Virginia health leaders have repeatedly said equity is at the core of the state’s coronavirus response, but the state doesn’t publish the figures that could measure its success. As of Wednesday, the Virginia Department of Health’s vaccination website doesn’t include local breakdowns of demographics, which makes it nearly impossible to gauge whether heavily impacted communities are receiving a fair distribution of vaccinations.
Richmond and Henrico Health Districts — two localities whose Black, Latino and immigrant populations have been disproportionately affected by the virus — released local vaccine demographics data Tuesday afternoon, making them among the first in the state to do so.
The findings are emblematic of a persisting statewide and national issue that public health officials, equity experts and advocates warned would happen in rolling out doses: the communities hit hardest by the virus are not the ones receiving vaccines that could protect them against it.
Black residents account for 61% of the city’s total hospitalizations and more than a third of Richmond’s cases since Jan. 11. They make up 12% of those vaccinated.
In Henrico, where about 1 in 4 people who tested positive for COVID-19 in the past four weeks was Black, the percentage drops to 10% of vaccinations.
Whites in both localities made up less than 30% of cases in the same timeframe, but are almost 40% of vaccinations.
The answer to “why?” isn’t simple, and the gaps in vaccinations aren’t because these populations aren’t eligible for a dose. Black and Latino workers make up nearly a third of the state’s health care workforce but were never a third of vaccinations when Virginia was in the first phase.
At least 43% of cleaning staff statewide are Latino or an immigrant. This industry is included among the professions outlined in the first and second phases because of the high risk of exposure, but there’s no guarantee that they’re receiving vaccines at the same rate as physicians or police officers.
The variability isn’t solely due to a mistrust in the health care system following centuries of racist practices in medical care — though that hesitancy plays a role. It’s the obstacles compounded with ongoing disparities that prior to the pandemic resulted in Black women dying at 2.5 times the rate of white women during or after pregnancy, said Chloe Edwards, a public policy expert and advocacy manager for Voices for Virginia’s Children.
“It comes down to accessing health care and having access to health insurance,” Edwards said.
In Richmond, the neighborhoods with the highest levels of segregation across racial and socio-economic lines are the ones most likely to be without transportation, internet access and phones. They also have the highest COVID rates. They’re also less likely to be near chain pharmacies providing vaccinations.
Among older populations, the barriers when attempting to get online appointments is worse, since almost 1 in 5 people ages 65 and up do not have internet. The odds jump to almost 30% for Black and Latino residents in the same age group.
For some eligible essential workers without paid sick leave, there’s a risk of losing wages involved with taking off work to get a vaccine, said Edwards. Then there’s the lack of data collection.
Richmond and Henrico’s report doesn’t have race and ethnicity recorded for 45% of vaccinations. Statewide, the percentage is about 42%.
Yet for vaccine recipients by sex, only 0.2% are not reported.
In the past month, women in Richmond and Henrico were about 52% of the COVID-19 cases recorded, reflecting the population percentage in both counties.
Since vaccinations began, they’ve been at least 64% of vaccinations in those same localities.
Cat Long, spokesperson for Richmond and Henrico health districts, said in a statement Wednesday that local health departments have had limited capacity to invest in improving data collection and sharing while balancing the coordination of vaccine distribution.
Long added that Richmond and Henrico have shifted to having a volunteer base dedicated solely to data entry at events, emphasizing its importance to providers and learning how to quickly pull in the data that’s coming from separate sources.
Vaccine distribution in Richmond and Henrico is split among health department events, hospitals, long-term care facilities and regional clinics, according to internal tracking at VDH.
As of Monday, the latest update available, 127,742 doses have been administered throughout Chesterfield, Chickahominy — which includes Hanover County — Henrico and Richmond health districts. There are more than 1.1 million people in these localities.
In a media briefing Monday, Amy Popovich, nurse manager at Richmond and Henrico health districts, said the health departments received an additional 1,600 vaccines specifically to vaccinate Black and Latino communities.
Mobile events in partnership with churches, community organizations like Sacred Heart Center — a nonprofit focused on Latino families — and independent living facilities are ongoing to help close the gap, Popovich said. Additional clinics will soon be added to focus on refugee communities.
Weekly Spanish town halls on vaccinations are incoming, with trusted messengers who’ve received the vaccine talking about their experience. A permanent vaccination site in South Richmond, which currently has none, will be up by March.
Dr. Alexander Samuel, Chesterfield Health District director, didn’t provide the local breakdown of vaccinations but said in a statement that “We’re working to identify vaccination partners who already have access to these communities. We’re also hoping to conduct vaccination events in these areas as well; they might be small scale to begin with, but will certainly become more robust and established with time.”
Samuel said the collection of race and ethnicity data will improve once the state launches a registration system, which as of Wednesday, is still not up.
By the numbers
Virginia recorded 3,203 new cases on Wednesday, slightly down from the single-day increase of 3,291 the day before. The state’s total caseload is at 537,319 and the positivity rate has dropped to 10.1%.
The state is 68 deaths away from surpassing 7,000 deaths. On Wednesday, the total number of deaths was 6,932.
Current COVID-19 hospitalizations decreased by 47 patients since Tuesday, according to the Virginia Hospital and Healthcare Association’s online dashboard, which is the most accurate representation of hospitalizations. The state’s hospitals had 2,201 COVID-19 patients.
COVID-19 figures for the Richmond area
Richmond and the surrounding counties of Chesterfield, Hanover and Henrico have had a total of 60,836 cases, 2,395 hospitalizations and 821 deaths.
Richmond has had 13,632 cases, 643 hospitalizations and 144 deaths.
Chesterfield has had 21,131 cases, 731 hospitalizations and 216 deaths.
Henrico has had 19,862 cases, 799 hospitalizations and 357 deaths.
Hanover has had 6,211 cases, 222 hospitalizations and 104 deaths.