Federal Retail Pharmacy Program Partners Critical in Ensuring Vaccine Access

During the COVID-19 pandemic, Federal Retail Pharmacy Program partners were “critical” in ensuring access to COVID-19 vaccination services across the country, according to an article published in Morbidity and Mortality Weekly Report.¹

Given the close proximity of 90% of Americans to community pharmacies, a concrete understanding of the role that pharmacies played in response to the COVID-19 pandemic is crucial for future public health planning efforts. The Federal Retail Pharmacy Program— a collaboration between the federal government, US states and territories, and 21 national pharmacy chains and independent pharmacy networks—has been vaccinating the public since the program’s implementation in February 2021. In the current study, investigators sought to evaluate the role of Federal Retail Pharmacy Program partners in the distribution of bivalent COVID-19 vaccines between September 1, 2022, and September 30, 2023, across various sociodemographic groups.

The Federal Retail Pharmacy Program was crucial in maximizing COVID-19 vaccination coverage.

Rates of bivalent doses administered by partner were calculated through 2 independent data sources: Federal Retail Pharmacy Program partner data reported directly to the CDC, and all-provider data submitted via individual jurisdiction’s immunization information systems. Data were then analyzed across 6 age cohorts, sex, 7 categories of race and ethnicity, and urban-rural classification.

Overall, approximately 59.8 million bivalent doses of COVID-19 vaccines were administered during the study time period; 67.7% of those doses were administered by Federal Retail Pharmacy Program Partners.

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When evaluating by age group, the highest percentage of bivalent COVID-19 vaccine doses administered by partners was to individuals aged 18 to 49 years, while the lowest percentage was administered to children aged 6 months to 4 years (70.6% vs 5.9%, respectively). By sex, 66.9% of men and 68.6% of women were vaccinated by partners. Race and ethnicity data showed that the highest proportion of partner-administered doses were among Asian and White individuals (60.2% and 56.2%), while the lowest proportion were administered among American Indian/Alaska Native individuals and individuals of other races (21.9% and 22.3%, respectively). More doses were administered to individuals of unknown race and ethnicity at Federal Retail Pharmacy Program partners (29.4%) compared with all-provider data (10.9%).

Investigators reviewed a full analytic sample of 59 distinct jurisdictions; all but 5 of these jurisdictions—American Samoa, the Northern Marina Islands, the Federated States of Micronesia, the Marshall Islands, and Palau—had Federal Retail Pharmacy Program partner presence. Within the 54 remaining jurisdictions, at least one-half of bivalent COVID-19 doses were administered by partners in 42 jurisdictions (77.8%). Within the 52 and 48 jurisdictions with urban and rural designated areas, respectively, the proportion of bivalent COVID-19 vaccine doses administered in urban areas by partners was higher vs rural areas (81.6% and 60%, respectively).

Of note is the significantly lower bivalent vaccination coverage compared with the completed monovalent primary COVID-19 vaccination series, the researchers noted, despite the widespread availability of bivalent doses through partner pharmacies. At the end of the public health emergency on May 11, 2023, only 17% of the US population had received the bivalent vaccine compared with 69.5% who had received a full primary series.

Study limitations include unavailable COVID-19 vaccination coverage estimates from the current data; disparities between the age groups used to describe vaccination among younger children (6 months to 4 years) and Federal Retail Pharmacy Program data, which only included vaccinated children aged 3 years and older vs all-provider data, which included children as young as 6 months of age; a higher number and percentage of records with unknown race and ethnicity in Federal Retail Pharmacy Program data compared with all-provider data; and the implementation of the National Center for Health Statistics Urban-Rural Classification in 2013, which may have changed the classifications of some areas previously defined as rural.

“[Federal Retail Pharmacy Program] partners were critical in ensuring access to bivalent COVID-19 vaccination services throughout the United States,” the researchers wrote. “This partnership could serve as a model to address vaccination services needs for administration of routinely recommended vaccines and potential future responses to vaccine-preventable disease emergencies.”

“Although the public health emergency has ended, the need to ensure that the US population has equitable access to all recommended vaccines, including COVID-19 vaccines, remains…. Partnering with pharmacies, in addition to other vaccine providers, can help accelerate vaccine access provision” throughout the country, the researchers concluded.

READ MORE: COVID-19 Resource Cente

Reference

1. El Kalach R, Jones-Jack N, Elam MA, et al. Federal Retail Pharmacy Program contributions to bivalent mRNA COVID-19 vaccinations across sociodemographic characteristics—United States, September 1, 2022–September 30, 2023. MMWR Morb Mortal Wkly Rep. 2024;73(13):286-290. doi:10.15585/mmwr.mm7313a2