[Archived] Alexandria Health Department’s COVID-19 Vaccine Prioritization Process

For Immediate Release: February 18, 2021

COVID-19 vaccine supply currently remains extremely limited. More than 45,000 people have pre-registered to receive the vaccine, yet Alexandria receives fewer than 2,000 first doses per week. While local demand for COVID-19 vaccination exceeds the supply, Alexandria Health Department (AHD) must prioritize certain groups for vaccination.

AHD is required to follow the state’s priority group phases provided by the Virginia Department of Health: Phase 1a, Phase 1b, and Phase 1c. Although bound by these phase guidelines, AHD has petitioned the state on behalf of residents and essential workers, when data or equity concerns indicate that an industry or a group should be elevated on the priority list.

As the current Phase 1b encompasses tens of thousands of people, AHD must prioritize even further within this group using policies and processes that are consistent with and reinforce the equity priorities in their Public Health Justice Principles.The following criteria are applied to prioritize appointment slots for those who have pre-registered until vaccine supply meets demand or the course of the pandemic changes and groups must be prioritized differently to better control disease transmission.

Alexandria residents ages 75 and older, long-term care residents and employees, and those under Phase 1a who live or work in Alexandria receive first priority for vaccine appointments. Phase 1a includes health care workers, human services workers, and primary caregivers for persons with severe conditions requiring a high level of daily care.
The remaining vaccine appointment slots are then divided in half and allocated according to the following process:

50% of vaccine is allocated for those ages 65-74

Alexandria residents ages 65-74 are divided into two groups.
The first priority group includes residents of 13 census tracts within the City with the highest social vulnerability scores. Members of this group receive early access to appointments based on the order in which they pre-registered.
The second priority group includes Alexandria residents outside of the 13 most vulnerable census tracts. Members of this group are invited to schedule an appointment based on the order in which they pre-registered.

50% of vaccine is allocated for Phase 1b’s essential workers and those ages 16-64 with underlying conditions that increase their risk of severe COVID-19 disease

Essential workers in Phase 1b are invited to schedule an appointment based on the order in which they pre-registered.
Simultaneously, appointments are opened to Alexandria residents ages 16-64, who are divided into two groups.
- The first priority group includes residents of 13 census tracts within the City with the highest social vulnerability scores. Members of this group receive early access to appointments based on the order in which they pre-registered.
- The second priority group includes Alexandria residents outside of the 13 most vulnerable census tracts. Members of this group are invited to schedule an appointment based on the order in which they pre-registered.

AHD prioritizes the top third, or 13, census tracts with the highest social vulnerability score on the CDC's Social Vulnerability Index to increase vaccine access for underserved or marginalized residents. The Index identifies 15 social factors, including poverty, race/ethnicity status, speaking English "less than well," and crowded housing, to help identify the residents that may be disproportionately burdened by COVID-19. The index results align with AHD’s monthly ZIP code analysis of COVID-19 cases, the City of Alexandria's 2019 Community Health Assessment, and rental and food assistance request data.

Throughout this pandemic, local, state, and national data has shown that those in the highest social vulnerability risk categories have higher rates of infection, hospitalization, and death due to COVID-19. Additionally, residents of these priority areas often live and work in conditions with fewer options to protect themselves and their families from COVID-19. Many of these residents are not able to work from home or isolate within the home. They may not have paid time off from work or affordable, rapid access to testing or medical care. These factors make vaccination a critical tool in the battle against COVID-19 for this population. Prioritizing residents in Alexandria’s 13 census tracts with the highest social vulnerability leverages limited vaccine supplies to maximize impact, reduces Alexandria’s number of cases and hospitalizations, saves lives, and helps to address long standing inequities.

Beyond the prioritization process, AHD also operationalizes equity work through persistent, proactive outreach to Phase 1b populations and modified scheduling procedures. This approach includes partnering with employers, City agencies, nonprofits and houses of worship, and utilizing multilingual educational tools (postcards, robocalls, signage, and volunteer delivered information packets) to reach essential workers and those ages 65 and up. AHD also offers pre-registration and appointment scheduling over the phone for residents without internet access or email addresses.

Visit alexandriava.gov/Vaccines to pre-register for a COVID-19 vaccine. Those who have already filled out the pre-registration form do not need to submit another.

For inquiries from the news media only, contact Natalie Talis, Population Health Manager, at natalie.talis@vdh.virginia.gov or 703.746.4914.