Virginia’s Mass Vaccination Effort and Health Facilities Inspections — Troubling Evidence

by James C. Sherlock

M. Norman Oliver M.D., Virginia Health Commissioner

Updated Jan 19 at 2:55 PM

If you’ve been wondering why Virginia has fumbled its rollout of the COVID-19 vaccine, consider this: The Virginia Department of Health. As of one week ago, the Virginia Department of Health had not yet developed a vaccination plan.

From a presentation, “Virginia Department of Health Budget,” to Senate Finance & Appropriations Committee by State Health Commissioner M. Norman Oliver on Jan. 12, 2021:

COVID-19 Mass Vaccination Effort

VDH is leading a Vaccine Unit that has been formed under the Public Health Surveillance and Guidance Workgroup of the Commonwealth’s unified command structure. The Vaccine Unit is currently developing a COVID-19 vaccination plan for the Commonwealth. Additionally, a Vaccine Advisory Workgroup will be formed to provide perspective from varying points of view on actions and policies developed by VDH as it relates to COVID-19 vaccine and other vaccine-preventable diseases.

FY21 – $30,184,899 (General Fund)
FY22 – $59,123,029 (General Fund)

So VDH was “currently developing a COVID 19 vaccination plan” and had not yet formed a vaccine advisory group on January 12, 2021. The citizens of Virginia have known since March of last year that the state would need a vaccination plan.

The same presentation then provided this gem:

GF Match for COVID Grant from CMS for Licensure and Certification.

VDH was awarded supplemental funding by the Centers for Medicare and Medicaid Services (CMS) through the CARES Act for Survey and Certification (S&C) activities associated with the increased workload due to COVID-19. Activities performed specific to Title 19 (Medicaid) require general fund match in order to receive the funding.

FY22 – $59,288  (General Fund)
FY22 – $474,300 (Non General Fund)

No FTE’s are associated with the one-time grant and match for Licensure and Certification. No other budget amendment funds FTEs to fill the massive shortfalls that VDH itself has defined in its Licensure and Certification workforce… the workforce that inspects hospitals and nursing homes…. which do not like to be inspected.

The Virginia Department of Health continues to disappoint on matters of urgent necessity in protecting the health of Virginians.

It didn’t take anything but reading of the New England Journal of Medicine, to which I suspect VDH has access, to realize in July of 2020 that vaccines were coming and that every Virginian who does not reject the virus would need to get vaccinated.

It doesn’t take anything but common sense to realize that Virginia needed to create last summer a plan to distribute the vaccines a manner that would optimize injections.

It doesn’t take anything but common situational awareness to see chain pharmacies at every major intersection in the state that already give flu shots and understand that they would be the most efficient at mass inoculation.

But instead, Virginia shipped all of its initial doses to the largest hospital in each region and hoped for the best.

Why does the Health Commissioner continue to hold his job?

Do the Governor and General Assembly even notice?


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70 responses to “Virginia’s Mass Vaccination Effort and Health Facilities Inspections — Troubling Evidence”

    1. Peter = crickets
      Larry =crickets
      Va Consumer = crickets
      Nancy = irrelevant nonsense
      Dick = crickets

      As far as this blog is concerned: the worst part is the left refuses to admit to those times when their world view simply doesn’t work.

      1. idiocracy Avatar

        And at least two of those were government employees. That could account for something.

        “Groupthink”, I believe it’s called.

      2. Nancy_Naive Avatar
        Nancy_Naive

        So, CJD, did you ever decide what onus the word “determine” placed on the States?

        1. idiocracy Avatar

          Are you suggesting that the powers-that-be in Vuh-gin-yuh are so stupid, incompetent, and moronic that they need the FedGov to tell them what to do?

          I’ll go with that.

          1. Nancy_Naive Avatar
            Nancy_Naive

            Yes, and no. Stupid? Yes.. So stupid, they NEED the fed to tell them what to do? No.

            Stupid since after the PPE issue they were gullible enough to believe that all the deals being cut by the feds with end distribution points meant shipments would be FOB.

          2. sherlockj Avatar

            Stupid enough, Nancy, to fail to provision the state emergency stockpile of PPE that they were obliged to do by their own pandemic emergency operations plan, now missing from state websites.

        2. idiocracy Avatar

          The other states managed to work it out.

      3. Nancy_Naive Avatar
        Nancy_Naive

        How’d MAGA work out for you, Bubba?

    2. sherlockj Avatar

      9 months, unless the Department of Health thought there would never be a vaccine.

      1. Nancy_Naive Avatar
        Nancy_Naive

        The HHS spent 7 of those months saying what a GREAT job they were doing arranging endpoint distribution contracts with over 60% of the pharmacies in the nation. Then, in November they pop the fact that the States are responsible for delivering to the pharmacies.

        But yes, Northam was an idiot not to spend 7 months duplicating effort and being called a idiot for duplicating effort by BR and the Republicans — especially in light of the Kushner PPE supply chain fiasco.

        1. sherlockj Avatar

          Your reply is preposterous. In what universe did any state think that the federal government was going to inject vaccines into the arms of 330 million Americans?

          1. Nancy_Naive Avatar
            Nancy_Naive

            I dunno, maybe this?

            “Ensuring access and affordability of the COVID-19 vaccine for all Americans is a top priority for the Trump Administration,” said HHS Secretary Alex Azar. “We are leveraging the existing private sector infrastructure to get safe and effective vaccines supported by Operation Warp Speed into communities and into arms as quickly as possible with no out-of-pocket costs. The vast majority of Americans live within five miles of a pharmacy, and our new agreement with pharmacy partners across America is a critical step toward making sure all Americans have access to safe and effective COVID-19 vaccines when they are available.”

          2. sherlockj Avatar

            Do you think that could be accomplished without states doing their part? The feds knew that the pharmacies needed to be involved. So did the states.

            The feds shipped Virginia’s doses to the state. The state vectored them to the largest hospitals, not the pharmacies. There they sit.

    1. Peter = crickets
      Larry =crickets
      Va Consumer = crickets
      Nancy = irrelevant nonsense
      Dick = crickets

      As far as this blog is concerned: the worst part is the left refuses to admit to those times when their world view simply doesn’t work.

      1. idiocracy Avatar

        And at least two of those were government employees. That could account for something.

        “Groupthink”, I believe it’s called.

      2. Nancy_Naive Avatar
        Nancy_Naive

        So, CJD, did you ever decide what onus the word “determine” placed on the States?

        1. idiocracy Avatar

          The other states managed to work it out.

      3. Nancy_Naive Avatar
        Nancy_Naive

        How’d MAGA work out for you, Bubba?

    2. sherlockj Avatar

      9 months, unless the Department of Health thought there would never be a vaccine.

      1. Nancy_Naive Avatar
        Nancy_Naive

        The HHS spent 7 of those months saying what a GREAT job they were doing arranging endpoint distribution contracts with over 60% of the pharmacies in the nation. Then, in November they pop the fact that the States are responsible for delivering to the pharmacies.

        But yes, Northam was an idiot not to spend 7 months duplicating effort and being called a idiot for duplicating effort by BR and the Republicans — especially in light of the Kushner PPE supply chain fiasco.

        1. sherlockj Avatar

          Your reply is preposterous. In what universe did any state think that the federal government was going to inject vaccines into the arms of 330 million Americans?

  1. djrippert Avatar

    West Virginia’s success: one data point –

    “The state’s vaccination success can be attributed to numerous factors. While all 49 other states are part of a federal program partnering with CVS and Walgreens to vaccinate long-term care and assisted living facilities, West Virginia chose to deliver its vaccine supply to 250 pharmacies statewide, most of which are small, independent stores. Those pharmacies already had data for many patients, making it easier to schedule vaccination appointments earlier, secure consent forms and match doses to eligible patients — efforts that are confounding the vaccine rollout in many other states.”

    https://www.beckershospitalreview.com/pharmacy/most-successful-vaccine-rollouts-in-us-4-state-strategies.html

    Once again, scheduling the vaccine appointments turns out to be very important.

  2. djrippert Avatar

    West Virginia’s success: one data point –

    “The state’s vaccination success can be attributed to numerous factors. While all 49 other states are part of a federal program partnering with CVS and Walgreens to vaccinate long-term care and assisted living facilities, West Virginia chose to deliver its vaccine supply to 250 pharmacies statewide, most of which are small, independent stores. Those pharmacies already had data for many patients, making it easier to schedule vaccination appointments earlier, secure consent forms and match doses to eligible patients — efforts that are confounding the vaccine rollout in many other states.”

    https://www.beckershospitalreview.com/pharmacy/most-successful-vaccine-rollouts-in-us-4-state-strategies.html

    Once again, scheduling the vaccine appointments turns out to be very important.

  3. djrippert Avatar

    South Dakota’s success: one data point –

    “As soon as that vaccine comes in, we’re getting it given to people, whereas you see national news, a lot of times they say it’s sitting in freezers somewhere. That’s not happening in our state, whether that’s Sanford, Monument out west or us with Avera. We’re getting it done,” David Basel, MD, an internal medicine physician/pediatrician at Avera Health, told KOTA-TV.

    He added that he attributes South Dakota’s success to partnerships at the city and state level.

    “We’re able to cut through the red tape, I think, so much more effectively than a lot of states are. We just get it done,” Dr. Basel said.

    https://www.beckershospitalreview.com/pharmacy/most-successful-vaccine-rollouts-in-us-4-state-strategies.html

  4. djrippert Avatar

    South Dakota’s success: one data point –

    “As soon as that vaccine comes in, we’re getting it given to people, whereas you see national news, a lot of times they say it’s sitting in freezers somewhere. That’s not happening in our state, whether that’s Sanford, Monument out west or us with Avera. We’re getting it done,” David Basel, MD, an internal medicine physician/pediatrician at Avera Health, told KOTA-TV.

    He added that he attributes South Dakota’s success to partnerships at the city and state level.

    “We’re able to cut through the red tape, I think, so much more effectively than a lot of states are. We just get it done,” Dr. Basel said.

    https://www.beckershospitalreview.com/pharmacy/most-successful-vaccine-rollouts-in-us-4-state-strategies.html

  5. djrippert Avatar

    Connecticut’s success: one data point –

    The federal effort to vaccinate nursing home staff and residents led by CVS Health and Walgreens hasn’t run into any major problems in Connecticut, said Chris Cox, senior vice president of pharmacy at CVS, adding that the company’s relationship with the state “has been seamless.”

    https://www.beckershospitalreview.com/pharmacy/most-successful-vaccine-rollouts-in-us-4-state-strategies.html

  6. djrippert Avatar

    Connecticut’s success: one data point –

    The federal effort to vaccinate nursing home staff and residents led by CVS Health and Walgreens hasn’t run into any major problems in Connecticut, said Chris Cox, senior vice president of pharmacy at CVS, adding that the company’s relationship with the state “has been seamless.”

    https://www.beckershospitalreview.com/pharmacy/most-successful-vaccine-rollouts-in-us-4-state-strategies.html

  7. djrippert Avatar

    New York Times – As of Jan 15 …Virginia:

    1. 40th among 50 states for percentage of citizens getting at least one shot
    2. 48th among 50 states for percentage of received doses used

    https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html

    Disgraceful incompetence in Virginia.

    1. UpAgnstTheWall Avatar
      UpAgnstTheWall

      For rankings like this digging into the baseline numbers is important – because there are definitely cases where the space between #40 and #30 is trivial.

      This is not the case here.

      The very top of the list is basically “boy it’s really easy to roll out vaccines in small states with nobody in them” but after that – I mean looking at how much better New York and Texas did than Virginia is a shame.

      I’ve never thought the “Governor Doctor” snark was effective because a pediatric neurologist isn’t the same as being an epidemiologist and the man himself never claimed otherwise. But VDH is handling this vaccine distribution poorly and he needs to step up and address it.

      1. idiocracy Avatar

        Why are we expecting people with medical degrees to have the skills and training that a supply chain management specialist would have?

        Apparently, we can’t even expect people with medical degrees to figure out that’s what they need to solve their vaccine distribution problem.

        “The importance of supply chain management proved crucial in the 2019-2020 fight against the coronavirus (COVID-19) pandemic that swept across the world. During the pandemic period, governments in countries which had in place effective domestic supply chain management had enough medical supplies to support their needs and enough to donate their surplus to front-line health workers in other jurisdictions.[37][38][39] Some organizations were able to quickly develop foreign supply chains in order to import much needed medical supplies.[40][41][42]”

        https://en.wikipedia.org/wiki/Supply_chain_management

        1. VDOTyranny Avatar
          VDOTyranny

          Should have left it to Walmart or Amazon to handle. As a prime member, I’d have my Chinese made “just good enough to not return” vaccine by now.

          Besides, supply chain management is a business thing and all progressives know that’s ewwe

          1. idiocracy Avatar

            Chains are oppressive, don’t you know

  8. djrippert Avatar

    New York Times – As of Jan 15 …Virginia:

    1. 40th among 50 states for percentage of citizens getting at least one shot
    2. 48th among 50 states for percentage of received doses used

    https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html

    Disgraceful incompetence in Virginia.

    1. UpAgnstTheWall Avatar
      UpAgnstTheWall

      For rankings like this digging into the baseline numbers is important – because there are definitely cases where the space between #40 and #30 is trivial.

      This is not the case here.

      The very top of the list is basically “boy it’s really easy to roll out vaccines in small states with nobody in them” but after that – I mean looking at how much better New York and Texas did than Virginia is a shame.

      I’ve never thought the “Governor Doctor” snark was effective because a pediatric neurologist isn’t the same as being an epidemiologist and the man himself never claimed otherwise. But VDH is handling this vaccine distribution poorly and he needs to step up and address it.

      1. idiocracy Avatar

        Why are we expecting people with medical degrees to have the skills and training that a supply chain management specialist would have?

        Apparently, we can’t even expect people with medical degrees to figure out that’s what they need to solve their vaccine distribution problem.

        “The importance of supply chain management proved crucial in the 2019-2020 fight against the coronavirus (COVID-19) pandemic that swept across the world. During the pandemic period, governments in countries which had in place effective domestic supply chain management had enough medical supplies to support their needs and enough to donate their surplus to front-line health workers in other jurisdictions.[37][38][39] Some organizations were able to quickly develop foreign supply chains in order to import much needed medical supplies.[40][41][42]”

        https://en.wikipedia.org/wiki/Supply_chain_management

  9. idiocracy Avatar

    It’s about like trying to win a war, isn’t it?

    1. Nancy_Naive Avatar
      Nancy_Naive

      Well, we didn’t win in Iraq or Afghanistan, but with deployment size, DC IS OURS!

      1. sherlockj Avatar

        Smooth transition to another subject, Nancy.

        1. Nancy_Naive Avatar
          Nancy_Naive

          I didn’t say “war” first. And seriously, aren’t you just a wee bit tired of the war analogy too? War on Poverty, War on Litter, War on Drugs, War on Covid, War on Hurricanes,… War on Everything But War.

          1. sherlockj Avatar

            I did not use a war analogy. The real thing made an impression on me.

          2. Nancy_Naive Avatar
            Nancy_Naive

            Coke? Yeah, I hear that makes an impression… when mixed with rum. Police action, no?

            Wayne? Anything about rum making it too gooey for the straw?

          3. I’m so tired of the war analogy I’m ready to declare a “War on wars on stuff”…

    2. Nancy_Naive Avatar
      Nancy_Naive

      Again… please read the CDC Centralized Distribution a few pages down.

      Note the storage temperatures in the distribution plan. Those are the 5 day temperatures

      “If necessary, the McKesson contract can cover rapid distribution of doses of refrigerated (2–8o Celsius) and frozen (-20oC) vaccines.”

      https://www.hhs.gov/sites/default/files/strategy-for-distributing-covid-19-vaccine.pdf

      1. idiocracy Avatar

        Maybe Virginia could ask NJ where they got all their refrigerators and freezers?

        1. Nancy_Naive Avatar
          Nancy_Naive

          Shhhh… bent noses.

      2. sherlockj Avatar

        Again, Virginia’s doses were distributed by the state to its largest hospitals, not the pharmacies. There they sit.

        1. Nancy_Naive Avatar
          Nancy_Naive

          Because… if you can read Cap’n… the fed promised to deliver to the pharmacy level, and when they didn’t, the State had to improvise!

          Where’s the result of the Califonia, North Dakota, Minnesota pilot programs?

          Now, Cap’n, how many times in your career did you make a contingency plan expecting your ADM’s plan to fail? Or planned for them to fail?

          1. sherlockj Avatar

            Stop it Nancy.

            You are smart enough to know the difference between federal master task order contracts that set the conditions of the sale and state delivery orders written under those contracts. The feds contracted the terms with the pharmacies, the states were responsible for issuing the delivery orders.

            Virginia either through neglect or on purpose, decided it had a better idea and sent its allocation of doses to our largest hospitals, hoping the redistribution would happen from there, which it did not.

            It is ok to recognize that government screws up, sometimes with deadly results like Virginia’s ignoring of its own Inspector General Report in 2017 that the VDH Office of Licensure and Inspection did not have nearly enough inspectors to carry out its responsibilities. The result was the unforced error of slaughtering nursing home residents in homes that were understaffed.

            It is OK, make that imperative, that people of the left criticise government when it fails.

            The Virginia Department of Health is a failed institution, and believers in government must call them out for it.

          2. Nancy_Naive Avatar
            Nancy_Naive

            It’s the fed that claimed expertise. This was going to be just like the vaunted N1H1. They said so. They failed. And you have been around long enough to know that affluence runs uphill while effluence runs down.

            The Congressional Committee hearings will sort it out.

          3. sherlockj Avatar

            You don’t believe that yourself, Nancy.

  10. idiocracy Avatar

    It’s about like trying to win a war, isn’t it?

    1. Nancy_Naive Avatar
      Nancy_Naive

      Well, we didn’t win in Iraq or Afghanistan, but with deployment size, DC IS OURS!

      1. sherlockj Avatar

        Smooth transition to another subject, Nancy.

        1. Nancy_Naive Avatar
          Nancy_Naive

          I didn’t say “war” first. And seriously, aren’t you just a wee bit tired of the war analogy too? War on Poverty, War on Litter, War on Drugs, War on Covid, War on Hurricanes,… War on Everything But War.

    2. Nancy_Naive Avatar
      Nancy_Naive

      Again… please read the CDC Centralized Distribution a few pages down.

      Note the storage temperatures in the distribution plan. Those are the 5 day temperatures

      “If necessary, the McKesson contract can cover rapid distribution of doses of refrigerated (2–8o Celsius) and frozen (-20oC) vaccines.”

      https://www.hhs.gov/sites/default/files/strategy-for-distributing-covid-19-vaccine.pdf

      1. idiocracy Avatar

        Maybe Virginia could ask NJ where they got all their refrigerators and freezers?

        1. Nancy_Naive Avatar
          Nancy_Naive

          Shhhh… bent noses.

      2. sherlockj Avatar

        Again, Virginia’s doses were distributed by the state to its largest hospitals, not the pharmacies. There they sit.

  11. Even the RTD’s pathethic editorial page recognizes the problem. But youll notice that it doesnt hold anyone to account. One of the only references in the active voice to actions by state government is “Virginia only has distributed…” without even mentioning state government. RTD asks, “Why have we inoculated fewer people than a half full footbll stadium?” “We”? As if the whole population of Virginia was responsible for the mess. It cites the better experience of other states and asks why Virginia can’t do better. Nowhere is there any indication that RTD bothered to ask to ask state officials these questions directly. Nor does it dare label the state government’s actions, or lack of action, as incompetence. Of course not. RTD wouldn’t want to inconvenience or embarrass folks in their beloved government. How foolish of me to expect that.

    Is there anyone on this blog who is now going to say we should most certainly rely on state government to accomplish this task? RTD had one thing right: turn it over to the private sector mom-and-pop stores to get it done.

  12. Even the RTD’s pathethic editorial page recognizes the problem. But youll notice that it doesnt hold anyone to account. One of the only references in the active voice to actions by state government is “Virginia only has distributed…” without even mentioning state government. RTD asks, “Why have we inoculated fewer people than a half full footbll stadium?” “We”? As if the whole population of Virginia was responsible for the mess. It cites the better experience of other states and asks why Virginia can’t do better. Nowhere is there any indication that RTD bothered to ask to ask state officials these questions directly. Nor does it dare label the state government’s actions, or lack of action, as incompetence. Of course not. RTD wouldn’t want to inconvenience or embarrass folks in their beloved government. How foolish of me to expect that.

    Is there anyone on this blog who is now going to say we should most certainly rely on state government to accomplish this task? RTD had one thing right: turn it over to the private sector mom-and-pop stores to get it done.

  13. I’m piling on here, but this complete failure on the vaccine front has exposed a shocking level of incompetence with the VA health system and at the health district level. The finger pointed at lack of funding would hold true if this wasn’t, as said above, months and months in the making. It would almost be comical if they weren’t playing with people’s lives.

    Anecdotally, the Blue Ridge Health District, formerly known as Thomas Jefferson HD, has turned away medical professionals who have volunteered their efforts to help administer the vaccine.

    You would think our doctor turned guv would be a shade more involved also. This is tired bureaucracy at its worst.

  14. I’m piling on here, but this complete failure on the vaccine front has exposed a shocking level of incompetence with the VA health system and at the health district level. The finger pointed at lack of funding would hold true if this wasn’t, as said above, months and months in the making. It would almost be comical if they weren’t playing with people’s lives.

    Anecdotally, the Blue Ridge Health District, formerly known as Thomas Jefferson HD, has turned away medical professionals who have volunteered their efforts to help administer the vaccine.

    You would think our doctor turned guv would be a shade more involved also. This is tired bureaucracy at its worst.

  15. S. E. Warwick Avatar
    S. E. Warwick

    The “data” that some of the decisions were allegedly based on seems vague at best. There were days since March when new deaths, allegedly all in the state, were fewer than new deaths associated with outbreaks.

    1. sherlockj Avatar

      It didn’t take anything but reading of the New England Journal of Medicine, to which I suspect VDH has access, to realize in July of 2020 that vaccines were coming and that every Virginian who does not reject the virus would need to get vaccinated.

      It doesn’t take anything but common sense to realize that Virginia needed to create last summer a plan to distribute the vaccines a manner that would optimize injections.

      It doesn’t take anything but common situational awareness to see chain pharmacies at every major intersection in the state who already give flu shots and understand that they would be the most efficient at mass inoculation.

      But instead, Virginia shipped all of its initial doses to the largest hospital in each region and hoped for the best.

      Why does the Health Commissioner continue to hold his job?

  16. S. E. Warwick Avatar
    S. E. Warwick

    The “data” that some of the decisions were allegedly based on seems vague at best. There were days since March when new deaths, allegedly all in the state, were fewer than new deaths associated with outbreaks.

    1. sherlockj Avatar

      It didn’t take anything but reading of the New England Journal of Medicine, to which I suspect VDH has access, to realize in July of 2020 that vaccines were coming and that every Virginian who does not reject the virus would need to get vaccinated.

      It doesn’t take anything but common sense to realize that Virginia needed to create last summer a plan to distribute the vaccines a manner that would optimize injections.

      It doesn’t take anything but common situational awareness to see chain pharmacies at every major intersection in the state who already give flu shots and understand that they would be the most efficient at mass inoculation.

      But instead, Virginia shipped all of its initial doses to the largest hospital in each region and hoped for the best.

      Why does the Health Commissioner continue to hold his job?

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