Domestic Funding for COVID-19 Vaccines: An Overview

Domestic Funding for COVID-19 Vaccines: An Overview

Updated November 22, 2021
Domestic Funding for COVID-19 Vaccines: An Overview
Federal efforts to develop, manufacture, purchase, and
medical R&D in the Defense Health Program account with
distribute Coronavirus Disease 2019 (COVID-19) vaccines
some flexibility to reallocate other funds toward R&D.
have involved a number of agencies. Many of these efforts
have thus far been funded by appropriations in COVID-19
BARDA and Other R&D, Manufacture, and Purchase:
relief acts, especially funding to the Department of Health
In the FY2020 and FY2021 supplemental appropriations
and Human Services (HHS) U.S. Public Health Service
acts, over $50 billion in Public Health and Social Services
(PHS) agencies and accounts in FY2020 and FY2021
Emergency Fund (PHSSEF) funding, available until
supplemental appropriations and in the American Rescue
September 30, 2024, is designated for a broad set of
Plan Act (ARPA, P.L. 117-2) budget reconciliation measure
medical countermeasures and surge capacity purposes,
enacted in March 2021.
including for the development, manufacture, and purchase
of vaccines and related supplies. The PHSSEF account
The following provides an overview of both (1)
funds BARDA, the main entity that has awarded large
appropriations and (2) allocations and obligations for
funding agreements to pharmaceutical companies for
selected domestic COVID-19 vaccine related activities.
vaccine development, manufacture, and purchase. Not less
(With the exception of the mandatory funding provided by
than $23.2 billion is set aside for BARDA in the FY2020
ARPA, all funding amounts discussed below are classified
and FY2021 supplemental appropriations that can be used
as discretionary.) The following is meant to inform a
for vaccine-related efforts.
general understanding of relevant funding, but does not
capture every federal account that can be used for vaccine-
ARPA further provides two relevant mandatory
related activities. This product does not address financing
appropriations: (1) in Section 2303, $6.05 billion, available
for vaccine administration (e.g., health insurance coverage)
until expended, to HHS for R&D, manufacturing,
or global vaccination funding (although some of the
production, and purchase of vaccines and other medical
funding for research and development [R&D], manufacture,
products—available for COVID-19, SARS-CoV-2 or its
and purchase has flexibility for international uses).
variants, and any disease with potential for creating a
pandemic; and (2) in Section 3101, $10 billion, available
Appropriations
until September 30, 2025, for activities under the Defense
The following summarizes two major categories of
Production Act (DPA) for the purchase, production and
COVID-19 vaccine-related appropriations. Many of the
distribution of medical supplies, including vaccines and
below appropriations are available for broad purposes;
related supplies, among others. Both of these ARPA
vaccine-related activities are one potential use of funds. In
appropriations have been assigned to HHS accounts—the
general, many of the HHS appropriations mentioned are
first to PHSSEF and the second to a new HHS DPA
available for multiple years or until expended, and some of
account.
the funding is transferrable between accounts by the HHS
Secretary.
Domestic Vaccination Programs
The Centers for Disease Control and Prevention (CDC), in
Research and Development, Manufacture, and
collaboration with other agencies, has led efforts with state,
Purchase
local, tribal, and territorial (SLTT) jurisdictions to plan and
COVID-19 vaccine R&D, manufacture, and purchase have
implement a nationwide vaccination program. Agencies
been largely supported by a collaboration among several
with health care programs (e.g., the Veterans Health
federal agencies, including the National Institutes of Health
Administration and Indian Health Service [IHS]) have
(NIH) and the Biomedical Advanced Research and
separately managed vaccination programs among
Development Authority (BARDA) of HHS, and DOD—
employees and covered populations. The Biden
formerly Operation Warp Speed (OWS) and now the
Administration has also expanded the role of additional
Countermeasures Acceleration Group (CAG). Six vaccines
agencies (e.g., the Federal Emergency Management Agency
were chosen for coordinated federal support under OWS.
[FEMA]) in vaccination programs.
Some vaccine R&D has been supported by NIH, BARDA,
and DOD separately from the OWS/CAG efforts.
CDC: Earlier in the pandemic, before vaccines were
available, CDC had received broad supplemental
NIH and DOD: FY2020 and FY2021 supplemental
appropriations for its pandemic-related activities in March
appropriations to NIH and DOD for COVID-19-related
2020, and used some of this funding for vaccination
R&D can fund vaccine R&D. In the FY2020 and FY2021
program grants and planning. Since then, CDC has received
supplemental appropriations acts, NIH received over $1.5
several appropriations specifically for vaccine-related
billion, available until September 30, 2024, broadly for
activities:
COVID-19 related research. The CARES Act (P.L. 116-
 Vaccination Programs and SLTT Grants. For efforts
136) provided DOD with $415 million for COVID-19
to plan, promote, distribute, administer, monitor, and
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Domestic Funding for COVID-19 Vaccines: An Overview
track COVID-19 vaccines, CDC received a total of
DOD: As communicated to CRS in May 2021, DOD has
$16.25 billion in FY2021, including $8.75 billion in the
allocated $534.9 million for COVID-19 vaccine R&D and
Coronavirus Response and Relief Supplemental
had obligated $506.4 million by that time. These COVID-
Appropriations Act, 2021 (CRRSA), enacted in
19 vaccine R&D efforts are separate from OWS/CAG
December, 2020 (P.L. 116-260, Division M), available
vaccine R&D. DOD has also been managing some
until September 30, 2024; and $7.5 billion in ARPA
OWS/CAG vaccine-related funding on behalf of HHS,
Section 2301, available until expended. Of the $8.75
utilizing its acquisition capabilities and authorities—
billion in CRRSA, at least $4.5 billion is designated for
especially for purchase and manufacturing agreements.
SLTT grants (or cooperative agreements), of which
$210 million must be transferred to IHS, and a separate
Further Considerations and Outlook
amount of not less than $300 million is designated for
Future domestic COVID-19 vaccine funding needs remain
“high-risk and underserved populations, including racial
uncertain. Federally supported vaccination efforts may be
and ethnic minority populations and rural communities.”
underway for some time with the ongoing booster and
The ARPA provision directs CDC to award
pediatric vaccination effort; potential for additional boosters
supplemental funding to eligible awardees that received
and additional pediatric vaccines; and a significant
grants under CRRSA based on a specified alternative
percentage of the population that remains unvaccinated.
formula.
Additional COVID-19 vaccine R&D may also help develop

new vaccines, especially for new variants. Balances of
Vaccine Confidence. CDC also received $1 billion for
previously appropriated funds may remain available to fund
vaccine confidence activities in ARPA Section 2302.
such efforts. The House-passed “Build Back Better Act”
(H.R. 5376) would provide $1.3 billion in pandemic
FEMA: Funding from the Disaster Relief Fund (DRF) has
preparedness funding that could be used for vaccine R&D,
been used to support FEMA’s vaccination efforts, including
production, and supply-related activities (Section 31022) in
by reimbursing certain costs for SLTT programs and
addition to broader public health funding that could support
supplying direct assistance (e.g., supplies, personnel) to
vaccine-related efforts (neither specific to COVID-19
mass vaccination sites. ARPA Section 4005 provides
vaccines). In the future, Congress may also consider the
additional funding of $50 billion for the DRF that can
support FEMA’s expanded activities.
conditions under which domestic COVID-19 vaccination

efforts could shift to routine financing and administration
approaches—no longer requiring sole federal purchase or
Other Funding: Many appropriations in the supplemental
support of mass vaccination sites and coordinated
appropriations acts and throughout ARPA can support
distribution.
domestic vaccination efforts, for example, funding for
public health workforce in ARPA Section 2501, and for
Table 1. Related CRS Products
community health centers in ARPA Section 2601 and
earlier appropriations. According to National Conference of
HHS Appropriations
State Legislatures data, some states and other jurisdictions
have used part of the CARES Act-funded Department of
CRS Report R46711, U.S. Public Health Service: COVID-19
the Treasury Coronavirus Relief Fund grants for
Supplemental Appropriations in the 116th Congress
vaccination efforts. For the similar ARPA-funded State and
CRS Report R46834, American Rescue Plan Act of 2021 (P.L.
Local Fiscal Recovery Fund programs, Treasury guidance
117-2): Public Health, Medical Supply Chain, Health Services, and
notes supporting vaccination efforts as a potential use of
Related Provisions
funds.
Non-HHS Appropriations and Roles
Allocations and Obligations
CRS Insight IN11273, COVID-19: The Basics of Domestic Defense
Response
As summarized above, many appropriations can support
vaccine-related activities. The following summarizes
CRS Report R46715, FEMA Assistance for Vaccine Administration
selected information on vaccine-specific allocations and
and Distribution: In Brief
obligations.
CRS Report R46298, General State and Local Fiscal Assistance
and COVID-19: Background and Available Data
HHS: As reported by the Government Accountability
CRS Insight IN11665, The American Rescue Plan Act, Section
Office (GAO), as of August 31, 2021, HHS allocated $40.0
9901—The Coronavirus State Fiscal Recovery Fund
billion toward vaccine-related activities (those of BARDA,
CRS Insight IN11664, The American Rescue Plan Act, Section
NIH, and CDC) for R&D, manufacture, purchase,
9901—The Coronavirus Local Fiscal Recovery Fund
distribution, and related activities with $31.9 billion
obligated (GAO-22-105051). This does not account for
Other Vaccine Financing and Funding
activities such as some CDC SLTT vaccine-related grants.
CRS Insight IN11609, COVID-19 Vaccine: Financing for Its
Separately, $14.8 billion of the $178 billion Provider Relief
Administration
Fund was allocated for “vaccine and therapeutic
CRS In Focus IF11796, Global COVID-19 Vaccine Distribution
development and procurement activities” as of August
2021, with $6.5 billion obligated (GAO-22-105051).

FEMA: According to FEMA, $6.1 billion had been
Kavya Sekar, Analyst in Health Policy
obligated from the DRF for vaccination efforts as of
IF11951
November 10, 2021.
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Domestic Funding for COVID-19 Vaccines: An Overview

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https://crsreports.congress.gov | IF11951 · VERSION 3 · UPDATED