Department of Veterans Affairs leaders told Congress they had secured nearly 200,000 initial doses of two separate coronavirus vaccines this week, and after federal approval of the first, about 73,000 of those vaccine doses will head to 37 VA facilities nationwide.
Those 37 are just initial sites, Veterans Health Administration Executive in Charge Dr. Richard Stone said Wednesday. They were chosen based on cold-storage capabilities, one of the biggest challenges with the Pfizer vaccine, the first to expected gain federal approval for general use.
Those 37 VA Medical Centers are:
- Birmingham, Alabama VA Health Care System
- Phoenix VA Health Care System
- Greater Los Angeles VA Health Care System
- Palo Alto, California VA Health Care System
- Eastern Colorado VA Health Care System
- Connecticut (West Haven Campus) VA Health Care System
- Washington, D.C. VA Health Care System
- Orlando, Florida VA Health Care System
- Augusta, Georgia VA Health Care System
- Edward J. Hines Jr. VA Hospital in Illinois
- Lexington, Kentucky VA Health Care System
- Southeast Louisiana (New Orleans) VA Health Care System
- Maryland (Baltimore) VA Health Care System
- Bedford, Massachusetts VA Health Care System
- Ann Arbor, Michigan VA Health Care System
- Minneapolis VA Health Care System
- Harry S. Truman Memorial Veterans Hospital in Columbia, Missouri
- St. Louis, Missouri VA Health Care System
- Omaha, Nebraska VA Health Care System
- Southern Nevada (North Las Vegas) VA Health Care System
- Raymond G. Murphy VA Health Care System in New Mexico
- New York Harbor (Brooklyn) VA Health Care System
- Western New York (Buffalo) VA Health Care System
- Durham, North Carolina VA Health Care System
- Cleveland VA Health Care System
- Oklahoma City VA Health Care System
- Portland, Oregon VA Health Care System
- Corporal Michael J. Crescenz VA Medical Center in Philadelphia;
- Pittsburgh, Pennsylvania VA Health Care System
- Caribbean (Puerto Rico) VA Health Care System
- Memphis, Tennessee VA Health Care System
- Dallas VA Medical Center
- Michael E. DeBakey VA Health Care System in Houston, Texas
- Audie L. Murphy VA Hospital in San Antonio, Texas
- Richmond, Virginia VA Health Care System
- Puget Sound, Washington VA Health Care System
- Milwaukee, Wisconsin VA Health Care System
Capitol Hill lawmakers have expressed concern VA has not released its full vaccine distribution plan like other federal agencies and states have already. This week was the first time VA publicly released some information on its plans, including the intial 37 sites.
Those sites are set to receive 73,000 doses of the Pfizer vaccine, enough for about 36,500 veterans or VA staff, since the vaccine requires at least two doses. VA also ordered 122,000 doses of the Moderna vaccine, which also requires two doses, but has the advantage of not having to be stored at temperatures quite as low as the Pfizer vaccine. The Moderna vaccine will head to 188 VA sites, Stone said, though that list had not been released as of Friday afternoon.
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Those shipments of the vaccines aren't nearly enough for VA's 9 million veteran patients and nearly 400,000 staff, Stone said, and VA will have to secure more as federal officials approve vaccines and more doses are produced.
"It's not an adequate amount and this will be a long process to reach all 7 million veterans who we believe will want a vaccine from us as well as all 400,000 VA employees," Stone said. "I don't think it's going to cover the entire nation in the way that it should."
A major concern for VA, Stone said, is the ability to transport the vaccines to more rural and remote areas since they require such low temperatures. Stone said VA expanded contracts for dry ice, is adding 36 more freezers in hub locations and may use direct flights to get the vaccines to more areas.
"I'm going to need the Moderna vaccine in order to reach the rural veteran," Stone told lawmakers Wednesday.
VA officials also outlined who is most likely to receive the vaccine from the department this week -- VA staff and veteran patients most at risk at the sites set to receive the vaccine first.
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Veterans will receive the vaccine based on risk of infection, including age, race and ethnicity, existing health conditions and other factors such as those living in nursing homes or other group living facilities.
In a nationwide study of more than a quarter of a million veterans released earlier this year, VA researchers found that Black and Hispanic veterans are twice as likely to test positive for the virus as white veterans. VA data showed that while Black and Hispanic veterans make up about 23% of VA patients, they account for nearly half of all VA COVID-19 cases.
VA data shows that Native veterans also are disproportionately at risk for the virus. Similar trends among Black, Hispanic and Native populations is reflected among the overall American population as well.
Survival rates do not differ significantly by race or ethnicity, however, VA officials said.
Older veterans, or those with health conditions such as cancer, diabetes or heart disease, are also more at risk.
Experts previously warned that veterans exposed to burn pits or who have experienced Gulf War Illness from military toxic exposures may also be at elevated risk for the virus.
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Many veterans will have to wait to receive a vaccine, VA cautioned, since there will only be limited supplies to begin with after the Food and Drug Administration approves them. Veterans will also not likely have a choice of which vaccine they receive, VA officials said.
It's also still unclear how long the vaccines may protect people from the virus, so VA urged veterans to continue to observe precautionary measures to prevent the spread of infection even after being vaccinated.
Veterans enrolled in VA health care do not pay copays for vaccinations provided during health visits, and VA officials said there are no current plans to charge any fees for the COVID-19 vaccine.
Virus hits another record high at VA
The coronavirus continues to spread among VA patients and staff, with active cases reaching another record high Friday afternoon.
As of Dec. 11, VA recorded 17,757 cases of patients actively sick from the virus, a more than 433% increase since Oct. 1 and up more than 20% since the start of the month.
More than 5,540 veterans have died because of the virus since the pandemic began, according to VA data, and more than 520 of those have been recorded in December alone, an average of 47 patient deaths recorded per day. If that rate continues, the final month of 2020 could become VA's deadliest of the pandemic thus far, reaching well beyond 1,000 patient deaths recorded.
That spike in deaths from COVID-19 complications means VA has averaged roughly 20 patient deaths per day since the start of the pandemic, up from the 17 per day average as of mid-October and 19 as of November -- exceeding the number of veterans lost on average each day to suicide.
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VA said previously that the number of deaths recorded in a given month may not be a fully accurate account of those who died that month, since data may lag behind, sometimes by weeks.
The department's overall patient mortality rate, however, continues to drop. As of Dec. 11, VA's mortality rate was about 4.2%, significantly lower than its high of 6.8% but still higher than the about 1.8% for Americans overall, according to the most recent Centers for Disease Control and Prevention data.
VA's mortality rate is influenced by the age and overall health of its patients, who tend to be older and less healthy than the overall American population. The department cares for a total of more than 9 million veterans, roughly half of the veterans in the United States, and has nearly 400,000 employees.
VA has also already recorded eight employee deaths from the virus in December so far. The highest number of VA staff COVID-19 deaths recorded previously in a single month was 11 in November, May and April. VA has recorded nearly 12,000 staff cases of the virus throughout the pandemic, and more than 1,400 were actively ill as of Dec. 11.
Since VA cares for about half of the roughly 18 million veterans in America, its numbers are representative only of those in its care and do not include veterans who receive care elsewhere or who do not qualify for VA health care.
The percentage of patients at the department who require hospitalization -- the statistic VA cites as the most reliable judge of how its patients are faring amid the pandemic -- has continued to fall since a height of 38% in March, reaching a low of 12% by the end of November, according to Press Secretary Christina Noel.
But the number of VA patients hospitalized because of the virus continues to increase, with 1,206 recorded as of Dec. 7 -- a nearly 250% increase from early October.
VA has recorded nearly 130,000 total COVID-19 cases since the start of the pandemic.
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Reach Abbie Bennett: abbie@connectingvets.com or @AbbieRBennett. Sign up for the Connecting Vets weekly newsletter to get more stories like this delivered to your inbox.