Feds to Start Using Pharmacies to Ramp Up Administration of COVID Vaccines

Alicia Ault

January 06, 2021

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The federal government is turning to private pharmacies to administer COVID-19 vaccines, in an effort to speed up the number of Americans being inoculated against the disease.

A Centers for Disease Control and Prevention (CDC) vaccine tracker reports that at least 5.3 million doses have been administered in the United States as of January 6, out of almost 17.3 million doses distributed. As late as December 23, Operation Warp Speed leaders had stated that 20 million doses would be distributed by the end of 2020.

"We've been examining the challenges that might have slowed the ramp up of administering vaccines over the last several weeks, taking immediate action and laying out ways for states to speed up administration," said US Department of Health and Human Services (HHS) Secretary Alex Azar in a briefing with reporters.

Azar said that distribution and administration had been hampered by the Christmas and New Year's holidays, and he said a reporting lag likely understates the true number of vaccines given. Acknowledging the slow pace of the rollout, Azar said, "we all know ultimate goal is not vaccines in warehouses or freezers, but shots in arms, helping to protect American lives."

HHS has now decided on an "early launch" of a federal partnership with 19 pharmacy chains, which will let states allocate vaccines directly to some 40,000 pharmacy locations, said Azar. "The plan had been to ramp up this partnership over time because vaccine supply would not be sufficient to spread across all of the pharmacy partners right away."

Instead, the partnership is being activated now, he said.

The pharmacies could vaccinate people over a certain age or in specific occupations, in "settings that may be more convenient and efficient than partners [states] have used so far, like hospitals," said Azar.

Walgreens and CVS are already working with the federal government to vaccinate residents and staff of long-term care facilities, but that effort is slow-going. As of January 6, only 511,000 doses have been administered at long-term care facilities, out of some 3.4 million that have been distributed, according to the CDC vaccine tracker.

Azar said it was time-consuming to secure consent from nursing home residents, which had delayed vaccination — even though he acknowledged that process had started months ago. "I do believe that we will be seeing significant ramp up of those vaccines getting into nursing home patients," he said.

The secretary also urged states to start giving vaccines to broader populations, not just healthcare workers or nursing home residents and workers. "Don't leave vaccines in the fridge. Don't leave vaccines in the vial," Azar said. "Providing flexibility around these phases, rather than proposing heavy-handed penalties around vaccine administration is best way to get more shots in arms faster."

Some governors have been trying to incentivize faster vaccinations. Maryland Governor Larry Hogan (R), for instance, announced that hospitals that haven't used 75% of their allocations may receive fewer doses in the future, according to the Baltimore Sun.

New York Governor Andrew Cuomo (D) said he would begin fining hospitals that had not administered all doses within a week, and would curb future supplies, also, according to Reuters .

"It would be much better to move quickly and end up vaccinating some lower priority people than let vaccines sit around while states try to micromanage this process," said Azar.

States have struggled to manage the administration process. Azar announced that the federal government is releasing $3 billion to states to support vaccination activities. The funds were included in the congressional stimulus package signed into law by President Donald Trump in late December and are allocated according to a population-based formula.

Continued Slow Uptake for Antibody Treatments

Azar also pushed the use of monoclonal antibodies that have emergency use authorization from the US Food and Drug Administration (FDA).

HHS reports that as of January 6, more than 400,000 doses of bamlanivimab and the combination therapy of casirivimab/imdevimab had been delivered to inpatient and outpatient facilities.

The treatments can keep Americans who are especially at risk for severe disease out of the hospital, said Azar. The federal government has just opened an infusion facility in El Centro, California, to help increase access to the therapies, he said.

"If you test positive, and are at risk for severe disease, you should ask your doctor why you are not being given one of the FDA-authorized antibody therapies," he said.

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