RESUMO
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.
RESUMO
BACKGROUND: Hospitalized elderly patients are at risk for subsequent influenza and pneumococcal disease. Despite this risk, they are often not vaccinated in this setting. METHODS: We reviewed the medical records of a national sample of 107 311 fee-for-service Medicare patients, 65 years or older, discharged from April 1, 1998, through March 31, 1999, with a principal diagnosis of acute myocardial infarction, heart failure, pneumonia, or stroke. We linked patient identifiers to Medicare Part B claims to identify influenza and pneumococcal vaccines paid for before, during, or after hospitalization. The main outcome measures were documentation by chart review or paid claim of influenza or pneumococcal vaccination. RESULTS: Of the 104 976 patients with a single hospitalization, 35 169 (33.5%; 95% confidence interval [CI], 33.2%-33.8%) received pneumococcal vaccination prior to admission, 444 (0.4%; 95% CI, 0.4%-0.5%) were vaccinated in the hospital, and 1076 (1.0%; 95% CI, 1.0%-1.1%) were vaccinated within 30 days of discharge. In the subgroup of 40 488 patients discharged from October through December, 12 782 (31.6%; 95% CI, 31.1%-32.0%) received influenza vaccination prior to admission, 755 (1.9%; 95% CI, 1.7%-2.0%) were vaccinated in the hospital, and 4302 (10.6%; 95% CI, 10.3%-10.9%) were vaccinated after discharge. Of patients who were unvaccinated prior to admission, 97.3% (95% CI, 97.1%-97.5%) did not receive influenza vaccine and 99.4% (95% CI, 99.3%-99.4%) did not receive pneumococcal vaccine before hospital discharge. CONCLUSION: National recommendations for inpatient vaccination against influenza and pneumococcal disease are not being followed for the vast majority of eligible Medicare patients admitted to the hospital.