, such as school districts and local law enforcement, to administer vaccinations. If you are prioritized by age or health condition, you should call VDH at (877) 275-8343 and request an appointment to get a vaccine at our office, or potentially be assigned to one of the 27 community partners we are working with. We are booking as many appointments as we can here in our office, but supply is very limited. Some of our other community partners are starting to reach out to those who have registered with VDH to offer slots.

If you have a Centra primary care physician you can try to schedule an appointment by calling (434) 200-1225. Soon some vaccination appointments should soon become available via other local providers and local pharmacies, where you will make an appointment.

Will there be mass vaccination events? At this time, our region does not have sufficient supply in the pipeline, and building up other point-of-care distribution pods has been the most efficient first step. But I am in regular contact with local leaders. Also, the National Guard is also working to stand up large-scale clinics around the commonwealth.

Why can’t more places administer vaccines? These vaccines have extremely delicate requirements for refrigeration, storage and administration. If they aren’t followed, doses may be thrown out and wasted. The commonwealth is eager to stand up partnerships quickly, like with Longwood recently. But safety is really important. Any administration site must be prepared to respond if a recipient has an allergic reaction, even though such reactions are rare.

Why did Longwood vaccinate employees last week? That was my decision. Longwood has been an incredible partner, offering to help the community however it could through its refrigeration capacity and nursing faculty and students. Two weeks ago we began planning for them to help with local essential personnel. We knew that would take some time. Meanwhile, they asked if there was any other group that could be organized quickly enough to start even sooner.

Because of licensing and logistical issues, the most efficient and feasible immediate group was their 850 or so employees. Every dose we get quickly off the shelf plays a role in helping stop the spread of the disease. So I authorized and requested them to vaccinate as many of their employees as possible, and incredibly they administered more than 650 doses over four days. Now they’re helping with essential workers we’ve assigned them. Gov. Northam has encouraged taking advantage of such opportunities, and last week commended our partnership and efforts with Longwood.

Is the vaccine safe? The vaccine is extraordinarily safe and effective, and we strongly encourage you to take it.   cdc.gov/coronavirus/2019-ncov/vaccines  is a good source of information, particularly if you have allergies or other conditions that may require you to consult with your health provider about whether to take the vaccine.

However, the vaccine does not work immediately. Efficacy builds up over several weeks, and is only fully reached after the second dose. Social distancing, making and other precautions remain essential to stopping the spread even after you get a dose. Prevalence in our community remains extremely high.

(Dr. H. Robert Nash is the health director for the Piedmont District.)