Purpose
The purpose of these success stories is to share best practices for public health interventions in areas with moderate-to-high scores on the CDC/ASTDR Social Vulnerability Index (SVI) through contracted ICATT pharmacy vendors. Each success story showcases real-world results of prevention, surveillance, and research activities conducted by the ICATT program. They demonstrate how the CDC meets national program goals. The stories below pertain to ICATT activities conducted between 2020 and 2024.
Afghan allies safely begin their new life in the United States
On August 29, 2021, President Biden directed the Department of Homeland Security (DHS) to lead Operation Allies Welcome (OAW). The program supported the safe resettlement of Afghan asylum seekers who worked with coalition forces in Afghanistan.
During the mission's arrival phase (August through October 2021), the Increasing Community Access to Testing (ICATT) program administered COVID-19 tests to Afghan allies at Washington Dulles and Philadelphia international airports. ICATT contractors and government staff collaborated to provide 24-hour testing. They tested more than 3,000 people per day. The airport testing program performed over 54,000 total tests during the arrival phase. These tests prevented the spread of COVID-19 as Afghans relocated to safe haven sites to await permanent placement in the United States.
During OAW's resettlement phase (November 2021 through September 2022), Afghan allies entered temporary safe haven sites in Indiana, Virginia, New Jersey, and Maryland. They received full medical screening and access to mental health services at these sites.
ICATT contractors performed routine COVID-19 testing as a part of their continuity of care. They administered more than 76,000 COVID-19 tests to Afghan allies and 28,000 to support staff from August 2021 to September 2022. ICATT's support of the inter-agency OAW is an example of a successful public-private partnership with CDC.
COVID-19 surge testing sites respond to COVID-19
The ICATT program works with testing vendors to increase availability of testing services when there is a surge in testing demand. Additionally, ICATT can coordinate with state and local public health agencies, federal partners, and ICATT testing vendors to provide no-cost and short-term COVID-19 surge testing sites to socially vulnerable communities.
Throughout the COVID-19 pandemic, jurisdictions utilized the ICATT program to provide temporary testing sites to their communities in response to surges in COVID-19 cases. From December 2021 to March 2022, ICATT contractors launched 65 surge testing sites in 28 jurisdictions and administered more than 122,000 tests.
ICATT border program sunsets after three years of COVID-19 testing support
In early 2021, federal agencies asked CDC's Increasing Community Access to Testing (ICATT) program to test unaccompanied children (UC) crossing the Southern border for COVID-19. Contractors performed testing of UC at intake and while they were temporarily housed in congregate settings.
ICATT expanded its program to support testing at nine locations along the U.S.-Mexico border. Locations included Department of Homeland Security (DHS) Customs and Border Protection (CBP) sites and HHS Office of Refugee Resettlement (ORR) facilities. In addition, ICATT tested foreign nationals being repatriated to Central and South American countries requiring COVID-19 test results prior to deportation.
Following suggested CDC guidance, ICATT contractors administered point-of-care rapid antigen and nucleic acid amplification tests (NAAT) to mitigate potential outbreaks among UC and the staff members who cared for them. After over 3 years of support and 1.4 million tests, ICATT sunset its operations at the Border on May 31, 2024.
ICATT provides data to CDC surveillance and vaccine effectiveness efforts
In November 2021, within days of the emergence of the Omicron variant, ICATT utilized its federal partnership with commercial pharmacies to gain access to S-gene target performance data for COVID-19 tests. ICATT leveraged this data and additional data from pharmacy partners to provide assessments of Omicron prevalence among 550,631 tests between December 7, 2021, and February 28, 2022. The S-gene target performance data continues to be used to track COVID-19 variant emergence and assess vaccine effectiveness (VE) against symptomatic infection for emerging variants prior to variant dominance.
The ICATT program has been a key platform for monitoring vaccine effectiveness against COVID-19 infection since 2021. The CDC COVID-19 vaccine effectiveness program informs vaccine policy decisions by providing timely and robust data collected through observational studies and surveillance platforms. Through its partnership with commercial pharmacies, ICATT utilizes data reported at the time of COVID-19 test registration, including vaccination history, combined with tests results, to estimate vaccine effectiveness.
What sets ICATT apart is its extensive reach and the prompt availability of data. ICATT operated in 49 states and conducted an average of over 400,000 weekly tests between January 1, 2021, and May 11, 2023. It is the largest VE platform and provides near real time data updates allowing for the assessment of VE estimates in children 5 and under, the first VE estimates after the emergence of the Omicron variant, and the first VE estimates of Omicron sublineage XBB.
CDC Bridge Access Program provide no-cost vaccines to vulnerable populations
The CDC Bridge Access Program quickly launched in the fall of 2023 when COVID-19 vaccines became commercially available, to ensure that uninsured/underinsured patients maintained access to vaccination services. The Bridge Access Program, a public-private partnership with pharmacies, was designed to temporarily provide access to no-cost COVID-19 vaccines among adults who are underinsured or uninsured.
To support offering no-cost vaccines through pharmacies, the Increasing Community Access to Testing (ICATT) program partnered with the Bridge Access Program and expanded its pharmacy services to offer vaccinations during the 2023-2024 vaccine season for uninsured/underinsured patients. CVS, Walgreens, and independent pharmacies contracted by eTrueNorth as part of the ICATT pharmacy network offered no-cost COVID-19 vaccines on behalf of the Bridge Access Program.
From September 2023 to August 2024, ICATT's network of 24,000 contracted pharmacies provided over 888,000 COVID-19 vaccines to uninsured and underinsured adults across all 50 states, including Washington D.C. and Puerto Rico. Of those vaccines, ICATT vendors administered 99% of doses in community clinics, 95% in respite centers, and 66% in retail pharmacy stores to racial and ethnic minorities. Additionally, they played a significant role in reaching individuals in low access and low vaccination areas, administering 18% of doses in community clinics, 82% in respite centers, and 13% across all retail pharmacy stores in those underserved communities.
The ICATT-Bridge Access Program contracts provided an additional incentive fee for community sites in low access and low vaccination areas and for doses administered at those sites. The vendors provided testing at 1,791 sites in low access and low vaccination areas and administered 151,680 doses at those sites.
Due to the Congressional rescission of unobligated COVID supplemental balances, the Bridge Access Program ended four months earlier than originally intended, On August 22, 2024, the FDA also authorized and approved updated 2024-2025 mRNA COVID-19 vaccines that more closely targeted currently circulating variants and provided better protection against serious consequences of COVID-19, including hospitalization and death. As a result of the introduction of updated vaccines, the 2023-2024 doses available through the Bridge Access Program could no longer be administered.
ICATT support of the Bridge Access Program is a successful example of expanding services within the ICATT pharmacy partner network to meet public health goals, specifically to improve equitable access and availability of COVID-19 vaccines in underserved or at-risk communities.
NIH RECOVER Initiative studies long COVID
The National Institutes of Health's National Heart, Lung, and Blood Institute (NHLBI) launched the Researching COVID to Enhance Recovery (RECOVER) Initiative to better understand the impact and treatment of acute and persistent SARS-CoV-2 infection. Long COVID causes chronic illness that lasts for at least 3 months after SARS-CoV2 infection and includes a wide range of symptoms, such as fatigue, shortness of breath, and brain fog. The RECOVER Initiative established 200 study sites across the United States to conduct a longitudinal study of COVID-19 patients, to better understand the etiology of Long COVID.
In October 2022, the RECOVER Initiative partnered with the ICATT program to increase study participant enrollment. As part of the collaboration, ICATT pharmacy partners (CVS, Walgreens, eTrueNorth, and Quest) included RECOVER Initiative enrollment information on their websites. ICATT pharmacy locations also provided patients who received a COVID-19 test with RECOVER Initiative enrollment information alongside their test results.
Between October 2022 and September 2023, the ICATT-RECOVER collaboration resulted in more than 13,000 additional visits to the RECOVER website, activation of 1,880 email hyperlinks and 300 banner hyperlinks, as well as enrollment of an additional 41 patients into a RECOVER cohort. Targeted distribution of enrollment information along with patients' test results increased public awareness regarding Long COVID and the RECOVER Initiative. This successful interagency collaboration effectively leveraged the ICATT pharmacy partner network to augment the enrollment of patients in the RECOVER Initiative.