In Norfolk and Portsmouth, only 29% of residents have gotten their coronavirus shots

Norfolk and Portsmouth are tied for the lowest percentage of people vaccinated against the coronavirus in Hampton Roads, with about three in 10 residents fully inoculated as of last week.

The low level of vaccine-generated immunity in those cities compared with neighbors may be surprising, especially following the federal and state aid sent to those areas this spring. The reasons are not quite clear — perhaps a combination of challenges based on demographics.

Public health officials are tracking the data to evaluate how close all communities are to reaching herd immunity, the level of vaccinated people needed to reduce the chance of vulnerable people coming in contact with the virus. No one knows for sure how many people must be vaccinated to control the spread, but epidemiologists believe between 70% to 85% of the population.

Northern Virginia could reach herd immunity by mid-summer, according to an analysis by the UVA Biocomplexity Institute a month ago. But many Hampton Roads localities might not get there this year.

That concerns local health leaders — although new COVID-19 cases have plummeted, most viruses ramp up again with colder temperatures. The least vaccinated localities may be at risk of outbreaks in a few months.

“What we’ve got to make sure we do in Norfolk and Portsmouth is ensure we have those numbers up as high as possible before the fall,” said Dr. Parham Jaberi, acting health director for Norfolk and Virginia Beach. “Because I do think that with the change in weather, we’re going to likely see more activity.”

As mass vaccination clinics throughout Virginia shutter and the demand for the shots dwindles, public health officials are shifting supplies to doctor’s offices and smaller-scale operations. That leaves local health leaders in places like Norfolk and Portsmouth looking at strategies to bring shots to the hardest-to-reach — and hardest-to-convince — communities.

Dr. Lauren James, Portsmouth’s health director, said vaccines lag in poorer communities, one of her city’s challenges.

“A lot of this just reflects the impact of social determinants of health,” she said. “What if you don’t have stable housing, or what if you don’t have a job that offers you benefits, or sick leave? If you don’t have a job where you can take time to go get a vaccine, or if you have other priorities, such as housing, you may not be able to pick up the opportunities that are available to get vaccinated.”

In Norfolk, where the vaccinated make up a little more than 29% of the population — the same as Portsmouth — Jaberi said he believes many residents continue to be wary of the vaccines.

Both cities have larger Black populations than in some other parts of the region. Despite grassroots efforts led by churches to increase vaccinations among Black residents, the minority group continues to have less confidence in the safety of the drugs, either because of a perception they were rushed out of the lab or a distrust stemming from a history of medical abuses against Black patients.

Jaberi also believes there’s a large portion of people who don’t know the shots are free. It doesn’t help that many vaccinators ask for patients to provide health insurance information, he said.

Though an insurance company might be billed a fee for the administration of a shot, there’s no copay for individuals. In fact, people don’t have to have any insurance to get a vaccine.

Over the next few weeks, Jaberi said he’ll be working with his team on ways to expand mobile clinics. The department plans to home in on specific Census tracts where vaccine uptake is particularly low. The city has a van to drive into underserved areas. The idea is to conduct small but strategic vaccination events.

“I think what Norfolk will need to do is just really double down on mobile outreach efforts and provide those vaccination opportunities in a much more hyperlocal way,” he said. “And so we may only vaccinate 10, 20, 30 folks at a time.”

Dr. Danny Avula, the state vaccination coordinator, said things might not be as bad for the Southside cities as they seem. Their low numbers could be the result of a distortion in the data.

Virginia includes the federally administered vaccine numbers, but the Department of Defense hasn’t broken them down by locality. That means some 200,000 fully vaccinated military and veterans aren’t included in the city and county level data.

“I think there is significant undercounting in those communities because they have large military populations,” Avula said.

Their vaccine coverage numbers, however, pale in comparison to places like James City County, one of Virginia’s original hotspots for the public health crisis. A little more than half of the residents there are fully vaccinated, a rate that is only outpaced on the east by Northampton County, with 53% of residents fully vaccinated.

Irene Ferrainolo, population health manager for the Hampton and Peninsula health districts, said the demographic characteristics of James City County lend to higher vaccine uptake. The county has many retirement communities, and older people in general have had more confidence in the vaccines. The residents also have a high level of education, which tends to correlate with increased trust in the science.

The county also has had churches and a health coalition specifically targeting people in underserved communities, she said, boosting shots among its Latino and Black residents.

Colonial Williamsburg Regional Visitor Center was also one of the first clinics, a partnership between local and state agencies, Ferrainolo said. Their communications team was aggressive in getting the word out. And while many vaccinators struggled with information technology and the scheduling process, James City County had one of the smoothest appointment-making operations, she said.

“Our point of view right now is not that the crisis is over, but we say the crazy is over,” she said.

Though the Federal Emergency Management Agency shut down its Norfolk clinic May 22, Jaberi said the local health department has continued using the old Macy’s building at Military Circle Mall two days a week. Though that hasn’t been prominently advertised, staff are there to finish up some second doses while also offering Pfizer shots to teens, many of whom just became eligible.

He’s in talks with the Virginia Unified Command about keeping it open as a site that can serve as a vaccination hub for the region.

That could benefit Portsmouth residents, too. Their clinic at the Sportsplex, run by a state contractor with FEMA funding, closed at the same time.

“The populations that we are working on now are a little bit harder to reach — adolescents, those in their 20s and 30s. They haven’t been affected by the hospitalization or death rate, so, there is a little bit more convincing needed, as they might not be concerned about their own health,” James said. “But it’s more so about the health of the community.”

Fully vaccinated against COVID-19

Accomack County: 39.5%

Chesapeake: 36.6%

Franklin: 35.5%

Gloucester County: 41.1%

Hampton: 35%

Isle of Wight County: 40.8%

James City County: 50.6%

Mathews County: 47%

Middlesex County: 48.2%

Newport News: 33.8%

Norfolk: 29.4%

Northampton County: 52.6%

Portsmouth: 29.5%

Poquoson: 46.1%

Suffolk: 35%

Virginia Beach: 38.9%

Williamsburg: 39.5%

York County: 42.5%

Source: Virginia Department of Health, June 10, 2021

For more information on where to find vaccines, visit vaccinate.virginia.gov or www.vaccines.gov. For phone assistance, call 1-877-VAX-IN-VA.

Elisha Sauers, 757-839-4754, elisha.sauers@pilotonline.com