The US Federal Retail Pharmacy Program: Optimizing COVID-19 Vaccine Delivery Through a Strategic Public-Private Partnership

Abstract

To help achieve the initial goal of providing universal COVID-19 vaccine access to approximately 258 million adults in 62 US jurisdictions, the federal government launched the Federal Retail Pharmacy Program (FRPP) on February 11, 2021. We describe FRPP's collaboration among the federal government, US jurisdictions, federal entity partners, and 21 national chain and independent pharmacy networks to provide large-scale access to COVID-19 vaccines, particularly in communities disproportionately affected by COVID-19 (eg, people aged ≥65 years, people from racial and ethnic minority groups). FRPP initially provided 10 000 vaccination sites for people to access COVID-19 vaccines, which was increased to >35 000 vaccination sites by May 2021 and sustained through January 31, 2022. From February 11, 2021, through January 31, 2022, FRPP vaccination sites received 293 million doses and administered 219 million doses, representing 45% of all COVID-19 immunizations provided nationwide (38% of all first doses, 72% of all booster doses). This unprecedented public-private partnership allowed the federal government to rapidly adapt and scale up an equitable vaccination program to reach adults, later expanding access to vaccine-eligible children, during the COVID-19 pandemic. As the largest federal COVID-19 vaccination program, FRPP exemplifies how public-private partnerships can expand access to immunizations during a public health emergency. Pharmacies can help meet critical national public health goals by serving as convenient access points for sustained health services. Lessons learned from this effort-including the importance of strong coordination and communication, efficient reporting systems and data quality, and increasing access to and demand for vaccine, among others-may help improve future immunization programs and support health system resiliency, emphasizing community-level access and health equity during public health emergencies.

Keywords: COVID-19; access; equity; pharmacy; vaccine distribution.

Figure 1.

Percentage of all COVID-19 vaccine doses administered by the Federal Retail Pharmacy Program (FRPP), by state and excluding territories, United States, February 11, 2021–January 31, 2022. Doses administered by pharmacies varied by state based on demand, jurisdictional characteristics, and geographic reach of pharmacy.

Figure 2.

Total number of doses administered by Federal Retail Pharmacy Program (FRPP) sites and non-FRPP jurisdiction and federal entity sites in areas with a high Equitable Distribution Index (EDI), United States, February 11, 2021–January 31, 2022. Because the federal government had included pharmacy-based FRPP sites in high-EDI areas (EDI > 0.66) by April 2021, FRPP provided steady access to vaccine in these areas. The periods were February–April 2021 (quarter 1), May–July 2021 (quarter 2), August–October 2021 (quarter 3), and November 2021–January 2022 (quarter 4).

Figure 3.

Vaccine doses administered by Federal Retail Pharmacy Program (FRPP) sites as a percentage of total doses given, United States, February 11, 2021–January 31, 2022. The highest volume of immunizations in pharmacies occurred during November 2021–January 2022; 62% of all FRPP doses administered during the surge in vaccination were attributed to the launch of boosters and pediatric vaccines. The periods were February–April 2021 (quarter 1), May–July 2021 (quarter 2), August–October 2021 (quarter 3), and November 2021–January 2022 (quarter 4).