COVID-19 Update for Virginia

COVID-19 Update for Virginia

December 14, 2021

Dear Colleague:

Thank you for your continued partnership in responding to the COVID-19 pandemic.  Please visit the Virginia Department of Health (VDH) website for current clinical and public health guidance, epidemiologic data, and other information.  Updates on the following topics are included in this correspondence:

  • Omicron (B.1.1.529) Variant Detected in Virginia
  • COVID-19 Booster Doses Recommended for Everyone Aged 16 Years and Older
  • COVID-19 Therapeutics Update
  • Widespread Flu Activity in Virginia

Omicron (B.1.1.529) Variant Detected in Virginia

VDH announced the first confirmed COVID-19 Omicron case in Virginia on December 9.  Additional Omicron cases are expected across the Commonwealth and these cases will be tracked on VDH’s Variants Dashboard.  Despite the detection of Omicron in Virginia, more than 99% of sequenced COVID-19 cases in Virginia are currently caused by the Delta variant and COVID-19 cases and hospitalizations are increasing.  Last week, the Centers for Disease Control and Prevention (CDC) published a summary about the initial Omicron cases in the United States.  Please encourage all your eligible patients to get vaccinated, get boosted, and layer other prevention strategies.  For the holidays, VDH updated its Social Gatherings and Events website to summarize steps people can take to celebrate safely.

COVID-19 Booster Doses Recommended for Everyone Aged 16 Years and Older

On December 9, the U.S. Food and Drug Administration (FDA) authorized and CDC recommended a single Pfizer-BioNTech booster dose for teenagers aged 16 and 17 years, at least 6 months after their initial Pfizer-BioNTech vaccination series.  Because the Pfizer-BioNTech vaccine is the only vaccine authorized for people in this age group, they should only receive the Pfizer-BioNTech COVID-19 Vaccine or Comirnaty as their booster dose.  Everyone ages 18 and older should get a booster shot either when they are 6 months after their initial Pfizer-BioNTech or Moderna series or 2 months after their initial Johnson & Johnson vaccine; they can choose which COVID-19 vaccine to receive as a booster shot.  Providers in Virginia can immediately begin administering booster doses in accordance with these CDC recommendations.  FDA revised its Pfizer-BioNTech fact sheets for providers and recipients.  CDC updated its  Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States and its Provider Requirements and Support.  VDH revised its standing orders for dispensing and administering COVID-19 vaccine.

COVID-19 Therapeutics Update

On December 3, FDA expanded the emergency use authorization (EUA) for bamlanivimab and etesevimab (“Bam/Ete”), two monoclonal antibodies that are administered together.  Bam/Ete can now be administered to younger pediatric patients, including newborns, for the treatment of mild to moderate COVID-19 or postexposure prophylaxis (PEP) in those at high risk for severe COVID-19; previously, this combination therapy was authorized for patients 12 years and older.  FDA issued a news release and the revised EUA package insert on December 3.

On December 8, FDA granted an EUA to AstraZeneca’s Evusheld (tixagevimab co-packaged with cilgavimab and administered together) for the pre-exposure prophylaxis (prevention) of COVID-19 in certain adults and pediatric individuals.  This product is authorized for persons aged 12 years or older (weighing at least 88 pounds) who are not currently infected with COVID-19, who have not been exposed to COVID-19, and who either have moderately to severely compromised immune systems or a history of severe adverse reactions to a COVID-19 vaccine and/or its component(s) such that vaccination is not recommended.  FDA issued a news release about Evusheld and the EUA package insert on December 8.

The U.S. Government has purchased doses of Evusheld.  From communications with the U.S. Department of Health and Human Services (HHS), it appears the initial allocation of the drug will be small (1200 doses) and available in the Commonwealth either this week or next.  Available initial doses will likely go to larger medical centers that treat more immunocompromised patients.

Widespread Flu Activity in Virginia

For the week ending December 4, the geographic spread of influenza (flu) in Virginia jumped from “sporadic” to “widespread” based on reported laboratory results, influenza-like illness (ILI), and outbreaks.  Because flu and COVID-19 clinical presentations are similar, both COVID-19 and flu testing are needed to distinguish these infections.  Please encourage all patients 6 months or older to get vaccinated now against flu to lower their risk of infection, hospitalization, and death.  This is particularly important with the upcoming winter holidays.  The COVID-19 and the flu vaccine can be administered at the same time.  CDC guidance for managing patients who are infected with or exposed to flu is available.

Thank you again for your continued partnership as we respond to the COVID-19 pandemic.   If you have questions about COVID-19, please contact your local health department.


M. Norman Oliver, MD, MA

State Health Commissioner