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.”
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Even though cases and the percentage of people testing positive have declined from the height of the most recent spike, the figures haven’t dropped enough to pull the majority of the state out of substantial to high transmission levels.
In a Friday update from UVA’s Biocomplexity Institute, which tracks COVID-19 trends and has conducted infectious disease modeling for decades, researchers noted the uptick in vaccinations — largely fueled by boosters — has also not been enough for localities to avoid future spread.
The pandemic’s wrath made clear older Virginians, immunocompromised individuals, Black and Latino residents and people in low-income areas have the most to lose when cases and hospitalizations rise.
But available data calls into question whether the booster shots — aimed initially at adding a layer of protection to the hyper-vulnerable — are going to those who most need it.
Of the more than half a million people who have received a booster as of Friday, nearly 75% are white. Latinos, who are among the most vaccinated population in the state, lag behind every other racial or ethnic group.
While white and Black residents have similar vaccination rates, the percentage of eligible whites who have received a third dose is nearly double that of Black Virginians.
Individuals with weakened immune systems were eligible back in August, but VDH data shows almost 81% of the people who have sought out an additional shot did so in the past month.
There’s no way of knowing if the 95,928 boosters reported between Aug. 14 and Sept. 27 went to immunocompromised people — who are estimated to be 3% of the state population — because the VDH doesn’t publicly report vaccinations by this status.
Wealthier localities have consistently been vaccinated at faster rates than cities and counties with higher poverty levels, but Virginia also doesn’t publicly report vaccination rates by census tract — one of the most hyper-local ways to roughly view the differences among neighborhoods.
Richmond and Henrico’s health districts are among the few that publish census tract data on a weekly basis. Though Latinos in both localities are among the most vaccinated, recent census tract data shows the Latinos living in the highest-poverty areas — along with predominantly Black communities — continue to face high risk of infection and low vaccination rates.
Dr. Rajesh Balkrishnan, a social epidemiologist who has researched access to health care in low-income areas for more than 20 years, said outreach, strategic community partnerships and prioritizing education about vaccine safety and preventative measures will be critical to avoiding worse disparities.
The VDH has emphasized its commitment to adopting these strategies throughout the rollout, but Balkrishnan said knowing the immediate impact of them is “incredibly difficult” without monitoring the infection and hospitalization rates in low-income neighborhoods with higher concentrations of Black and Latino people.
“They just need to be particularly reinforced in areas where there are high-risk populations and populations which potentially could just slip away,” he said. “All of these departments are clearly understaffed and underfunded, but I think it’s about time that we start doing that across different districts.”
Other concerted efforts Balkrishnan said could make a difference include public health departments having programs in place specifically geared toward populations with less access to resources and medical care that do not idle as mass efforts such as community vaccine centers are underway.
Without doing so, Balkrishnan said, there’s a decent chance the widening gap of risk between the least vaccinated and most vaccinated will overlap with a widening crack in disparities.
Logan Anderson, spokesperson for the VDH, said the agency’s primary focus continues to be reaching those who have yet to get their first dose as they face the highest risk of severe disease.
Across Virginia, the least vaccinated groups who are eligible are Black residents and 12- to 15-year-olds.
But not being in a high-risk group doesn’t mean the pandemic is over, said Stevens, the VCU Health epidemiologist. Most people don’t live in isolation, he added, which is why vaccination is a global issue.
“If you say the world is a block and the house three doors down is on fire, you’re probably not just gonna sit there and do nothing about it,” Stevens said. “You’re going to realize that fire gets spread.”