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With the successful development of safe and effective vaccines to combat the COVID-19 pandemic available for use, the federal government has partnered with health care providers and pharmacies to ensure the vaccine is effectively distributed in the U.S. These partnerships are critical to achieve widespread adoption of the vaccines to control the COVID-19 virus across the country and among diverse and vulnerable populations.

This basic will describe the federal government’s partnership with retail pharmacies to vaccinate our nation’s highly vulnerable in long-term care facilities (LTCFs) as well as the general public nationwide.

The Federal Retail Pharmacy Program for COVID-19 Vaccination

The Department of Health and Human Services (HHS) has partnered with pharmacies in the U.S. to increase access to the COVID-19 vaccine through the Federal Pharmacy Partnership Strategy for COVID-19 Vaccination program. Through this program, retail pharmacies and independent pharmacy networks collaborate with the federal government to ensure expanded access to the COVID-19 vaccine. With more than 90 percent of people living within five miles of a community pharmacy, pharmacies have a unique reach and ability to provide access to COVID-19 vaccine. At this time, the program uses all three FDA approved vaccines from Pfizer, Moderna, and Johnson & Johnson.

Based on the incremental availability of the COVID-19 vaccine, select retail pharmacy locations receive a direct allocation from the federal government of the vaccine and then provide the vaccine to eligible individuals who are determined by priority guidance from each state. There are currently 21 participating national pharmacy partners and independent pharmacy networks; it is expected that the program will expand to include more than 40,000 pharmacies nationwide and in the territories.

The CDC initially worked with states and territories to select these partners to start the program in their communities based on a variety of factors, including a pharmacy’s ability to reach vulnerable and high-risk populations. A variety of pharmacies, including independent, chain, and grocer pharmacies are part of the federal program; those that are not can enroll with states directly to become COVID-19 vaccine providers. The CDC continuously updates a list of retail pharmacies that are participating in the program that varies by state and territory. As more vaccine supply becomes available in the coming months, the program will expand to cover more locations and reach even more Americans.

On March 2nd, the President announced a directive that all states prioritize school staff and childcare workers for COVID-19 vaccination. These individuals will be able to sign up for an appointment at over 9,000 pharmacy locations participating in the program nationwide.

The CDC has also been tracking the daily progress of the COVID-19 vaccine distribution by state, territories, and federal entities.

Pharmacy Partnership for Long-Term Care Program for COVID-19 Vaccination

The Pharmacy Partnership for Long-Term Care (LTC) Program was created through the U.S. Department of Health and Human Services to offer on-site COVID-19 vaccinations to our nation’s highly vulnerable populations. The CDC partnered with CVS, Walgreens, and select pharmacies included in the Managed Health Care Associates (MHA) network to provide and administer the COVID-19 vaccines to more than 70,000 enrolled long-term care facilities (LTCFs) nationwide. The goal of the program is to ensure that vulnerable and higher-risk Americans and the health care personnel who care for them in these facilities are prioritized and successfully vaccinated. This prioritization for vaccinating LTCFs is based on recommendations from the Advisory Committee on Immunization Practices (ACIP).

The LTCF vaccination program is divided into three categories: skilled nursing facilities (SNFs), and assisted living facilities (ALFs) and other facilities. In many states, SNFs were prioritized for vaccination first, followed by ALFs. Allocations of the vaccine for the LTC program were calculated based on an LTCFs bed counts multiplied by two to account for staff. At this time, the program uses both the Pfizer and the Moderna vaccines.

The timing of on-site vaccination clinics for ALFs varied by jurisdiction and facility type. For example, some states have multiple jurisdictions; in some instances, a city will have a different jurisdiction than the state it is in, with the two activating the pieces of their LTC vaccination program at different times.

Looking Ahead

The pharmacy partners host three clinics at each LTCF to cover the first and second doses of the vaccines for residents and staff. In terms of progress to date, CVS and Walgreens have completed all second dose clinics at SNFs and are nearing completion of all second dose clinics at ALFs.  Since the program began in late December 2020, there has been a 94 percent decrease in COVID-19 cases and an 84 percent decrease in COVID-19 deaths in long-term care facilities.

While efforts to vaccinate vulnerable populations continue with multiple access points to vaccination, barriers remain, including increased vaccine hesitancy among immigrant and Black, Hispanic, and Native American populations who mistrust the government based on historically harmful and exploitive experiences with denial of medical treatment and fears of discrimination and legal implications for undocumented immigrants who wish to receive the vaccine.

To help combat vaccine hesitancy, the CDC COVID-19 Response Vaccine Taskforce has implemented their Vaccinate with Confidence strategic framework. The strategy focuses on reinforcing trust by regularly sharing accurate information on the vaccine, promoting confidence among health care personnel in their decision to get vaccinated, engaging with communities in a sustainable, equitable, and inclusive way, and by producing communications materials to support vaccine confidence. CVS and Walgreens have focused on expanding local education of the vaccine through trusted community leaders, non-profits, faith-based organizations, and local media, and by using public service announcements, mail, email, and phone outreach. Ensuring these populations are prioritized and successfully vaccinated is critical to the success of the federal partnership to ensure equity and to achieve herd immunity from COVID-19.

Key Definitions

  • Retail Pharmacy An independent, chain, supermarket, or mass merchandiser pharmacy that is licensed by the state that dispenses medications to the general public.
  • Long-Term Care Facility (LTCF) Facilities that provide medical and personal care for Americans who cannot or choose not to live independently. These facilities include nursing homes, skilled nursing facilities, and assisted living facilities.
  •  Assisted Living Facilities (ALF) A housing facility for adults who are disabled or cannot or chose not to live independently. These facilities offer medication management, and support of activities of daily living (ADLs) including grooming, housekeeping, meals, transportation, and social activities.
  • Skilled Nursing Facilities (SNF) An inpatient rehabilitation and medical treatment facility staffed with licensed medical professionals and technical personnel that manage, observe, and evaluate patient conditions and care.

A full glossary of common health care terms can be found HERE.

Additional Resources

CDC: Federal Retail Pharmacy Program

CDC: Long-Term Care Pharmacy Partnerships

CDC: Vaccinate with ConfidenceCMS: Nursing Home Data