CDC Provided Oversight and Assistance, but Recipients Faced Challenges in Implementing a COVID-19 Vaccine Confidence Strategy

Why OIG Did This Audit

Through the American Rescue Plan (ARP) Act of 2021, the Centers for Disease Control and Prevention (CDC) awarded nearly $244 million to 64 State, Local, and Territorial recipients (recipients) to develop and implement strategies in strengthening COVID-19 vaccine confidence using CDC’s COVID-19 Vaccinate with Confidence strategic (Vaccine Confidence strategy) framework.

Our objectives were to determine (1) whether CDC provided oversight and assistance to the recipients in developing and implementing strategies that followed the CDC’s Vaccine Confidence strategy, (2) how much of the ARP award funds each of the recipients had expended at the time of our audit, and (3) any potential challenges or barriers that the recipients faced when spending the ARP award funds.

How OIG Did This Audit

Our audit covered the oversight and assistance CDC provided to 64 recipients that were awarded nearly $244 million in ARP supplemental funding. We obtained the recipient supplemental award and expenditure data to identify how much of the ARP award funds each of the recipients had expended at the time of our audit. We then administered an online survey to the recipients and analyzed and summarized the survey responses to determine challenges or barriers faced in developing and implementing a vaccine confidence strategy, and to assess the oversight and assistance provided by CDC.

What OIG Found

CDC provided oversight and assistance to the recipients in developing and implementing a vaccine confidence strategy by utilizing recipient data, conducting periodic outreach through webinars and technical assistance calls, among other things. Of the nearly $244 million in funding to the 64 recipients, more than $116 million, or nearly 48 percent, had been expended as of March 4, 2024. On the basis of the recipients’ responses to the OIG survey, we identified challenges or barriers that the recipients faced in developing and implementing a vaccine confidence strategy. Some of those challenges or barriers included (1) language and location barriers, (2) lengthy contract processes, (3) COVID-19 fatigue, and (4) vaccine mistrust or hesitancy, which impacted recipients’ expending of award funds. The challenges or barriers that were identified in developing and implementing a vaccine confidence strategy from the survey of recipients provide CDC with areas on which to focus when implementing future strategies.

What OIG Recommends

This report includes no recommendations. However, CDC indicated that it would use the suggestions and feedback from the recipients’ responses to the OIG survey to improve the development and oversight of its Vaccinate with Confidence strategic framework until its completion, as well as initiatives that are in response to future public health emergencies. CDC elected not to provide formal written comments on our draft report but did provide technical comments, which we addressed as appropriate.

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