Who's on first?

After nearly a year of lockdowns and quarantine to keep Covid at bay, people are eager to get back to what passes for normal and anxious to get their “shot” of Covid vaccine. Details about how to get inoculated are confusing and often contradictory.

Go to https://www.vdh.virginia.gov/covid-19-faq/vaccination/ for some FAQs.

When the initial two vaccines— one from Pfizer, the other from Moderna—became available priorities were established to ensure that those most vulnerable and exposed were first in line. Group 1a included health care workers, first responders, residents of nursing homes and critical care facilities, and their staff.

Phase 1b   included essential workers; people over age 65; people age 16-64 with an underlying medical condition; people living in correctional facilities, homeless shelters, and migrant labor camps.

People were asked to sign up at their local health district website to get on a vaccination list. (Goochland is part of the Chickahominy Health District (CHD), which also includes Hanover, New Kent, and Charles City Counties. Go to https://www.vdh.virginia.gov/chickahominy/). At close of business yesterday, February 12, this list was merged with a state database, which is intended to improve access to vaccine appointments.

On Thursday, February 11, Dr. Thomas Franck, Health Director, and Caitlyn Hodge of the CHD participated in a Zoom session about the Covid vaccination process in Goochland. Kudos to Jerusalem Baptist Church, the CHD, Goochland Christian Churches Association, and the Goochland NAACP for facilitating the event to share this information with the community.

Franck and Hodge are “boots on the ground” in the local vaccination process. Franck explained that CHD receives about 1,800 doses per week of the Moderna vaccine, which is not enough to get the population of the CHD, approximately 160,000 people, inoculated in a timely manner. The Pfizer shot must be kept very cold, which requires special freezers that, like many other things during Covid, are on back order. CHD ordered some of these freezers in October, but they have not yet arrived, without the freezers, CHD cannot administer the Pfizer shot.

Those with the greatest risk of dying must get the shot first, Franck said. That is why they’re being so careful about following the priority groups. CHD is roughly halfway down the 1b list, which includes roughly half the population—approximately 80,000 people— of the district. At 1,800 doses per week that will take a long time.

The good news, said Franck, is that vaccine production is starting to pick up. The CHD received about one third of the doses it requested. The lack of supply is the main reason for the slowness of the process. He expects the number of available doses to increase dramatically by mid-March.

So far, about ten percent of Virginia’s population has received at least one dose of the vaccine. Goochland, said Franck, has administered more than 3,000 doses, about 12.7 percent of the population, had gotten at least one shot, a little ahead of the state.

There were questions from people in 1b who have not heard anything weeks after signing up. Francks said that 1b has been divided into tiers based on risk. They want to make sure that highest risk individuals get vaccinated first. He said that he expects vaccination appointments to be offed to all of 1b in the next few weeks. People can call 804-365-3240 to sign up by phone if they are unable to do so online.

Franck said that cancer patients and those with allergies can have the vaccine. Those who have had severe anaphylaxis will get the vaccine and be observed at the vaccination site for 30 minutes to make sure they have no serious allergic reactions.

Once on the list when your time comes you will get an email inviting you to participate in an upcoming clinic.

Franck expects the Johnson and Johnson vaccine to be shipped soon after its emergency approval, which is expected in the next few weeks, but had no idea how much the CHD could receive. That is a one dose vaccine, which simplifies the inoculation process.

Franck suggested that people sign up on as many vaccine sites as they can to improve their chances for an appointment. CHD loaded its waiting onto the CVS list to sign up quickly, but those appointments filled as soon as they opened.

Because the vaccines are so new, there is no way of telling how long the vaccine will offer protection from Covid, said Franck.

People who wish to volunteer to help the vaccination effort may sign up for the Virginia Medical Reserve Corps, which is the backbone of inoculation clinics. Volunteers are sites can sometimes get leftover vaccine t the end of the day.

Giving the vaccination, explained Franck, requires special training. Registered nurses’, pharmacist, EMT-Intermediate, and Paramedic are doing this. Each vaccine has its own training. Vaccinators must observe and be observed giving shots before being “cut loose” to vaccinate.

Acknowledgement of registration is coming, said Franck, but is not a current practice. The waiting list is fluid. People with higher priorities are put to the head of the line. “You could get bumped down or moved up on the list” depending on circumstances.

Hodge said that the state’s new preregistration portal will enable people to check that they are on the list and their status. The main centralized portal is expected to be operational on Tuesday, said Hodge incorporating those already on the Chickahominy list. No preregistration will be available until Tuesday.

Primary care physicians and pharmacies will get an allocation of doses as the supply increases. Franck estimated that could be a month or two down the road for categories 1c and 2, which is the general public.

Hodge said that the call centers are answered live during business hours and will return calls for those who leave messages at other times. She encouraged those who 75 or older to check to see where they are on the list, because they should be getting calls soon.

Franck said everyone should be vaccinated, even those who have recovered from Covid. He said that having the infection provides some immunity for at least 90 days. He said that people should not worry about being tested over and over. The PCR test is so sensitive that people sometimes test positive after recoverin because dead virus can linger in your system.

Hodge said that folks in quarantine, because they’ve been exposed, should wait until after their quarantine period is over to avoid the possibility of infecting others. “Please don’t come to a clinic if you’re supposed to be in isolation or quarantine,” she said.

Franck said that is seems reasonable that CHD will be in 1b for three months. When 75-80 percent of people in 1b have been vaccinated, he would move to 1c. CHD is getting close to opening up to all 1b, perhaps in the next few weeks. It all depends on the vaccine supply. “We can vaccinate 1,000 people a day, we’re just waiting for the vaccine to come in.”

There will be a dedicated clinic day each week in Goochland for vaccinations, starting in March, as the dose supply increases.

In general, said Hodge, second vaccine doses will be given at the same place as the initial dose. Second does appointments are generally given on the way out of the first shot.

If you miss the call for your appointment, you will not lose your spot. You will not be crossed off the list if you miss the call.

People who have had surgery, are on dialysis, have cancer, or put on a new medication are eligible for vaccination if cleared by their doctor and feeling well.  The Covid vaccine must be separated from any other vaccine by two weeks.

If your appointment is cancelled by inclement weather, CHD will contact you to reschedule.

Franck said he expects herd immunity—reached when a combination of those who have had Covid and those vaccinated reaches 75-80 percent— will stop the spread of the virus sometime during the summer.

Go to https://www.facebook.com/300112260025103/videos/897957434366880 to watch the entire presentation.