BACKGROUND: The Federal Retail Pharmacy Program (FRPP) integrated pharmacies as partners in the national effort to maximize vaccination during the COVID-19 public health emergency. OBJECTIVES: The objective of this study was to quantify the contribution of pharmacies participating in FRPP to COVID-19 vaccination efforts during December 2020-September 2023 across sociodemographic groups in the United States. METHODS: Data on COVID-19 vaccine doses administered reported to CDC by FRPP and jurisdictional immunization information systems (IIS) of all 50 states, the District of Columbia, and U.S. territories were analyzed to estimate FRPP contributions. RESULTS: Approximately 314.9 million COVID-19 vaccine doses were administered by FRPP throughout this period, constituting 48.9% of all COVID-19 vaccine doses administered. FRPP contributions to COVID-19 vaccination ranged from 12.9% to 56.8% for persons aged 6 months-4 years and 12-17 years, respectively. FRPP made the highest contribution to administering COVID-19 doses to Non-Hispanic Asian (48.7%) and Hispanic/Latino (49.8%) persons. The proportion of COVID-19 doses given by FRPP pharmacies was found to be higher in urban areas (57%) compared with rural areas (45%). CONCLUSION: FRPP administered a substantial proportion of COVID-19 vaccine doses in the United States and provided vaccine access for persons across a wide range of groups. Pharmacies can complement vaccination efforts during public health emergency situations and in routine vaccination programs.

The Federal Retail Pharmacy Program (FRPP) facilitated integration of pharmacies as partners in national efforts to scale up vaccination capacity during the COVID-19 pandemic emergency response. To evaluate FRPP's contribution to vaccination efforts across various sociodemographic groups, data on COVID-19 bivalent mRNA vaccine doses administered during September 1, 2022-September 30, 2023, were evaluated from two sources: 1) FRPP data reported directly to CDC and 2) jurisdictional immunization information systems data reported to CDC from all 50 states, the District of Columbia, U.S. territories, and freely associated states. Among 59.8 million COVID-19 bivalent vaccine doses administered in the United States during this period, 40.5 million (67.7%) were administered by FRPP partners. The proportion of COVID-19 bivalent doses administered by FRPP partners ranged from 5.9% among children aged 6 months-4 years to 70.6% among adults aged 18-49 years. Among some racial and ethnic minority groups (e.g., Hispanic or Latino, non-Hispanic Black or African American, non-Hispanic Native Hawaiian or other Pacific Islander, and non-Hispanic Asian persons), ≥45% of COVID-19 bivalent vaccine doses were administered by FRPP partners. Further, in urban and rural areas, FRPP partners administered 81.6% and 60.0% of bivalent vaccine doses, respectively. The FRPP partnership administered approximately two thirds of all bivalent COVID-19 vaccine doses in the United States and provided vaccine access for persons across a wide range of sociodemographic groups, demonstrating that this program could serve as a model to address vaccination services needs for routine vaccines and to provide health services in other public health emergencies.

During December 2020 through May 2023, the Centers for Disease Control and Prevention's (CDC) Immunization Services Division supported and executed the largest vaccine distribution effort in U.S. history, delivering nearly one billion doses of COVID-19 vaccine to vaccine providers in all 50 states, District of Columbia, Puerto Rico, Virgin Islands, Guam, Federated States of Micronesia, American Samoa, Marshall Islands, Northern Mariana Islands, and Palau. While existing infrastructure, ordering, and distribution mechanisms were in place from the Vaccines for Children Program (VFC) and experience had been gained during the 2009 H1N1 pandemic and incorporated into influenza vaccination pandemic planning, the scale and complexity of the national mobilization against a novel coronavirus resulted in many previously unforeseen challenges, particularly related to transporting and storing the majority of the U.S. COVID-19 vaccine at frozen and ultra-cold temperatures. This article describes the infrastructure supporting the distribution of U.S. government-purchased COVID-19 vaccines that was in place pre-pandemic, and the infrastructure, processes, and communications efforts developed to support the heightened demands of the COVID-19 vaccination program, and describes lessons learned.

Immunizations are an important tool to reduce the burden of vaccine preventable diseases and improve population health.(1) High-quality immunization data is essential to inform clinical and public health interventions and respond to outbreaks of vaccine-preventable diseases. To track COVID-19 vaccines and vaccinations, CDC established an integrated network that included vaccination provider systems, health information exchange systems, immunization information systems, pharmacy and dialysis systems, vaccine ordering systems, electronic health records, and tools to support mass vaccination clinics. All these systems reported data to CDC's COVID-19 response system (either directly or indirectly) where it was processed, analyzed, and disseminated. This unprecedented vaccine tracking effort provided essential information for public health officials that was used to monitor the COVID-19 response and guide decisions. This paper will describe systems, processes, and policies that enabled monitoring and reporting of COVID-19 vaccination efforts and share challenges and lessons learned for future public health emergency responses.