Audit of DoD Implementation of the DoD Coronavirus Disease–2019 Vaccine Distribution Plan (DODIG-2022-058)

What We Did:

Our objective was to determine whether DoD officials effectively distributed and administered the coronavirus disease–2019 (COVID-19) vaccine to the DoD workforce in accordance with DoD guidance.

What We Found:

While the DoD strived to vaccinate its workforce against COVID-19 as quickly as possible, DoD officials did not have reliable data on which to base vaccine allocation decisions, or determine if they effectively administered the COVID-19 vaccine to the DoD workforce. Specifically, DoD officials could not definitively determine the vaccine eligible population at each military treatment facility and had difficulty reporting reliable vaccine administration data. In addition, the DoD also encountered the following challenges as it administered the vaccine.

• The majority of the respondents to the survey we conducted as part of this audit responded that they did not know their tier in the schema that prioritized the DoD workforce for vaccination. In addition, military treatment facilities in close proximity to each other did not always coordinate their movement to the next schema tier.

• Officials at some overseas military treatment facilities in our sample indicated they were not being allocated enough vaccine for their population that was dependent on the DoD for vaccination.

• Overseas military treatment facilities in our sample were not always permitted to vaccinate local nationals who were part of the DoD workforce and worked alongside U.S. personnel.

Having accurate information regarding the population requiring vaccination and reliable vaccine administration data is necessary to support the DoD wide vaccination effort. Because the DoD lacked a definitive understanding of military treatment facilities’ vaccine-eligible populations, including where populations fell in the DoD’s vaccine prioritization schema, and reliable vaccine administration data, the Defense Health Agency, the Military Departments, and the National Guard Bureau may not have made the most effective allocation decisions. In addition, without reliable vaccine administration data, the DoD may not be able to determine whether it effectively administered the vaccine.

As part of the DoD COVID-19 Vaccination Plan, the DoD used a coordinated communications strategy that included media, key leaders, and digital and social media engagement to build confidence in the COVID-19 vaccine. The coordinated communications strategy was meant to encourage DoD members to voluntarily take the vaccine by explaining credible health and safety data, the benefits to both individuals and the community of receiving the vaccine, and the vaccination process. We issued an anonymous survey to the DoD workforce to assess the effectiveness of the DoD communications strategy and the respondents’ opinions related to the COVID-19 vaccine. The respondents provided positive reviews of the DoD’s communications and messaging, often stating that they had received all the information they needed to make an informed decision about receiving the COVID 19 vaccine.

What We Recommend:

We recommend that the Defense Health Agency Director, with input from the Military Departments, the National Guard Bureau, and other stakeholders, review challenges and difficulties encountered during the distribution and administration of the COVID-19 vaccine, compile a report detailing the issues, and determine if corrective actions are necessary to support future pandemic response planning. At a minimum, the review should include the following challenges and difficulties:

• Determining the vaccine-eligible population at each military treatment facility;

• Reporting vaccine administration data;

• Communicating vaccination tier eligibility;

• Coordinating tier movement between military treatment facilities;

• Allocating vaccine to overseas locations; and

• Vaccinating local nationals who work alongside U.S. personnel at overseas locations.

In addition, we recommend that the Assistant Secretary of Defense, Health Affairs form and lead a working group consisting of DoD Components and address the issues identified by the Defense Health Agency.