Danny Avula, Virginia’s vaccine coordinator, had gotten used to the daily flood of emails from people frustrated with a slow and confusing coronavirus vaccine rollout.

But one recent day, he visited a vaccine clinic in Richmond and received a much-needed boost to his spirits. “Just a great buzz of patients who have been waiting and are ecstatic about getting their chance,” he said.

As national vaccine production accelerates, state and local officials across the Washington region are sounding similar notes of optimism — even as they continue to voice concern about racial disparities in vaccination rates.

They are scrambling to ready mass-vaccination sites and other distribution points for what is expected to be a rapidly increasing number of doses over the next two months.

“The supply-demand curve is shifting,” Avula said. “We’ve gone from a pace of having little supply with lots of demand, to a place where we have lots of demand and the supply to meet that demand.”

Virginia is averaging about 55,000 shots per day, and Avula anticipates pushing that to 70,000 in the coming weeks. Maryland and the District are forecasting similar expansions, with Maryland exceeding 42,000 shots daily and officials there saying they have capacity for 100,000 a day, supply permitting.

Locally and nationally, about a quarter of adults have received at least a first dose.

President Biden has vowed that the United States will have enough vaccine to administer to all American adults by the end of May. Based on projections from the federal government, Avula said he expects sharp supply increases in Virginia by early April.

In Maryland, state Sen. Bill Ferguson (D-Baltimore City) and other Democratic lawmakers for weeks have complained about many facets of the state’s inoculation effort. But at Monday’s meeting of a legislative work group aimed at holding health officials accountable, he began with praise.

“People were lined up blocks and blocks and blocks, but everybody was in a good mood,” he said, describing his visit to a large-scale vaccination site at the Baltimore City Convention Center. “It was an incredibly efficient system, and the line was continuously moving. It’s amazing what has been set up in that facility.”

Acting Maryland health secretary Dennis Schrader, whose confirmation Ferguson has delayed because of concerns about vaccinations, assured the work group “the buck stops” with him when it comes to getting shots into people’s arms as supply becomes more abundant. He told lawmakers four mass-vaccination sites are up and running, and two more will be by the end of the month.

Ferguson told reporters Friday that the state’s vaccination effort is “getting better, but it’s not quite there yet.” He noted that the administration of Gov. Larry Hogan (R) has repeatedly blamed inadequate supply for problems with the rollout, and said a flood of vaccine will be a pivotal test of whether the state’s multi-access system is effective.

“It’s a very big moment when supply is no longer an issue,” Ferguson said. “They’ve been talking about a decentralized, multi-access system from the beginning. We’ll see if that works.”

Large-scale vaccination sites, which can deliver thousands of doses per day, are one key to getting shots out fast. District officials have said they’ll send many doses to three large sites, the first of which opened at the Washington Convention Center last weekend.

In Alexandria, workers have installed 64 vaccination tables in neat rows inside a formerly vacant office building. Officials at Inova Health System, which has partnered with local officials to create the site, say they’ll be able to move 64 people through every five minutes once it opens — hopefully by the end of the month.

That adds up more than 6,000 shots per day. And officials say the site could be expanded to administer double that.

The center has more than 1,000 parking spots and is down the street from a Metro station. Pharmacists will be on hand to answer patients’ questions, and plexiglass barriers are already in place to divide rows of 400 socially-distanced chairs, where people will be monitored for side effects for 10 to 30 minutes after their shots.

Inova chief executive J. Stephen Jones said the number of injections delivered daily will depend on supply.

“Unfortunately, our predictions on vaccine availability have not been particularly accurate nationwide,” Jones said. “So I think the answer will be, when we know the number, we’ll be able to deliver that number.”

But officials acknowledge such mass-vax sites are not for everyone, particularly those who may be hesitant about receiving the vaccine. Retail pharmacies, which have so far been hampered by supply limitations, are expected to play an increasing role. And private doctors and other providers, who can offer more intimate settings, have largely been left out of the vaccine launch while supplies have been short.

“We have lots more capacity in our hospitals and a number of health systems around the state who have stepped up and said, ‘Hey, we can do 1,000 a week, 10,000 a week, 15,000 a week,’ ” Avula said of Virginia. “But increasingly, we will need that expertise and trust and relationship that providers have with their patients to help move more people to make that decision.”

Steve Schwartz, a primary care doctor with a large practice in Montgomery County, Md., said he and many others are more than ready to meet the moment. Schwartz said his practice delivers 500 to 1,000 doses of flu vaccine weekly at the height of flu season and can seamlessly transition to the coronavirus vaccine.

The practice has been registered with the state of Maryland to deliver vaccinations since December but has yet to receive a dose.

“You have an infrastructure . . . lying in idle,” he said. “It’s frustrating because we’ve spent a lot of professional time redirecting resources to plan to give it, trying to be ready to go.”

In the District, doses have been administered at a rate similar to Maryland and Virginia, relative to population. But a significant portion of the shots have gone to nonresidents who work in the city as teachers, doctors, nurses or in other essential front-line jobs.

“I’m happy to report that the number of doses that we are receiving is going up,” Mayor Muriel E. Bowser (D) said at a news conference. “Still, we know that our system can accommodate many, many, many more doses.”

D.C.’s initial vaccination registration website sparked immense frustration, with tens of thousands of requests overwhelming the first-come, first-served system. On Wednesday, the District switched to a preregistration system that will allocate appointments each week, notifying people who have registered and are eligible when it is their turn.

“None of this will work if people who are eligible aren’t in the system, so we need people to go and get signed up,” Bowser said. On the other hand, she said, there’s no longer an advantage to being first into the system. “There doesn’t have to be a mad rush.”

Virginia has been using a similar preregistration system, and Maryland — which has drawn complaints for having multiple, competing systems — launched a statewide preregistration system on Saturday.

All three jurisdictions have opened vaccinations to senior citizens, health-care workers and teachers. Beyond that, the groups of essential workers and people with health conditions who qualify vary by state.

But those eligibility requirements could fall away as soon as next month, officials predict. It will be “open season,” Anthony S. Fauci, the nation’s leading infectious-disease expert, has said, and the search for vaccine doses will shift to a search for arms to receive a surging supply.

Equity issues, however, continue to be a major source of concern.

Maryland has seen among the highest levels of racial disparity in vaccine administration in the country. The state is boosting the number of appointments at its Six Flags vaccination site reserved for residents of majority-Black Prince George’s County, part of a statewide program that is also creating pop-up clinics and sending mobile vaccination trailers into communities with historical barriers to accessing health care.

The District — which also has a huge gap between the percentage of its population that is Black and the percentage of vaccinations going to Black people — is also making numerous efforts to keep people from being left behind. They include stepping up programs to reach those who aren’t Internet-savvy, lack transportation or face difficulties for any other reason, and to persuade people with doubts about the vaccine that it’s safe and necessary.

“We don’t need to take our foot off the gas in focusing on more vulnerable communities and focusing on people who need more tech assistance, or call assistance, or reminders, or more information,” Bowser said. “We all have to be focused if we want an equitable distribution of the vaccine.”

How to register






Vaccination Support Center: 855-634-6829

Erin Cox in Washington and Laura Vozzella in Richmond contributed to this report.