As director of the Roanoke City & Alleghany Health Districts (RCAHD), I am extremely proud of the work our staff has done to vaccinate thousands of our citizens each week. With partners such as Carilion Clinic, our federally qualified health centers, and local retail pharmacies, well over 20,000 frontline essential workers and older residents have now received at least one dose of vaccine through RCAHD partnership clinics.

The RCAHD currently receives 3150 doses of COVID-19 vaccine every week for the over 25,000 people who have expressed interest in getting the vaccine through our online pre-registration survey and who meet current Phase 1B eligibility criteria. Thousands more people join the list every day. At this time, we are prioritizing vaccine distribution based on occupation (the top three tiers of Phase 1B “essential workers”), age, race and ethnicity, and geographic location. Because older individuals are more likely to have severe illness and death associated with COVID-19 infections, we have prioritized vaccine appointments for those residents who are over age 75. Because healthcare workers, people who work in law enforcement, hazmat, or corrections, and K-12 and childcare center employees are more likely to get exposed to the virus and less likely to have the option to work from home, these essential workers have also been prioritized. We expect it will take the rest of February to vaccinate this entire group of workers.

When we distribute vaccine, a foremost consideration is: How do our decisions address health equity? In the context of COVID vaccination efforts, “health equity” means that we are intentional in our efforts to assure that our residents have access to the vaccine, no matter who they are, where they live, or how much money they have. We also need to consider communities that have had higher rates of COVID-19 and/ or lower rates of interest in the vaccine. To achieve equity, we need to consider what disadvantages some of our residents may face and we need to work with our partners to overcome those disadvantages.

So what steps are we taking to achieve equity?

• To address disparities by geography, throughout the RCAHD, since early January we have held vaccine clinics in the city of Covington and in Craig, Alleghany, and Botetourt counties. Through these efforts, over 1,000 doses of COVID vaccine have been provided to members of our community who are located in the more rural parts of the districts.
  
• To address disparities by race and ethnicity, RCAHD is partnering with Roanoke City. City Manager Bob Cowell and his team are meeting with key stakeholders from communities of color to enhance equitable opportunities for vaccine. Furthermore, Carilion Clinic’s Community Outreach Team and the Office of Diversity, Equity and Inclusion are involved in efforts to address health disparities. Working together, we want to raise awareness of vaccine availability and increase registrations of under-represented, high-risk populations, especially in Black and Hispanic communities.
  
• To address potential disparities by access to technology, we are directly reaching out to people who do not have email addresses.
  

We know the registration process has been difficult, and we share the public’s frustration with not having enough supply to meet the current demand. Let us always remember that we are in this together. I ask you to consider how we can help each other. Check on your elderly neighbors and friends. Please help them sign up for vaccine on our website, and help them with transportation to their appointments. Together we get through this difficult time.