WASHINGTON — Plans to begin administering COVID-19 vaccines this month to millions of vulnerable Americans will depend not on public health departments, but largely on the nation's two largest for-profit pharmacy chains.
CVS Health and Walgreens Boots Alliance were tapped by the Trump administration to vaccinate more than 3 million residents of nursing homes and other long-term care facilities, which are expected to get the first wave of vaccines, perhaps as soon as next week.
The leading role for the two pharmacy giants highlights the power and reach of the companies, which together have some 20,000 pharmacy locations nationwide.
It also underscores how, after years of underinvestment in public health, the U.S. is highly dependent on for-profit companies for critical public services such as immunizations.
"We're in a situation where we don't have a public sector that's able to do something like this," said Jeffrey Levi, the former director of the nonprofit Trust for America's Health. "We have to work with the system we have."
Federal officials say the partnership with the pharmacy companies is a model that will rapidly get vaccine to needy patients.
"I'm incredibly confident that these public-private partnerships are ready to execute," U.S. Army Gen. Gus Perna told reporters this week. Perna is chief operating officer of Operation Warp Speed, the federal initiative set up by the Trump administration to support development and distribution of COVID-19 vaccines and medicines.
Some public health leaders nevertheless remain leery of the heavy reliance on multibillion-dollar corporations whose primary duty is to their shareholders, especially as the full scope of the companies' vaccine distribution work remain secret.
Neither CVS and Walgreens nor the U.S. Department of Health and Human Services would provide copies of the agreements signed between the companies and the federal government.
"At the end of the day, these are businesses," said Lori Tremmel Freeman, who directs the National Assn. of County and City Health Officials. "They are not the same as a health department, whose business is keeping people safe. Health departments have no other motive. They don't care about the bottom line."