CVS, Walgreens and Walmart share how to navigate vaccinations at the local pharmacy

The Federal Retail Pharmacy Program is prioritizing vaccinating all school staff and childcare workers during the month of March, according to a March 2 directive from the Department of Health and Human Services.

Teachers and staff in pre-K-12 schools and childcare programs will be able to sign up for an appointment at over 9,000 pharmacy locations, according to the Centers for Disease Control and Prevention.

Earlier this year, pharmacies were also on the front lines in getting vaccines into the arms of residents of long-term care facilities.

How other eligible Americans get a vaccine at their local pharmacy depends upon vaccine rollout plans in individual states and upon the supply, which has been unpredictable.

In November, even before a vaccine became available, 19 pharmacies partnered with the Department of Health and Human Services for consumer access to a COVID-19 vaccine. That number has grown to 21. On February 11, the federal government announced that one million doses would be going directly to 6,500 pharmacies as part of the Federal Retail Pharmacy Program.

But vaccination confusion plagued some initial pharmacy efforts in February.

A spokesman for CVS, among the biggest pharmacies in the Federal Pharmacy Retail Program, acknowledged the potential for vaccine appointment confusion.

"When the first two approved vaccines were in development, the challenges that CVS Health faced were related to storing the vaccines as they both have special requirements and both vaccines require two doses and timing between each dose varies," said Charles Keller, a CVS District Leader in Houston, Texas, by email.

"Additionally, there are state-specific eligibility requirements that we must adhere to, and this can cause some confusion for customers looking to make an appointment."

The CDC directs individuals who are interested in getting vaccinated at their local pharmacy to their pharmacy's website or to visit VaccineFinder.org.

A visit to the VaccineFinder.org site muddies the waters, except for residents of Alaska, Tennessee, Indiana, Iowa, Oklahoma, Utah and New York, excluding New York City, where it says the vaccine is available at pharmacies. "In other states, information may be limited while more providers and pharmacies are added in the coming weeks," the site says.

Most pharmacy partners are using online scheduling systems, and walk-ins are not accepted.

In February, even the National Governors Association looked for clarification on how the pharmacy program would work in tandem with state efforts.

"We believe it is important that the [Centers for Disease Control and Prevention] in its reporting distinguish between these separate efforts to avoid confusion and provide a clear understanding to the American people," according to the February 15 letter to President Joe Biden.

HOW TO GET VACCINATED THROUGH PHARMACIES

Healthcare Finance News asked three of the biggest pharmacies in the Federal Retail Pharmacy Program – CVS Health, Walgreens and Walmart – about their vaccination programs.

CVS is currently vaccinating individuals in 29 states and Puerto Rico, based on federal eligibility guidelines with a "limited supply" of the Moderna, Pfizer and Janssen (Johnson & Johnson) vaccine, according to Keller.

"CVS Health is also prioritizing CVS pharmacies located in vulnerable communities, with a particular focus on Black and Hispanic populations which includes proactive patient outreach, community-based partnerships, vaccines clinics and education-focused marketing," Keller said.

"As we expand to additional states and locations, we will begin to increase access to vaccines by using mobile vaccination vans and offering community-based vaccination clinics by working with nonprofit organizations."

Walmart spokeswoman Marilee McInnis said the expectation is that the vaccine will be available in the vast majority of their pharmacies across the country as supply allows.

"Walmart is partnering with the CDC and states to move as quickly as possible to help administer vaccines to eligible populations in participating states, with an emphasis on reaching customers in vulnerable communities with limited access to care," McInnis said.

"Walmart and Sam's Club pharmacies are currently administering vaccines in more than three dozen jurisdictions, including Puerto Rico and Washington, D.C., through federal and state efforts."

Walgreens supports vaccinations across 43 states and jurisdictions as part of the Federal Retail Pharmacy Program. It has administered approximately five million COVID-19 vaccinations across long-term care facilities, in more than 4,700 stores and through clinics.

"As we have throughout the pandemic, Walgreens will continue to be there for our customers to help them with their health and wellness needs, and we're committed to accelerating COVID-19 vaccinations as quickly as supply allows," said Rina Shah, the group vice president of Pharmacy Operations for Walgreens.

"With a flexible model of care that can meet patients where they are – be it in our stores or at off-site vaccination clinics – we're ready to administer COVID-19 vaccines in all of our more than 9,000 store locations once they become available for mass availability."

All three pharmacy chains recognize that demand for the vaccine currently outweighs supply.

Walgreens has received approximately one million COVID-19 vaccine doses from Johnson & Johnson, Moderna and Pfizer per week, as of early March.

"Consumers are eager to get vaccinated, but we don't yet have enough vaccine supply for everyone who wants one," Shah said. "With the recent emergency use authorization of Johnson & Johnson's vaccine, and as supply increases, we anticipate vaccinations to be available to the general population in the late spring/early summer time frame."

As vaccine availability grows, more appointments will become available.

"Once the vaccine is available to the general public, we plan to administer vaccines at CVS Pharmacy locations nationwide, with the ability to administer up to 20 to 25 million shots per month by our approximately 50,000 healthcare providers," Keller said.

Individuals who are interested in getting the COVID-19 vaccine through CVS can confirm their eligibility on their state's website and then schedule an appointment online, in the CVS app, or by calling customer service.

"Walk-ins will not be accepted, so it's important for customers to check their local CVS pharmacy location and book an appointment when they are eligible to do so," Keller said.

Consumers can sign up to get a vaccine through Walmart based on vaccine supply and eligibility, which will vary based on state and local guidelines. Eligible customers can make an appointment through the Walmart and Sam's Club online schedulers.

"Appointment availability is based on current allocation, so appointments will be limited based on quantities allocated by federal and state governments," McInnis said.

To make a vaccine appointment at Walgreens, eligible patients can schedule online through the pharmacy's online portal. For scheduling via phone, individuals can call 1-800-Walgreens or their local Walgreens to access the scheduler, which is available in English and Spanish.

In addition to the Federal Retail Pharmacy Program, pharmacies can get vaccines from states through the Pharmacy Transfer Program, according to the CDC. With this, states can choose to transfer some of their federally allocated vaccine doses to federal pharmacy partners to further expand vaccine access.

WHY THIS MATTERS

Getting vaccinated is seen as the most effective way (along with the other safety measures such as mask-wearing) to stem the year-long pandemic and lockdown and prevent COVID-19 cases, deaths and surges at area hospitals.

Hospitals continue to suffer financially due to the pandemic and the loss of elective procedures that keep them afloat. The American Hospital Association asked Congress for relief funding for hospitals in the $1.9 trillion American Rescue Plan that passed the House today, but did not get it.

COLLECTION OF PATIENT DATA

The pharmacy program recently came under fire for collecting patients' information.

Chains such as CVS Health, Walmart and Walgreens-Boots Alliance are collecting data from millions of customers as they sign up for shots, enrolling them in patient systems and having recipients register customer profiles, according to The Wall Street Journal.

The companies said the information is critical in streamlining vaccinations and improving record-keeping while ensuring only qualified people are receiving shots.

Neither CVS nor Walgreens require members to sign up for loyalty programs, which track purchases, in order to register for a vaccine.

McInnis said that, in addition to appointments, the Walmart scheduler "will provide a digital reminder when it is time to return for a second vaccine if required, which is why customers are asked to create a profile, helping to ensure they receive the second dose of the vaccine."

THE LARGER TREND

As of March 10, the U.S. had administered more than 95.7 million vaccine doses, according to the CDC. Roughly 19% of the population have had at least one dose and about 10% are fully vaccinated.

A third of adults reported feeling confused about the vaccination process in the U.S., according to a January survey from the Kaiser Family Foundation. Feelings of confusion were most commonly reported among individuals 18 to 29 years old (40%) and Black adults (46%).

Reports of widespread confusion stretch from Massachusetts to California and are related to disjointed online portals for vaccine appointments and muddled communications around eligibility.

Making matters worse, scammers are taking advantage of the confusion in attempts to squeeze money out of vulnerable individuals, according to the Federal Trade Commission.

The COVID-19 vaccine is free of charge for everyone. Participating pharmacies will bill private and public insurance for the vaccine administration fee. For uninsured patients, this fee will be reimbursed through the Health Resources and Services Administration's Provider Relief Fund. No one will receive a bill for a COVID-19 vaccine, according to the CDC.

In July, the U.S. agreed to pay Pfizer $1.95 billion for 100 million doses of the vaccine – the equivalent of $39 for a two-shot immunization, according to Bloomberg. In August, Moderna released a price of $32-$37 per dose ($64-$74 for a two-shot immunization). These prices include only the vaccine itself, not administrative costs.

The average administrative cost is $45 per member to receive the appropriate vaccine dose or doses, according to Eileen Flick, director of Health Technical Services at Segal.

Pharmacies participating in the Federal Retail Pharmacy Program include:

• Walgreens (including Duane Reade)
• CVS Pharmacy, Inc. (including Long's)
• Walmart, Inc. (including Sam's Club)
• Rite Aid Corp.
• The Kroger Co. (including Kroger, Harris Teeter and Fred Meyer, Fry's, Ralphs, King Soopers, Smiths, City Market, Dillons, Mariano's, Pick-n-Save, Copps, and Metro Market)
• Publix Super Markets, Inc.
• Costco Wholesale Corp.
• Albertsons Companies, Inc. (including Osco, Jewel-Osco, Albertsons, Albertsons Market, Safeway, Tom Thumb, Star Market, Shaw's, Haggen, Acme, Randalls, Carrs, Market Street, United, Vons, Pavilions, Amigos, Lucky's, Pak n Save and Sav-On)
• Hy-Vee, Inc.
• Meijer Inc.
• H-E-B, LP
• Retail Business Services, LLC (including Food Lion, Giant Food, the Giant Company, Hannaford Bros Co., and Stop & Shop)
• Southeastern Grocers
• Topco Associates, LLC (including Acme Fresh Markets, Associated Food Stores, Bashas, Big-Y Pharmacy and Wellness Center, Brookshire's Pharmacy, Super One Pharmacy, FRESH by Brookshire's Pharmacy, Coborn's Pharmacy, Cash Wise Pharmacy, MarketPlace Pharmacy, Giant Eagle, Hartig Drug Company, King Kullen, Food City Pharmacy, Ingles Pharmacy, Raley's, Bel Air, Nob Hill Pharmacies, Save Mart Pharmacies, Lucky Pharmacies, SpartanNash, Price Chopper, Market 32, Tops Friendly Markets, ShopRite, Wegmans, and Weis Markets)
• CPESN USA, LLC
• GeriMed (long-term care and retail pharmacies)
• Good Neighbor Pharmacy and AmerisourceBergen Drug Corporation's pharmacy services administrative organization (PSAO), Elevate Provider
• Health Mart Pharmacies
• Innovatix (long-term care pharmacies)
• LeaderNET and Medicine Shoppe, Cardinal Health's PSAOs
• Managed Health Care Associates (retail and long-term care pharmacies)

Twitter: @HackettMallory
Email the writer: mhackett@himss.org