As vaccine availability continues to improve across the Commonwealth, the Richmond and Henrico Health Districts are expanding vaccine eligibility to encompass all Phase 1b groups. This significant step includes frontline essential workers and individuals aged 16-64 with specific underlying medical conditions and disabilities that elevate their risk of severe illness from COVID-19. This expansion means that over half of Richmond and Henrico residents, including the most vulnerable and frequently exposed, are now eligible to receive the vaccine. While it will take time to vaccinate everyone eligible, this expansion represents a major advancement in the fight against the pandemic.
As of March 8th, 2021, the following individuals within Phase 1a and Phase 1b are eligible for COVID-19 vaccination:
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Residents and staff of long-term care facilities
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Healthcare workers, including primary caregivers for individuals with severe medical conditions requiring significant daily care
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Individuals aged 65 and older, including those in independent living facilities
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Residents and staff of correctional facilities and homeless shelters
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Residents and staff of congregate living settings such as group homes and recovery residences
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Frontline Essential Workers, encompassing:
- Police, Fire, and Hazmat personnel
- Corrections and homeless shelter staff
- Childcare and PreK-12 teachers and staff (both public and private)
- Food and Agriculture workers (including veterinarians and food service employees)
- Manufacturing sector workers
- Grocery store employees
- Public transit workers
- Mail carriers (USPS and private services)
- Essential government officials critical for continuity of government (including judges and public-facing judicial staff)
- Clergy and Faith leaders
- Janitorial and Cleaning staff
How is Priority Determined Within Phase 1b?
Richmond and Henrico Health Districts have outlined a strategic approach to prioritize vaccinations within Phase 1b, ensuring that the most vulnerable populations receive protection first. The allocation of vaccine doses to each priority group is dynamic and adjusted based on vaccination progress within groups and evolving vaccine supply.
Should vaccine supply become limited, further prioritization within these groups will be implemented. This ensures that residents at the highest risk are vaccinated first. Richmond and Henrico Health Districts and their partners will consider several key factors for each group to ensure equitable vaccine access for those at greatest risk of severe illness, those living in communities heavily impacted by infection, and those facing significant barriers to healthcare.
Image alt text: Pie chart illustrating vaccine dose allocation percentages for Phase 1b priority groups in Richmond and Henrico Health Districts as of March 8th, 2021, showing the distribution across different essential worker categories, seniors, and congregate care settings.
Prioritizing Phase 1a & Congregate Care Residents
Richmond and Henrico Health Districts remain committed to offering priority vaccination appointments to any remaining Phase 1a healthcare workers and individuals residing in congregate settings such as jails, group homes, and long-term care facilities. These populations were among the first eligible and continue to be a focus.
Prioritizing Adults Age 65+
Moving forward, a significant portion – half of the vaccine supply – is dedicated to vaccinating seniors in the region. To prioritize within this large group, the following framework is applied for seniors who have pre-registered for the vaccine:
- Age: Older seniors within this age bracket will be prioritized for earlier vaccination.
- Race and Ethnicity: To address health disparities, Black, Hispanic/Latinx, and American Indian or Alaska Native residents will receive priority access.
- Burden of Disease: The prevalence of infection, hospitalization, and death rates in a person’s residential area is considered for prioritization.
- Social Vulnerability Score (SVI): The SVI of an individual’s residential area is a key factor in determining priority. (See the section below for more information on SVI).
Prioritizing Frontline Essential Workers
The prioritization of frontline essential workers who have pre-registered for vaccination mirrors the approach used for seniors, focusing on similar vulnerability factors:
- Age: Older essential workers will be prioritized within this group.
- Race and Ethnicity: Black, Hispanic/Latinx, and American Indian or Alaska Native essential workers will receive priority to promote equitable access.
- Burden of Disease: The level of infection, hospitalization, and death rates in the worker’s residential area is taken into account.
- Social Vulnerability Score (SVI): The SVI of the worker’s residential area is a factor in prioritization.
- Level of Work-Based Exposure: The degree of potential exposure to COVID-19 in the essential worker’s job role is considered. Resources from OSHA (Occupational Safety and Health Administration) provide guidance on assessing work-based exposure levels.
Essential workers who have pre-registered through the Vaccinate Virginia system and are over 65 or aged 16–64 with serious underlying medical conditions or disabilities may be offered vaccination appointments and receive the vaccine sooner than their colleagues due to their inclusion in these higher-priority Phase 1b categories.
Workplace and Workforce Group Prioritization
Beyond individual essential workers, Richmond and Henrico Health Districts will assess entire workplaces and workforce groups to determine their collective risk and exposure levels. Employers are asked to report on specific metrics that indicate the overall risk level of their employees:
- Percentage of employees with jobs that carry an elevated risk of exposure to COVID-19 at work.
- Percentage of employees who identify as Black, Hispanic/Latinx, and/or American Indian or Alaska Native.
- Percentage of employees who are over the age of 65.
- Percentage of employees who lack workplace-provided health insurance.
- Percentage of employees with limited English proficiency.
- Percentage of employees who have a high school diploma or less.
Workplaces and workforce groups demonstrating elevated risk and vulnerability may be offered a pathway for simultaneous vaccination of all interested employees. This might involve large-scale vaccination events or scheduled appointments across multiple days and times to accommodate varying work shifts.
Richmond and Henrico Health Districts are actively engaging with employers in the region. Businesses or organizations that believe they qualify as Phase 1b and have not yet been contacted are encouraged to complete the organization form as soon as possible.
Prioritizing Individuals Aged 16-64 with Underlying Medical Conditions and Disabilities
Each week, Richmond and Henrico Health Districts allocate a portion of their total vaccine doses to various healthcare providers, including free clinics, community health centers, primary care practices, specialty outpatient clinics, and health systems. These providers are tasked with vaccinating their existing patients aged 16–64 who have underlying medical conditions or disabilities.
When selecting patients for vaccination within this group, providers are asked to consider the following prioritization factors:
- Age: Older individuals within this age group will be prioritized for vaccination.
- Race and Ethnicity: Black, Hispanic/Latinx, and American Indian or Alaska Native residents will be prioritized to address health equity.
- Socioeconomic Status: Residents who are uninsured or underinsured will be given priority consideration.
Individuals within this eligible group who do not have a primary care provider can still receive the vaccine at Richmond and Henrico Health Districts’ vaccination events. These individuals should complete the statewide pre-registration form, and a member of the registration team will reach out to them.
How to Get Vaccinated
Anyone interested in receiving a COVID-19 vaccination in Virginia, regardless of their current eligibility phase, should pre-register at vaccinate.virginia.gov. Even if you are not yet in Phases 1a or 1b, pre-registration ensures you are in the system and will be contacted when it is your turn. If you have already pre-registered, you can visit the Vaccinate Virginia website to check your registration status at any time.
For individuals who are unable to pre-register online, assistance is available by phone. Call 1-877-VAX-IN-VA (1-877-829-4682) to pre-register with the help of a representative. Assistance is available in both English and Spanish, with callback options in 100 additional languages.
Health department staff will contact pre-registered individuals via phone or email to begin the appointment scheduling process. Vaccinations are administered by appointment only through several pathways:
- Large, small, and mobile vaccination events organized by RHHD throughout the region.
- Safety-net clinics such as Capital Area Health Network, Crossover, Health Brigade, and Daily Planet Health Services.
- Urgent care providers, including Patient First.
- Health Systems like Bon Secours Richmond, HCA, and VCU Health System.
- Primary Care Providers in specific communities.
- Local pharmacies, such as Hope, Westwood, and Bremo pharmacies.
- Retail pharmacies, including CVS and Walgreens.
To ensure equitable vaccine access for all eligible residents, Richmond and Henrico Health Districts are also establishing pop-up clinics in communities where residents may face barriers related to technology or transportation for registration and vaccination. Continued partnerships with faith-based and community organizations are crucial for outreach and promoting vaccination within their communities.
Vaccine access options will continue to expand as vaccine supply increases in the coming months.
Understanding the CDC’s Social Vulnerability Index
The Centers for Disease Control and Prevention (CDC) developed the Social Vulnerability Index (SVI) to identify communities that are disproportionately vulnerable to hardship during emergencies like the COVID-19 pandemic. The SVI considers community-wide factors such as race, language, poverty rates, employment status, educational attainment, transportation access, homeownership rates, and the prevalence of single-parent households. In Richmond and Henrico, neighborhoods with higher SVI scores have experienced higher rates of COVID-19 infection, hospitalization, and mortality. These neighborhoods are also more likely to have a higher proportion of Black, Latinx, and older residents, highlighting the importance of SVI in equitable vaccine distribution.
