U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 1

From the Factory to the Frontlines

The Operation Warp Speed Strategy for Distributing a COVID-19 Vaccine

What This Strategy Aims to Do

This report to Congress details a strategy to achieve the principal purpose and objective of 

Operation Warp Speed (OWS): ensuring that every American who wants to receive a COVID-19 

vaccine can receive one, by delivering safe and effective vaccine doses to the American people 

beginning January 2021.

The leadership of OWS has committed to being transparent with Congress, the media, and the 

American people. OWS has provided regular briefings on topics of interest to Congress and the 

media and will continue to provide updates and announcements as OWS reaches new milestones. 

Congress has been a vital partner in the all-of-America response to the COVID-19 pandemic. 

With support provided through emergency supplemental and flexible discretionary funding, 

OWS has now made strong progress toward a safe and effective COVID-19 vaccine, with multiple 

candidates in Phase 3 clinical trials.

Simultaneously, OWS and partners are developing a plan for delivering a safe and effective 

product to Americans as quickly and reliably as possible. Experts from the Department of 

Health and Human Services (HHS) are leading vaccine development, while experts from the 

Department of Defense (DoD) are partnering with the Centers for Disease Control and Prevention 

(CDC) and other parts of HHS to coordinate supply, production, and distribution of vaccines. 

Successful implementation of the national COVID-19 vaccination program requires precise 

coordination across federal, state, local, tribal, and territorial governments and among many 

public and private partners. Cooperation on each of these fronts has already begun, as detailed 

throughout this strategy document.

OWS is harnessing the strength of existing vaccine delivery infrastructure while leveraging 

innovative strategies, new public-private partnerships, and robust engagement of state, local, 

tribal, and territorial health departments to ensure efficient, effective, and equitable access to 

COVID-19 vaccines. 

Some variables that will impact the planning of this vaccination program are unknown 

until a vaccine is authorized or approved by the Food and Drug Administration (FDA), such 

as populations for whom a given vaccine is most appropriate, distribution and storage 

requirements, dosage requirements, and other variables. This document lays out a flexible 

strategy that can accommodate a range of scenarios.

Through the COVID-19 vaccination program, OWS seeks to achieve maximum uptake of the 

vaccine across all population groups. The eventual objective of the vaccination program is to 

leave the U.S. government and commercial infrastructure better able to respond to pandemics 

and public health crises in the future.
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 2

What Is the Strategy?

Once a vaccine has received approval or authorization from the FDA, the four key tasks to achieve 

the primary objective of ensuring vaccine access for every American who wants it are to:

 Continue engaging with state, tribal, territorial, and local partners, other stakeholders, 

and the public to communicate public health information, before and after distribution 

begins, around the vaccine and promote vaccine confidence and uptake.

 Distribute vaccines immediately upon granting of Emergency Use Authorization/ 

Biologics License Application, using a transparently developed, phased allocation 

methodology.

 Ensure safe administration of the vaccine and availability of administration supplies.

 Monitor necessary data from the vaccination program through an information 

technology (IT) system capable of supporting and tracking distribution, 

administration, and other necessary data.

This report lays out the requirements for each of these tasks and how OWS has taken action and 

is planning future actions to execute on them. 

Multiple Critical Components to Vaccine Implementation MULTIPLE CRITICAL COMPONENTS TO VACCINE IMPLEMENTATION

Supply - Monitor, Track, Report 

Vaccine Uptake, Use, and Coverage

ADE and Vaccine Effectiveness 

Monitoring and Reporting

Regulatory Considerations

Prioritizing 

population

Allocation of 

Vaccine 

Distribution

(MFR –Dist- State) Administration Safety, Effectiveness, 

Uptake, Second dose

Vaccine 

Recovery

Communication and Stakeholder Guidance

(state, tribal, local, special populations, private sector partners, public)

Data

Public health impact relies on rapid, efficient, and high uptake 

of complete vaccine series, with focus on high-risk groups
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 3

Distribution

What is required: A distribution plan must be able to deliver vaccines immediately upon FDA 

authorization or licensure to all possible administration endpoints, while remaining flexible 

enough to accommodate a variety of factors, including varying product requirements and 

manufacturing timelines and volumes. Any distribution effort must ensure safety of the products, 

maintain control and visibility, manage uptake and acceptance, ensure traceability of product, 

and maximize coverage, which requires a centralized solution as well as close local partnerships.

What we are doing: OWS is developing a cooperative plan for centralized distribution that will 

be executed in phases by the federal government, the 64 jurisdictions CDC works with (all 50 

states, six localities, and territories and freely associated states), Tribes, industry partners, and 

other entities. 

Distribution has three key components:

 Partnerships with state, local and tribal health departments, territories, Tribes, 

and federal entities to allocate and distribute vaccines, augmented by direct 

distribution to commercial partners.

 A centralized distributor contract with potential for back-up distributors for 

additional storage and handling requirements.

 A flexible, scalable, secure web-based IT vaccine tracking system for ongoing 

vaccine allocation, ordering, uptake, and management.

State, Tribal, and Local Partnerships

CDC is working with state, local and tribal health departments to hone existing plans for vaccine 

distribution and administration. CDC has worked for decades with these partners, including 

under cooperative agreements, to ensure public health systems are prepared with plans, 

trained personnel, strategic relationships and partnerships, data systems, and other resources 

needed for sustaining a successful routine immunization infrastructure, and these plans will 

be adapted for this vaccine program.

CDC awarded grants as part of the Coronavirus Aid, Relief, and Economic Security (CARES) 

Act and the Families First Coronavirus Response Act that can help immunization programs 

begin preparation for vaccine distribution and administration. The funding will be used to 

enhance capacity to support staffing, communication and stakeholder engagement, pandemic 

preparedness, and mass vaccination.

A multi-agency federal team has worked with five pilot jurisdictions—California, Florida, 

Minnesota, North Dakota, and Philadelphia—to utilize a basic plan for administration and 

adapt it to create jurisdiction-specific plans that will serve as models for other jurisdictions. 

Jurisdiction planning will cover coordination with federal facilities in their jurisdiction, 

coordination with national chain partners, vaccination of critical work forces, and reaching 

underserved populations.

Each jurisdiction will be required to develop a “microplan,” based on their existing plans as well 

as outputs from the first five jurisdictions supported, with CDC providing technical assistance. 

These microplans will identify vaccination sites and necessary logistical considerations and 

lay out how the sites will be onboarded into the necessary IT system. The microplans will need 

to be flexible to allow adaptation as more information about the specific characteristics of the 

vaccines becomes available.
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 4

Under their cooperative agreements with CDC through which CARES Act awards were made, 

jurisdictions will then onboard providers to the IT system and identify and plan for the necessary 

vaccination workforce. Jurisdictions will also be responsible for laying specific groundwork for 

vaccinating high-risk and prioritized populations through various outreach efforts, including 

a work group or stakeholder groups, and forming a vaccination committee.

Jurisdictions will be expected to incorporate planning for distribution of vaccines to members of Tribes into their microplans. In addition, CDC and OWS are working with the Indian 

Health Service (IHS) to develop a plan for direct IHS distribution of vaccine to Tribes that 

desire that option.

Centralized Distribution

Centralized distribution allows the government full visibility, control, and ability to shift 

assets and use data to optimize vaccine uptake. On August 14, CDC announced its centralized 

distributor contract by executing an existing contract option with McKesson, which distributed 

the H1N1 vaccine during the H1N1 pandemic in 2009–2010. The current contract with McKesson, 

awarded as part of a competitive bidding process in 2016, includes an option for the distribution 

of vaccines in the event of a pandemic.

Once vaccines are allocated to a given jurisdiction or authorized partner, McKesson will deliver 

a specific amount of vaccine to a designated location. In many instances, delivery locations will 

be sites where vaccine will be administered. Alternatively, vaccines can be delivered to locations 

in jurisdictions to be further distributed to administration sites within health department 

networks. Vaccines can also be delivered to locations integrated into national retail pharmacy 

networks for distribution to individual pharmacies. 

This system will be scalable to meet demand. Some vaccine with ultra-cold storage requirements 

may be shipped directly from the manufacturer to the administration sites, but all distribution 

will be managed by this centralized system. 

If necessary, the McKesson contract can cover rapid distribution of doses of refrigerated (2–8o 

Celsius) and frozen (-20oC) vaccines. 

The COVID-19 pandemic has likely accelerated a trend towards different ways of engaging with the 

healthcare system, and successful delivery of this vaccine will need to incorporate new types of 

sites and approaches for vaccine delivery. For example, during H1N1, once vaccines became widely 

available pharmacies played an important role in the vaccine distribution; pharmacies’ role is even 

more critical to vaccinations today and will be fully integrated into the distribution plan. 

Ordering and Tracking Systems

Vaccine allocation and centralized distribution will utilize HHS’s Vaccine Tracking System 

(VTrckS), which is a secure, web-based IT system that integrates the entire publicly funded 

vaccine supply chain from purchasing and ordering through distribution to participating state, 

local, and territorial health departments and healthcare providers.

VTrckS is being scaled for distribution of pandemic vaccines, to include the onboarding of 

new providers under each jurisdiction’s microplan. For the COVID-19 vaccination program, 

additional providers, including private partners (e.g., pharmacy chains) and other federal 

entities (e.g., the Indian Health Service), will be onboarded to enable allocation to and ordering 

directly by these partners, in addition to the state, local, and territory allocations. 

Through the linkage of a number of systems, information technology will also help direct 

people to where to get vaccinated using web-based “finder” systems. 
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 5

A Potential Phased Structure

Phase 1: Upon FDA authorization or approval, initial vaccine doses will be distributed in a focused manner, with the goal of maximizing vaccine acceptance and public health protection 

while minimizing waste and inefficiency.

Although final decisions about prioritization will not be made until closer to implementation, 

select scenarios have been developed to assist with state and local planning. State and local 

health departments have been given specific scenarios to plan for during this stage, while scenario planning for distribution and administration plans specific to focused populations has 

begun at the federal level.

Phase 2: As the volume of available vaccine increases, distribution will expand, increasing access to the larger population. When larger quantities of vaccine become available, there will be 

two simultaneous objectives: 1) to provide widespread access to vaccination and achieve coverage 

across the United States population and 2) to ensure high uptake in target populations, particularly those who are at high risk for severe outcomes from COVID-19.

Phase 3: If the risk of COVID-19 persists such that there remains a public health need for an 

ongoing vaccination program, COVID-19 vaccines will ultimately be universally available and 

integrated into routine vaccination programs, run by both public and private partners.

Based on the timeline associated with FDA regulatory decision-making, increasing quantities 

of produced vaccines may be stockpiled as manufacturing proceeds before a regulatory decision 

has been made, which would mean that distribution may begin directly with Phase 2 or Phase 3. 

Allocation: Allocations in the early phases will be based in part on methodology previously developed and reviewed by public health experts as part of pandemic planning. This methodology 

will be adjusted based on experience from COVID-19, real-time data on the virus and its impact 

on populations, performance of each vaccine, and the ongoing needs of the essential workforce. 

Distribution will adjust as volume of vaccine doses increases, 

moving from targeted to broader populations reached (phased approach)

Limited Doses Available Large Number of Doses Available Continued Vaccination,

Shift to Routine Strategy

• Constrained supply

• Highly targeted administration required to 

achieve coverage in priority populations

• Likely sufficient supply to meet demand

• Supply increases access

• Broad administration network required 

including surge capacity

• Likely excess supply

• Broad administration network for 

increased access

• Tightly focus administration

• Administer vaccine in closed settings (places 

of work, other vaccination sites) specific to 

priority populations

• Expand beyond initial populations

• Administer through commercial and private 

sector partners (pharmacies, doctors offices, 

clinics)

• Administer through public health sites (mobile 

clinics, FQHCs, targeted communities)

Doses available per month

(baseline as of 07/16)

Illustrative scenario for planning purposes; will be adapted based on the clinical / manufacturing

information on all OWS candidates and vaccine prioritization

~660M cumulative

doses available

Illustrative ramp-down, not 

based on OWS decisions or 

candidate projections

• Open vaccination

• Administer through commercial and 

private partners

• Maintain PH sites where required

Volume

doses

available

(per month)

Max

Trials only

Key

factors

Likely 

admin

strategies
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 6

To develop and update populations to target in settings with limited doses of vaccine, the 

National Institutes of Health (NIH) and CDC requested that the National Academies of Sciences, 

Engineering, and Medicine and the National Academy of Medicine (NAM) develop an overarching 

framework to assist policymakers in the U.S. and global health communities in planning for 

equitable allocation of vaccines against COVID-19. 

NAM established a committee to consider the criteria that should be used to set priorities for 

equitable distribution of potential vaccine and released a discussion draft of a preliminary 

allocation framework on September 1. The findings from the NAM committee will be shared 

with the CDC’s Advisory Committee on Immunization Practices (ACIP), to help inform the 

committee’s deliberations related to vaccine priority groups and ensuring equity in vaccination 

in the United States.

ACIP will review evidence on COVID-19 epidemiology and burden, vaccine safety, vaccine 

efficacy, evidence quality, and implementation issues to inform recommendations for 

COVID-19 vaccine policy, including priority groups for vaccination, which are submitted to 

the CDC director for adoption. ACIP meetings are open to the public, and committee records 

are required to be made available to the public, ensuring transparency and visibility for this 

recommendation-making process. 

ACIP formed a COVID-19 Vaccine Work Group to help inform its evidence-based approaches to 

COVID-19 vaccination policy, including the initial vaccine prioritization strategy to be presented 

to the full ACIP for deliberation at public ACIP meetings, development of recommendations, and 

eventual presentation of these recommendations to the CDC for consideration in determining 

population prioritization.

ACIP embarked on early planning for these efforts. The framework developed during, and the 

lessons learned from, the H1N1 influenza vaccine implementation are being used to guide 

COVID-19 vaccine prioritization. CDC learned several lessons from the H1N1 response and 

vaccine distribution, including the real possibility of uncertainties in the pharmaceutical 

manufacturing process, which requires the distribution plan to anticipate delays and respond to 

changing circumstances. Further, demand is likely to vary regionally and in diverse populations 

within a given geographic area. Nimble delivery and allocation strategies will be essential.
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 7

Administration

What is required: Successful administration requires identifying prioritized populations and 

working cooperatively with state, local and tribal public health departments and other key 

partners to ensure individuals in targeted groups safely receive vaccines when limited doses 

initially become available. 

What we are doing: Through collaborative planning with states and private sector provider 

partners such as pharmacies, vaccine administration sites will be selected to optimize access 

to vaccines throughout the distribution process. 

Administration tasks within each distribution phase will include:

 Delivery of vaccine to sites, with the goal of no upfront costs to providers and no outof-pocket cost to the vaccine recipient.

 Ensuring administration sites, as covered in the jurisdiction’s microplans, have the 

capabilities for storing, handling, and administering vaccine products with specific 

distribution and administration requirements.

 Supporting reliable distribution of ancillary supplies that may be necessary for vaccine 

administration.

 Engagement of traditional and non-traditional administration sites and approaches in 

vaccination planning to allow for flexibility to accommodate vaccine requirements.

Delivery and Cost

The federal government is procuring hundreds of millions of doses of safe and effective vaccines, 

and has contracted with McKesson for purposes of vaccine distribution, such that no American 

will be charged for either the COVID-19 vaccine or its distribution. Various plans, supported 

by the CARES Act and the Families First Coronavirus Response Act, are under development 

with the objective of ensuring no one will be charged any out–of-pocket expenses for the 

administration of the vaccine either. The objective is to ensure no one desiring vaccination will 

face an economic barrier to receiving one. 

Section 3203 of the CARES Act (P.L. 116-136) requires health insurance issuers and plans to 

cover any ACIP-recommended COVID-19 preventive service, including vaccines, without costsharing within 15 days of such recommendation to the CDC. Once a licensed COVID-19 vaccine 

is recommended by ACIP, and the recommendation is adopted by the CDC Director, required 

coverage for vaccines as preventative services for Medicaid Early and Periodic Screening, 

Diagnostic and Treatment beneficiaries and the Affordable Care Act provisions for most private 

insurance coverage and for the Medicaid expansion populations will also apply.

Ancillary Supplies

Supporting and securing an adequate quantity of ancillary supplies needed for administration 

has been a collaborative, interagency effort. OWS has aimed to procure and assemble 6.6 million 

ancillary supply kits, including pediatric, adult, and mixed-use kits, which would support the 

vaccination of up to 660 million doses of vaccine. These kits will include needles, syringes, 

alcohol pads, vaccination cards, and limited PPE for vaccinators.

HHS’s Biomedical Advanced Research and Development Authority (BARDA) has awarded four 

large task orders for needles and syringes. BARDA will support additional solicitations, in 

coordination with the Strategic National Stockpile, to maximize the availability of needles 
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 8

and syringes toward the end of 2020. BARDA and the DoD Joint Program Executive Office for 

Chemical, and Biological, Radiological, and Nuclear Defense (JPEO-CBRND) have awarded 

three agreements to increase needle and syringe capacity in the U.S. for the future, some of 

which will be available in time to support the COVID-19 vaccination in early 2021. BARDA and 

the JPEOCBRND have also awarded agreements with two domestic manufacturers of vials to 

increase capacity necessary to support multiple vaccine candidates.

Administration Sites

Administration site options will vary depending on the nature of the vaccine and the phase of 

the vaccination program. During Phase 1, administration sites may be more limited to settings 

that can optimize reaching the target population while meeting the early requirements 

for storage and handling of vaccine product. During Phase 2, an expanded administration 

network would, for instance, likely include adult and pediatric healthcare providers and 

pharmacies. These considerations will be part of planning done by the jurisdictions discussed 

in the Distribution section.

As part of efforts to make administration sites easily accessible, the program will make 

maximum use of all healthcare professionals licensed to administer vaccines, including allied 

health professionals such as pharmacists.

HHS is also committed to ensuring rural populations can receive the vaccine, and has decades 

of experience working with public health partners addressing the needs of hard-to-reach 

populations. CDC will work with local communities, governments, and other partners to 

identify the best places and times to reach this population and utilize strategic distribution 

points via community health centers, schools, workplaces, mobile clinics, and pharmacies.

OVERVIEW OF DISTRIBUTION AND ADMINISTRATION
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 9

Monitoring

What is required: The vaccination program requires extensive data monitoring infrastructure, 

including appropriate IT architecture, to incorporate claims and payment processes, to identify 

when a person needs a potential second dose, to monitor outcomes and adverse events, and to 

account for products the U.S. government is spending billions of dollars to research, develop, 

and produce. Data will need to be available both federally and at the state, local, and tribal level 

to ensure efficient management of the vaccination program.

What we are doing: OWS will construct and integrate an IT architecture that achieves this 

objective, building off of existing IT infrastructure and filling gaps with new IT solutions.

CDC has already been working to improve the data infrastructure needed to better track 

vaccines, vaccination, and related information. The COVID-19 vaccination program requires 

significant enhancement of the IT that will support enhancements and data exchange that are 

critical for a multi-dose candidate to ensure proper administration of a potential second dose.

Immunization Information Systems used by state, territory, and city entities that deliver 

public vaccinations will be central to this IT infrastructure. Major pharmaceutical retailers 

have proven and reliable dispensing record systems, while healthcare systems, hospitals, and 

private providers employ Electronic Health Record systems to store, monitor, and track patient 

information. Points of administration with undeveloped infrastructure—such as ad hoc mobile 

clinics and other rapidly mobilized mass vaccination sites—will be provided with free access 

and training for purpose-built web-based applications to support vaccine data administration 

and tracking, with an array of options available to make these accessible. 

Together, this data will be reported into a common IT infrastructure that will support analysis 

and reporting. The IT infrastructure will support partners with a broad range of tools for 

record-keeping, data on who is being vaccinated, and reminders for second doses. 

In all cases, administration records will be aggregated, anonymized, and de-identified to 

protect personally identifiable, private health information to the maximum extent possible.

Before a vaccine is authorized for use, evidence of its safety and efficacy is limited to the 

results from clinical trials, where patients are selected carefully and followed up very 

closely under controlled conditions. Because some technologies have limited previous data 

on safety in humans, the long-term safety of these vaccines will be carefully assessed using 

pharmacovigilance surveillance and Phase 4 (post-licensure) clinical trials.

The key objective of pharmacovigilance is to determine each vaccine’s performance in real-life 

scenarios, to study efficacy, and to discover any infrequent and rare side effects not identified 

in clinical trials. OWS will also use pharmacovigilance analytics, which serves as one of the 

instruments for the continuous monitoring of pharmacovigilance data. Robust analytical tools 

will be used to leverage large amounts of data and the benefits of using such data across the value 

chain, including regulatory obligations. Pharmacovigilance provides timely information about 

the safety of each vaccine to patients, healthcare professionals, and the public, contributing to 

the protection of patients and the promotion of public health.
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 10

Engagement

What is required: To support vaccine distribution, administration, and monitoring, as well 

as promote vaccine uptake, vaccine confidence, and reporting of adverse events, a successful 

vaccination program requires engaging a nationwide network of partners. Working with 

established partners—especially those that are trusted sources for target audiences—is critical 

to advancing public understanding of, access to, and acceptance of eventual vaccines.

What we are doing: To build partnerships as part of the vaccination program and deliver an 

effective communications strategy, OWS is engaging public, nonprofit, and private partners, 

while leveraging the government’s longstanding relationships with state health departments, 

tribal nations and organizations, healthcare systems, the vaccine industry, health insurance 

issuers and plans, and non-traditional partners. 

Partnerships

State, local and tribal health departments have conducted pandemic vaccination planning with 

immunization and preparedness funding from CDC for over a decade. Rapidly updating these 

vaccination response plans for COVID-19 will ensure readiness for timely administration of 

COVID-19 vaccines. 

This work builds on existing successful partnerships: Each year, CDC safely distributes more 

than 80 million doses of vaccines to approximately 40,000 public and private health providers 

across the country, in addition to the tens of millions of other vaccines distributed through other 

channels. During the 2009 H1N1 pandemic, more than 70,000 provider sites participated in the 

expanded vaccination program. This represents strong baseline capacity and partnerships for 

distribution and administration.

HHS’s Office of Intergovernmental and External Affairs has established communication 

channels with almost 30 private sector organizations representing hospitals, physicians, 

nurses, nursing homes, community health centers, health insurance issuers and plans, drug 

stores, influencers, foundations, patients, and seniors’ groups to provide regular updates on 

the work of OWS, including the distribution program. 

HHS has also been holding regular calls with intergovernmental partners at the state, 

local, tribal, and territorial levels, with robust dialogue on how the federal government will 

successfully partner with them on the vaccination program. 

Further, work has begun with organizations representing minority populations and vulnerable 

communities, with consultation already occurring with more than 150 organizations dedicated 

to addressing health disparities. Faith-based and other trusted community organizations can 

also be critical in addressing vaccine hesitancy, and HHS’s Center for Faith and Opportunity 

Initiatives is working with minority-serving faith and community groups to enlist their help in 

educating Americans and encouraging participation in the vaccination program. 

Communications

Strategic communications and public messaging are critical to ensure maximum acceptance of 

vaccines, requiring a saturation of messaging across the national media. 

An information campaign led by HHS’s public affairs department—developed using humancentered design, extensive public and stakeholder engagement, and research on message 

development and delivery—will focus on vaccine safety and efficacy, and target key populations 

and communities to ensure maximum vaccine acceptance.
From the Factory to the Frontlines

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES | PAGE 11

CDC and other HHS components are working collaboratively within OWS to ensure that 

consistent and accurate information is at the foundation of the communications effort. The 

plan will also help inform the American people about the OWS strategy of delivering faster 

results while still following the same processes for safety and effectiveness that Americans 

expect with any other vaccine.

Identifying the right messages to promote vaccine confidence, countering misinformation, and 

targeting outreach to vulnerable and at-risk populations will be necessary to achieve high coverage. CDC will build on its existing relationships with local public health partners and health 

departments to effectively implement communications, and CDC is also working to develop innovative approaches to improve vaccine uptake among hard-to-reach critical populations.

Understanding that public confidence in vaccines is necessary for vaccine uptake and acceptance, CDC will make use of its strategic framework, Vaccinate with Confidence, which it has 

used successfully to strengthen public trust in vaccines and prevent vaccine-preventable disease outbreaks. This framework emphasizes three key priorities: protect communities, empower families, and stop myths. Within this framework, CDC is already working with local 

partners and using trusted messengers to establish new partnerships and contain the spread 

of misinformation.