U.S. COVID-19 Vaccination Program: Vaccine Channel Portfolio by Jurisdiction

U.S. COVID-19 Vaccination Program: Vaccine Channel Portfolio by Jurisdiction

How COVID-19 vaccines get to you: how CDC is tracking vaccine distribution, delivery, and administration throughout the United States.

Purpose

This report provides an overview of the multiple channels being used to ensure all Americans have access to COVID-19 vaccine. Jurisdictional delivery and administration portfolios vary across the United States because of population variability.

Vaccine administration data for the federal programs are reported to jurisdictions’ Immunization Information Services, but they cannot always be separated from administration data for jurisdictional vaccination programs. In some instances, provider type identifiers are missing and/or providers use inventory from both jurisdictional and federal allocations. Therefore, administration data for federal programs is presented in aggregate with jurisdictional totals. Federal entities report their administration data directly to CDC, so this category is listed separately.

Administration ratios are provided to assess how well delivered doses of vaccine are being administered. These are important metrics to track, as they ensure the nation’s vaccine inventory is being used efficiently; however, they have limitations. First, comparing jurisdictions without considering the unique characteristics of each (for example, rural states vs. states with large urban centers) can lead to inaccurate conclusions. Further, jurisdictions and the federal government are striving to make vaccine accessible to all segments of the population, including those who have historically experienced barriers to critical healthcare-related services. Efforts to reach these populations that have been underserved might affect administration ratios but are necessary to ensure equitable vaccine distribution and administration.

U.S. COVID-19 Vaccination Program: Vaccine Channel Portfolio by Jurisdiction

Administration Ratio

Administration ratios (i.e., percentage of delivered doses that have been administered) are measured and presented in four ways: an unadjusted measure and a lagged adjusted measure for all channels (overall) and for jurisdiction + federal programs (excludes federal entities).

Left to right: Figure 1 depicts the percentage of COVID-19 vaccine doses delivered to jurisdictions by channel. Figure 2 (middle) depicts the percentage of doses administered by jurisdictional partners and federal programs (retail pharmacy, HRSA FHQC, and FEMA CVC pilots) combined and by federal entities (Bureau of Prisons, Department of Defense, Indian Health Service, and Veteran Health Administration). Furthest to the right, administration ratios (i.e., percentage of delivered doses that have been administered) are measured and presented in four ways: an unadjusted measure and a lagged adjusted measure for all channels (overall) and for jurisdiction + federal programs (excludes federal entities). Data for three city-based jurisdictions, New York City, Philadelphia, and Chicago are included in their respective states. Includes data reported as of April 1, 2021. HRSA: Health Resources and Services Administration; FQHC: Federally Qualified Health Center; FEMA: Federal Emergency Management Agency; CVC: Community Vaccination Center; HHS: US Department of Health and Human Services; NIH: National Institutes of Health.

Definitions and Methods

Vaccines Delivered: Includes all doses shipped and recorded through the Centers for Disease Control and Prevention’s (CDC) vaccine ordering system, Vaccine Tracking System (VTrckS). Doses delivered totals include all data reported through April 1, 2021. Vaccines delivered are grouped into three categories:

  • Jurisdiction: Doses delivered to jurisdictions (state, territory, freely associated state, tribe, or local entity) based on the allotment provided by the federal government. Excludes additional doses transferred to jurisdictions by Federal Emergency Management Agency (FEMA) for use within Community Vaccination Center (CVC) pilot sites or in mobile clinics.
  • Federal Programs: Programs through which participants receive their own vaccine allocation from the federal government and report vaccine doses administered through the local jurisdiction’s immunization information system (IIS). These include:
    • Federal Retail Pharmacy Program: The federal government provides vaccine allotments to 21 retail pharmacy chains that represent approximately 48,000 potential vaccination sites across the country. Totals include deliveries provided as part of the Pharmacy Partnership for Long-Term Care Program to vaccinate staff and residents of nursing homes and assisted living facilities. Participating pharmacies may also receive inventory from jurisdictions via federal pharmacy state transfer program (i.e., the jurisdiction transfers doses directly to a pharmacy partner), which are included in these totals. States that have onboarded pharmacies to be vaccine providers allowing pharmacies to order directly from the state are excluded here and included in the jurisdiction totals.
    • Health Resources and Services Administration’s (HRSA) Federally Qualified Community Health Center Programexternal icon: HRSA leverages its own federal vaccine allotment and sends inventory to select health centers for administration.
    • FEMA CVC Pilot Site and Mobile Vaccination Programexternal icon: FEMA transfers its vaccine allocation to the state for ordering and administration and provides logistical, financial, and other support for vaccination clinics.
    • US Dept. Of Heath and Human Services (HHS)/National Institutes of Health Program: Small program managing doses allocated to multiple HHS agencies for administration to critical federal infrastructure personnel.
    • Federal Dialysis Center Program: Launched on March 29, 2021; allocations are made directly to participating dialysis center participants to vaccinate patients on dialysis.
  • Federal Entities: Includes the Bureau of Prisons, Department of Defense, Indian Health Service, and Veterans Health Administration, each receiving its own vaccine allocation.

Vaccines Administered: Includes doses administered within the jurisdiction within a category described above and reported to CDC as of 6am ET on April 1, 2021. COVID-19 Vaccination Reporting Overview provides an overarching view of the IT systems and how they integrate to track COVID-19 vaccine distribution and administration. Vaccine administration data for the federal programs are reported to jurisdictions’ IISs and cannot be fully accounted for due to instances where provider type identifiers are missing and/or the use of mixed inventory from both state and federal allocations. Therefore, their administration totals are presented in aggregate with jurisdictional totals. Federal entity administration totals include doses administered by one of the four listed groups within the jurisdiction and are reported directly to CDC.

Unadjusted Administration Ratio: Calculated as the percentage of doses delivered to a jurisdiction that have been administered as of the date reported.

Adjusted Administration Ratio: Calculated as the percentage of doses delivered to a jurisdiction that have been administered, using a cumulative 7-day rolling average for both administrations and deliveries, and a 3-day lag for doses delivered. This accounts for:

  • Technical issues delaying timely reporting
  • Vaccines needing to be redistributed within a jurisdiction, which could mean a longer time between initial distribution and administration
  • Jurisdictions having multiple data systems at the local and state levels
  • Providers not reporting vaccine doses administered within the required 72-hour period

The adjusted metric is the standard being used to assess administration ratios for the US COVID-19 Vaccination Program. Interpretation of these metrics for remote jurisdictions (e.g., territories, Hawaii, Alaska) should be done with caution, as they have different delivery schedules than jurisdictions located in the continental United States.

Overall Administration Ratio: Percentage of doses (unadjusted and adjusted) delivered to a jurisdiction that have been administered as of the date reported. This includes all doses delivered and administered in the jurisdiction through any channel.

Jurisdiction + Federal Programs Administration Ratio: Percentage of doses (unadjusted and adjusted) delivered to a jurisdiction that have been administered as of the date reported. This includes doses delivered and administered by jurisdictions and through federal programs but excludes those delivered to and administered by federal entities.