![handle is hein.crs/goveerg0001 and id is 1 raw text is: Congres I Resaarch Service
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October 19, 2021
Domestic Funding for COVID-19 Vaccines: An Overview
Federal efforts to develop, manufacture, purchase, and
distribute Coronavirus Disease 2019 (COVID-19) vaccines
have involved a number of agencies. Many of these efforts
have thus far been funded by appropriations in COVID-19
relief acts, especially funding to the Department of Health
and Human Services (HHS) U.S. Public Health Service
(PHS) agencies and accounts in FY2020 and FY2021
supplemental appropriations andin the American Rescue
Plan Act (ARPA, P.L. 117-2) budget reconciliation measure
enacted in March 2021.
The following provides an overview of both (1)
appropriations and (2) allocations and obligations for
selected domestic COVID-19 vaccine related activities.
(With the exception of the mandatory funding providedby
ARPA, all funding amounts discussed below are classified
as discretionary.) The following is meant to informa
general understanding ofrelevant funding, but does not
capture every federal account that can be used for vaccine-
related activities. Many of the below appropriations are
available for broad purposes; vaccine-related purposes are
one potentialuse of funds. In general, many of the HHS
appropriations mentioned are available for multiple yeais or
until expended, and some of the funding is transferrable
between accounts by the HHS Secretary. This product does
not address financingforvaccine administration (e.g.,
health insurance coverage) orglobal vaccination funding
(although some of the funding for research and
development [R&D], manufacture, andpurchase has
flexibility for international uses).
Appropriations
Research and Development, Manufacture, and
Purchase
COVID-19 vaccine R&D, manufacture, and purchase have
been largely supported by a collaboration among several
federal agencies, including the National Ins titutes of Health
(NIH) and the Biomedical Advanced Research and
Development Authority (BARDA) of HHS, and DOD-
formerly Operation Warp Speed (OWS) and now the
Countermeasures Acceleration Group (CAG). Six vaccines
were chosen for coordinated federal support under OW S.
Some vaccine R&Dhas been supportedby NIH, BARDA,
and DOD separately fromthe OWS/CAGefforts.
NIH and DOD: FY2020 and FY2021 supplemental
appropriations to NIH and DOD for COVID-19-related
R&D can fund vaccine R&D. In the FY2020 and FY2021
supplemental appropriations acts, NIHreceived over $1.5
billion, available until September 30, 2024, broadly for
COVID-19 related research. The CARES Act (P.L. 116-
136) provided DOD with $415 million for COVID-19
medical R&D in the DefenseHealth Programaccount with
some flexibility to reallocate other funds toward R&D.
BARDA and Other R&D, Manufacture, and Purchase:
In the FY2020 and FY2021 supplementalappropriations
acts, over $50billion in Public Health and Social Services
Emergency Fund (PHSSEF) funding, available until
September 30, 2024, is for a broad set of medical
countermeasures and surge capacity purposes, including for
the development, manufacture, and purchase of vaccines
and related supplies. The PHSSEF account funds BARDA,
the main entity that has awarded large funding agreements
to pharmaceuticalcompanies for vaccine development,
manufacture, and purchase. Not less than $23.2 billion is set
aside for BARDA in the FY2020 and FY2021 supplemental
appropriations that can be used for vaccine-related efforts.
ARPA further provides two relevant mandatory
appropriations: (1) in Section 2303, $6.05 billion, available
until expended, to HHS for R&D, manufacturing,
production, and purchase of vaccines and other medical
products-available for COVID-19, SARS-CoV-2 or its
v ariants, and any dis ease with potential for creating a
pandemic; and (2) in Section 3101, $10 billion, available
until September 30, 2025, for activities under the Defense
Production Act (DPA) for the purchase, production and
distribution of medical supplies, including vaccines and
related supplies, among others. Both of these ARPA
appropriations have been assigned to HHS accounts-the
first to PHSSEF and the second to a new HHS DPA
account.
Domestic Vaccination Programs
The Centers for Disease Control and Prevention(CDC), in
collaboration with other agencies, has led efforts with state,
local, tribal, and territorial (SLTT) jurisdictions to plan and
implement a nationwide vaccination program. Agencies
with health care programs (e.g., the Veterans Health
Administration and Indian Health Service [IHS])have
separately managed vaccination programs among
employees and covered populations. The Biden
Administration has also expanded therole of additional
agencies (e.g., the Federal Emergency Management Agency
[FEMA]) in vaccination programs.
CDC: Earlier in the pandemic, before vaccines were
available, CDC had received broad supplemental
appropriations for its pandemic-related activities in March
2020, and used some of this funding for vaccination
programgrants and planning. Since then, CDChas received
several appropriations specifically for vaccine-related
activities:
* Vaccination Programs and SLT grants. For efforts
to plan, promote, distribute, administer, monitor, and
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