The ultimate guide to Amazon’s advertising business, which is $21 billion and growing

amazon advertising executive 2x1

Amazon’s e-commerce dominance is quickly expanding to advertising.

The pandemic has drastically cut ad budgets as marketers reign back their spending, but e-commerce advertising is booming as people shop more from home – with Amazon leading the pack.

EMarketer said Amazon claimed 10.3% of the US digital ad market in 2020, up from 7.8% in 2019 – competing with Google and Facebook for ad budgets. That growth has attracted Walmart, Instacart, Walgreens and other retailers that have joined Amazon in vying for a slice of the pie.

Here’s the latest on what we know about Amazon’s moves to grow its advertising business.

How big is advertising for Amazon?

Amazon made about $21.5 billion from advertising in 2020, up from roughly $9.3 billion in the year-ago period.

While that amount is a tiny sliver of Amazon’s revenue from retail sales and Amazon Web Services, its cloud business, advertising is one of its fastest-growing areas. The tech giant continues to cut into advertisers’ search budgets that mostly go to Google.

The pandemic’s impact on Amazon

While advertisers have slashed TV and some digital budgets during the pandemic, Amazon’s advertising has grown as people do more of their shopping online. Amazon has also increased the advertising potential of Twitch, its live-streaming service whose viewership has grown during the pandemic.

Ad tech’s role in Amazon’s ad business

Advertisers and sellers often cite a lack of data and tools as challenges in advertising on Amazon, which has given rise to a cottage industry of firms that specialize in helping marketers navigate the site. Meanwhile, Amazon has pushed further into programmatic advertising with its OTT arm that sells ads in some Fire TV apps.

Ad measurement

Amazon has loads of data about how people shop and has offered advertisers more data to help buy and target ads. Still, advertisers say that Amazon’s data can be limited and continue to find new ways to measure ads.

Who runs Amazon’s ad business?

Amazon is notoriously secretive as a workplace. As Amazon’s advertising ambitions have grown, it’s cultivated a team of execs who pitch advertisers on its ad business.

They include several longtime Amazon employees, including Colleen Aubrey, who is part of Amazon’s executive suite. Amazon has also hired big names from ad agencies and brands over the past few years to build teams that work directly with advertisers.

How to get a job at Amazon

Amazon is consistently looking for advertising talent, but its heavy focus on culture makes it hard for outsiders to break into the company.

We talked to insiders about how to ace the interview process.

Read the original article on Business Insider

The ultimate guide to Amazon’s advertising business, which is $13 billion and growing

amazon advertising executive 2x1

Amazon’s e-commerce dominance is quickly expanding to advertising.

The pandemic has drastically cut ad budgets as marketers reign back their spending, but e-commerce advertising is booming as people shop more from home – with Amazon leading the pack.

EMarketer forecast that e-commerce advertising would rise 39% to $17.4 billion in the US in 2020, to represent 12% of digital ad spend. That growth has attracted Walmart, CVS, and Walgreens and other retailers that have joined Amazon in vying for a slice of the pie.

Here’s the latest on what we know about Amazon’s moves to grow its advertising business.

How big is advertising for Amazon?

Amazon made about $13.5 billion from advertising in the first three quarters of 2020, up from roughly $9.3 billion in the year-ago period.

While that amount is a tiny sliver of Amazon’s revenue from retail sales and Amazon Web Services, its cloud business, advertising is one of its fastest-growing areas. The tech giant continues to cut into advertisers’ search budgets that mostly go to Google.

The pandemic’s impact on Amazon

While advertisers have slashed TV and some digital budgets during the pandemic, Amazon’s advertising has grown as people do more of their shopping online. Amazon has also increased the advertising potential of Twitch, its live-streaming service whose viewership has grown during the pandemic.

Ad tech’s role in Amazon’s ad business

Advertisers and sellers often cite a lack of data and tools as challenges in advertising on Amazon, which has given rise to a cottage industry of firms that specialize in helping marketers navigate the site. Meanwhile, Amazon has pushed further into programmatic advertising with its OTT arm that sells ads in some Fire TV apps.

Ad measurement

Amazon has loads of data about how people shop and has offered advertisers more data to help buy and target ads. Still, advertisers say that Amazon’s data can be limited and continue to find new ways to measure ads.

Who runs Amazon’s ad business?

Amazon is notoriously secretive as a workplace. As Amazon’s advertising ambitions have grown, it’s cultivated a team of execs who pitch advertisers on its ad business.

They include several longtime Amazon employees, including Colleen Aubrey, who is part of Amazon’s executive suite. Amazon has also hired big names from ad agencies and brands over the past few years to build teams that work directly with advertisers.

How to get a job at Amazon

Amazon is consistently looking for advertising talent, but its heavy focus on culture makes it hard for outsiders to break into the company.

We talked to insiders about how to ace the interview process.

Read the original article on Business Insider

The CDC is reportedly eyeing a ‘promising’ partnership with Dollar General to bring vaccines to rural communities, and Target is expanding access to shots with in-store CVS clinics

dollar general
dollar general

  • The CDC is eyeing a potential partnership with Dollar General, USA Today reported.
  • Dollar General has locations within 10-15 miles of rural communities in 46 states, the CDC said.
  • Target is now offering vaccine doses through over 600 in-store CVS pharmacies in 17 states.
  • See more stories on Insider’s business page.

In the latest efforts to expand access to COVID-19 vaccines, the Centers for Disease Control and Prevention is reportedly looking a partnership with Dollar General to bring vaccines to rural communities, while Target and CVS are working together to expand the rollout in 17 states.

Target began providing vaccine doses on Wednesday in over 600 CVS pharmacies located inside its store locations, the company said in an emailed statement to Insider. Eligible people can find an appointment through CVS’s website.

Shots are available at store locations in Virginia, New York, Alabama, Texas, Louisiana, Arizona, Hawaii, Ohio, Florida, South Carolina, Maryland, Connecticut, Massachusetts, Rhode Island, New Jersey, California, and Pennsylvania, the retailer said in the statement.

Target added that, “as states open up vaccines for frontline and essential workers, we’ll work with CVS and others to offer vaccines to team members within our stores and distribution centers in the future.”

Separately, the CDC is looking into working with Dollar General to expand vaccine outreach to Americans in rural areas, USA Today reported on Tuesday.

“We’re exploring a promising collaboration with Dollar General stores, which have locations that include refrigeration capacity within 10 or 15 miles of our rural communities in all but four states,” CDC director Rochelle Walensky said Tuesday at Health Action Alliance’s National Business Summit, according to USA Today. Dollar General has over 17,000 stores in 46 states.

Dollar General did not immediate respond to Insider’s request for comment.

Dollar General was the first retailer to announce plans to pay workers to get vaccinated. In January, the discount store said it will offer all 157,000 employees four hours worth of pay if they get the vaccine.

In February, the White House announced that over 40,000 pharmacies nationwide are set to receive vaccine doses to give to eligible people for free per the rollout of the Federal Retail Pharmacy Program for COVID-19 Vaccination.

Last month, select CVS Pharmacy locations began offering around 570,000 COVID-19 vaccine doses in 17 states as part of the program. CVS administered over three million vaccines and 15 million COVID-19 tests nationwide by mid-February.

The pharmacy chains and retailers partnering with the government in vaccine distribution include Walgreens, Walmart, Rite Aid, Kroger, Publix, Costco, Albertsons, Hy-Vee, Meijer, and Winn-Dixie.

To date, 95.7 million vaccine doses have been provided to people in the US, according to Bloomberg’s COVID-19 tracker. An average of 2.17 million doses per day were administered this week, according to Bloomberg data.

Read the original article on Business Insider

Retail trade group slams Texas and Mississippi for lifting mask mandates, saying it puts workers at risk

masks stores
Joanne Millar store manger of Joules in Belfast places a sign in the shop window advising customers that face masks must be worn at all times as face coverings are now compulsory for shoppers.

  • Texas and Mississippi governors announced mask mandates will be lifted.
  • Retail trade group RILA opposes the moves and calls it a “premature victory celebration.”
  • Retail workers have had to enforce mask rules and risk dangerous confrontations in the last year.
  • Visit the Business section of Insider for more stories.

Texas Governor Greg Abbott just announced the lifting of the state’s mask mandate by an executive order effective on March 10. Mississippi Gov. Tate Reeves also announced that state mask mandates would be lifted and businesses would be allowed to operate at full capacity beginning March 3. The Retail Industry Leaders Association (RILA) has already opposed the move, Nathaniel Meyersohn at CNN reported.

RILA counts as members some of the biggest retailers in the country, including Target, Walmart, Lowes, Walgreens, and Dollar General.

“Relaxing common-sense safety protocols like wearing masks is a mistake. We are certainly supportive of governors re-opening their economies and giving beleaguered restaurants and other small businesses the opportunity to rebuild and rehire workers,” RILA Executive Vice President of Communications and State Affairs Jason Brewer told Insider in an email. “But going backwards on safety measures will unfairly put retail employees back in the role of enforcing guidelines still recommended by the CDC and other public health advocates. It could also jeopardize the safety of pharmacies and grocers that are gearing up as vaccination centers.”

Several RILA members are also vaccine distribution sites, including CVS and Wegmans. 

“Tremendous strides have been made in recent weeks lowering the rate of COVID-19 infections and vaccinating seniors and other vulnerable populations. We should not jeopardize this progress with a premature victory celebration,” Brewer said. 

Since the beginning of the pandemic, US retail workers have been tasked with the job of enforcing mask policies. Employees were left in the difficult position of not having official mask policies, or not being allowed to ask customers to mask up.

Some customers have refused to wear masks for political reasons, and encounters have even turned violent, with workers shot or assaulted for asking customers to wear masks. Of stores that did not let employees enforce mask rules, spokespeople cited concerns for employee safety.

Texas has the most COVID-19 hotspots of any US state, with 10 counties reporting more than 100 cases per 100,000 residents over the past week. Infection rate counts were artificially low in late February when a severe storm overtook much of the state, but numbers are starting to rebound.

Read the original article on Business Insider

CVS locations in these 17 states will get more vaccines this week

CVS pharmacy
  • CVS stores in Florida, Alabama, Arizona, Pennsylvania, Louisiana, and Ohio will now have vaccines available.
  • Around 570,000 COVID-19 vaccine doses will be distributed to CVS pharmacy locations.
  • Vaccine appointments for these doses will begin starting February 25.
  • Visit the Business section of Insider for more stories.

Select CVS Pharmacy locations will offer around 570,000 COVID-19 vaccine doses in 17 states including the newly added states of Florida, Alabama, Arizona, Pennsylvania, Louisiana, and Ohio, CVS Health said on Wednesday in a press release

Eligible people can book appointments starting February 24 for these doses with shots beginning February 25, the company said. The doses will be provided through the Federal Retail Pharmacy Program, a plan meant to increase access to the vaccine in which over 40,000 US pharmacies are set to receive vaccine doses to offer eligible people at no cost starting February 11. 

CVS has been offering vaccines on a limited basis in Ohio as it relied on state allocations, but now that the Federal Retail Pharmacy Program is activated in the state, the number of stores will increase as supply grows, a company spokesperson told Insider.

CVS Health’s in-store vaccine rollout initially began on February 12 in 11 states including California, Hawaii, Texas, South Carolina, Rhode Island, New York, New Jersey, Massachusetts, Connecticut, Maryland, and Virginia. CVS Pharmacy is able to administer from 20 million to 25 million shots per month, according to the press release.

The locations were selected based on a number of factors including the High SVI rank determined by the Centers for Disease Control and Prevention Social Vulnerability Index, population density, and demographics, according to CVS.

“Feedback on every aspect of the vaccination process has been incredibly positive, from the digital experience to interacting with our team of health care professionals,” said Karen S. Lynch, President, and CEO at CVS Health said in the press release. “We’re also making significant progress in reaching vulnerable communities, which will continue to be an essential part of our vaccination effort.”

The pharmaceutical company added it will expand in additional states as more supply becomes available. The spokesperson declined to share future expansion plans with Insider at the moment.

Last week, the drugstore chain said that it administered over three million COVID-19 vaccines and around 15 million COVID-19 tests nationwide.

Separately, Walgreens is set to receive a weekly allocation of over 480,000 vaccine doses starting February 25, the company announced last week. It also said that it provided over three million vaccinations across long-term facilities and vulnerable communities that are prioritized by the state.  

As part of the Federal Retail Pharmacy Program, Walgreens began in-store vaccinations in 17 states and administered about 180,000 doses of the first weekly vaccine allocation, the company said.

Read the original article on Business Insider

Farfetch plans to pour money into marketing as it takes on Amazon for online luxury shoppers

Good morning and welcome to Insider Advertising for February 2. I’m senior advertising reporter Lauren Johnson, and here’s what’s going on:

If this email was forwarded to you, sign up here for your daily insider’s guide to advertising and media.

Tips, comments, suggestions? Drop me a line at LJohnson@businessinsider.com or on Twitter at @LaurenJohnson.


farfetch
An image from Farfetch’s September 2020 ‘Open Doors to a World of Fashion’ ad campaign.

High-end fashion seller Farfetch is about to make a big marketing push as it takes on Amazon for luxury shoppers online

Read the story.


 

Amazon Web Services CEO Andy Jassy
Amazon Web Services CEO Andy Jassy

Andy Jassy could be the next CEO of Amazon. Insiders dish on what it’s like to work for Jeff Bezos’ likely successor who built AWS into a $40 billion business.

Read the story.


roz brewer profile 4x3
Roz Brewer.

New Walgreens chief Roz Brewer broke barriers to become the only Black female Fortune 500 CEO. Now she faces her toughest challenge yet: winning the vaccine-distribution race.

Read the story.


More stories we’re reading:

Thanks for reading and see you tomorrow! You can reach me in the meantime at LJohnson@businessinsider.com and subscribe to this daily email here.

Read the original article on Business Insider

What we know about vaccines and variants

Pills 2 (2)

Hello, 

Man, what an end to the week. The coronavirus variant first identified in South Africa was found in the US, and we got vaccine results from Novavax, and from Johnson & Johnson’s one-shot coronavirus vaccine.

We’ll get into all that and more, but first – new to our newsletter? You sign up here for daily dispatches from the healthcare team.

Also – we’re hiring another reporter for the team! Are you a journalist looking to dig deep on digital health, break news, and make sense of what’s ahead for the industry? Be sure to apply here!


vaccines
A pharmacist fills a syringe to prepare a dose of the Pfizer-BioNTech Covid-19 vaccine for front-line health care workers at a vaccination site at Torrance Memorial Medical Center on December 19, 2020 in Torrance, California.

We’re learning more about how vaccines work against variants

It’s been a mixed bag of vaccine news this week, kicking off with the news that Merck is dropping out of the race.

With the pharma giant tapping out, all eyes have been on the next wave of results, with more than 200 vaccines still in the works.

Andrew Dunn mapped out what the year ahead looks like for those candidates.

Read the full breakdown here>>

And as new, more infectious variants have emerged around the world, a big question has been around how they’ll interact with vaccines. 

On Monday, Moderna said that it is designing a new version of its COVID-19 shot to fight the variant first found in South Africa

Then on Thursday, Novavax shared results from its UK and South Africa trials, finding that its coronavirus vaccine was highly effective in the UK, but didn’t work nearly as well in South Africa, where a new variant is circulating widely.

The news was followed shortly after on Friday morning with the long-awaited results from Johnson & Johnson’s one-dose vaccine. The company said its vaccine is 66% effective against COVID-19 based on a global trial run in places including the US, Latin American and South Africa. 

The results – while not as high as Pfizer and Moderna’s – come with some big questions. For one, having only one dose could be a game-changer. J&J shared that its vaccine was 85% effective at preventing severe disease, across all variants, which would be a big help in curbing the pandemic. 

Read the full story here>>

J&J’s single-dose coronavirus vaccine is 66% effective against COVID-19, raising worries that some variants may lower protection


California COVID vaccine rollout Six Flags Magic Mountain
At a mass vaccination site set up in a California Six Flags, a nurse administers the COVID vaccine. The state has delivered 45% of its allotted vaccines, compared to North Dakota’s 84% and South Dakota’s 75%.

Vaccine rollout is going well – depending on what state you’re in

Meanwhile, Moderna and Pfizer/BioNTech’s shots are still rolling out across the US. In some places, usage has been better than others. 

On Capitol Hill, members of Congress have received shots, but essential Hill workers have not, Kimberly Leonard reports. 

Patricia Kelly Yeo spoke to experts in the Dakotas about how they’re approaching administering vaccines. For the more rural areas, having a centralized systems has been a big help.  

For states and cities with bigger populations, she found there are two big takeaways from North Dakota and South Dakota’s experiences. Collaboration is key, and so is keeping the rollout system centralized. 

Read the full story here>>

How the Dakotas are successfully rolling out COVID vaccines – and 2 major lessons for larger states


Rosalind Brewer
In March, Rosalind Brewer will become the third Black woman in modern history to lead a Fortune 500 company.

Walgreens has tapped a new CEO 

On Tuesday, The Wall Street Journal broke the news that Walgreens had found its next top exec.

Starbucks COO Roz Brewer is leaving the coffee giant to become Walgreens CEO. She’ll be the only Black woman leading a Fortune 500 company.

It’s a move most Wall Street analysts are cheering on, saying Walgreens “nailed” the choice for a successor to Stefano Pessina who will stay on as executive chairman. 

Shelby Livingston has a full look at what analysts think is ahead for the company with the pick. 

Read the full story here>>

‘Nailed it’: 4 Wall Street analysts lay out why Roz Brewer is the best pick to turn around Walgreens


Humana CEO Bruce Broussard
Humana CEO Bruce Broussard

A conversation with Humana CEO Bruce Broussard

Last Friday, Shelby had a chat with Humana CEO Bruce Broussard. 

Broussard told her about competing with some of the health-insurance startups taking on the red-hot Medicare Advantage market, like Oscar and Devoted. 

Humana for its part has its own answer: a new venture called Author. It launched in 2021 in South Carolina, and already has 15,000 members, Broussard told Shelby. 

Read the full scoop here>>

Speaking of the insurance upstarts, Shelby and the graphics team here at Insider took a closer look at Medicare Advantage enrollment heading into 2021. 

While health-insurance startups are gaining a bigger foothold in the lucrative Medicare Advantage market, they’re still no match for established insurers.

(It’s pretty striking to see the enrollment numbers for giants like UnitedHealthcare stacked next to some of the tiny younger players.)

As part of Shelby’s conversation with Broussard, they discussed what led Humana to invest heavily in primary care. The conversation turned into one about the future of health insurers, medicine, and Humana itself. 

Read the full story here>>

The CEO of major health insurer Humana laid out why he’s betting big on primary care


fitbit sense

The latest on Big Tech’s healthcare ambitions

Tech giants are keeping busy, as Blake Dodge has been reporting over the past few weeks. 

That’s especially the case for companies as part of the Alphabet umbrella. She and Alphabet reporter Hugh Langley teamed up over the past week on some dispatches from Google’s parent company. 

One of the pockets of the healthcare industry tech companies seem to be focused on is monitoring health at home. Blake mapped out how those strategies are playing out so far at Apple, Amazon, Verily, and Google (hint: it’s a lot of smart watches). 

Read the full story here>>

Big tech wants to monitor your health at home. From Verily to Amazon, here’s where they’re placing their bets.


insider events future of healthcare 2x1

Talking the future of digital health and biotech

Over in the land of startups and funding, things are always a-buzz. Here’s what you need to know.

With that all in mind, I wanted to let you know about an event Megan is moderating on February 10 at 3 p.m. ET. She’ll be talking to top healthcare VCs about the year ahead for startups trying to make a dent in the $3.8 trillion healthcare industry.

Tune in>>

SIGN UP HERE: Hear from healthcare’s biggest VCs on the future of digital health, biotech, and startups


I hope you all have great weekends! I’ll be spending mine outside, probably double-masking to stay extra safe. 

Tips? Feedback? Find me at lramsey@businessinsider.com. You can reach the entire healthcare team at healthcare@businessinsider.com

– Lydia

Read the original article on Business Insider

Starbucks COO Roz Brewer is leaving the coffee giant to become Walgreens CEO, and the only Black woman leading a Fortune 500 company

roz brewer starbucks
Starbucks COO Roz Brewer is leaving the coffee giant.

Starbucks chief operating officer Roz Brewer is stepping down from the role, the coffee giant announced on Tuesday. 

Brewer has accepted a chief executive role at “another publicly-traded company and will be leaving Starbucks at the end of February,” the company said in a press release. 

Walgreens Boots Alliance is set to announce that Brewer will be the new CEO of the company, the Wall Street Journal reports, citing people familiar with the matter. The Journal broke the news in the middle of Starbucks’ earnings call on Tuesday, with an analyst congratulating Brewer on the call. 

Brewer will replace CEO Stefano Pessina, who said in July that he would step down as the CEO of Walgreens when the company found a new chief executive. The company recently announced plans to build a 200-person internal technology startup.

Read more: Walgreens is teasing a 200-person in-house startup that aims to improve healthcare. Here’s what to know.

The new gig will make Brewer the only current Black female CEO of a Fortune 500 company. Only two Black women have led Fortune 500 companies: Ursula Burns, Xerox’s CEO from 2009 until 2016, and Mary Winston, who was the interim CEO of Bed Bath & Beyond for less than a year in 2019. 

Women currently hold 30, or 6%, of CEO positions at S&P 500 companies as of December 2020, according to Catalyst, a nonprofit research group focused on advancing women in leadership roles.

Brewer’s ascent is not only significant for women but for women of color, who are dramatically underrepresented in senior management levels, according to the latest “Women in the Workplace” report by McKinsey & Company. Between January 2015 and January 2020, representation of women in senior-vice-president positions grew from 23 to 28 percent, and representation in the C-suite grew from 17 to 21 percent, according to the report. Additionally, one in five C-suite leaders is a woman, and fewer than one in 30 is a woman of color.

Read more: How Dunkin’ stole Starbucks’ crown as king of social media in 2020 using TikTok stars, purple drinks, and coffee-scented candles

Starbucks and Walgreens did not immediately respond to Insider’s request for comment on Brewer’s reported new job.  

“Roz, on behalf of the entire leadership team, I want to thank you for your leadership and wish you every success in the new role,” Johnson said on a call with investors on Tuesday. 

According to Starbucks, the chief operating responsibilities “are being distributed to other members of the existing leadership team.” Johnson promised that the company would “not miss a beat” as others take on Brewer’s responsibilities. 

Brewer had a big impact at Starbucks in less than 4 years

Brewer is no stranger to being the top boss.

Prior to coming to Starbucks, she served as president and CEO of Walmart’s Sam’s Club division. At the time, she was the first woman and first Black woman to lead a division of Walmart. 

When Brewer started at Starbucks in late 2017, she was charged with rebooting sales in the US.

At a 2018 shareholder meeting, she outlined several initiatives to revive sales including expanding the brand’s food business, increasing the number of cold beverages, expanding the company’s digital footprint, and boosting delivery options.

Under her watch, Starbucks’ beloved happy hour changed a couple of times, causing some controversy. In 2018, fans could only access happy hour promotions via the Starbucks app, a move aimed at driving mobile sales. A year later, the coffee giant launched a more consistent happy hour on Thursdays. 

Brewer quickly became an influential executive at the coffee giant. In 2019, she was named to Nation’s Restaurant News Power List.

Brewer is one of two top executives leaving Starbucks in the near future. Starbucks announced earlier in January that chief financial officer Pat Grismer will retire on February 1, serving as an advisor to Johnson through May 2. 

There have been some murmurs that Brewer had the potential to succeed Johnson at Starbucks’ next CEO. Johnson is the successor of Howard Schultz, the chain’s long-time CEO who built the company into the international giant it is today.

Are you a Starbucks worker with a story to share? Email ktaylor@insider.com. 

Read the original article on Business Insider

Health officials slam Walgreens and CVS for ‘fiasco’ vaccine rollout to nursing homes

pfizer vaccine covid 19 nursing homes
Vera Leip, 88, receives a Pfizer-BioNtech COVID-19 vaccine at the John Knox Village Continuing Care Retirement Community on December 16, 2020 in Pompano Beach, Florida.

  • CVS and Walgreens have come under fire from health officials over the slow rollout of the COVID-19 vaccine to nursing homes, CNN reported.
  • As part of the federal government’s program to vaccinate elderly people in care, the two companies claim to be on track to get the first of the two-part dose done by January 25.
  • But health officials in many states have said the progress is poor, hampered by bureaucracy.
  • West Virginia, which opted out of the program, has made much faster progress by relying on its network of smaller pharmacies with good ties to the community, The Conversation reported.
  • CVS and Walgreens did not immediately respond to Insider’s request for comment. 
  • Visit Business Insider’s homepage for more stories.

CVS and Walgreens have come under fire from local officials for the slow rollout of their vaccinations program to nursing homes. 

As of January 14, around a quarter of the 4.7 million doses allocated to the companies had been administered CNN reported.

In statements to the network, the companies insisted they are still on track to have the first round of the two-phase vaccine completed by January 25.

But health officials in some states have said that the process has been frustratingly slow.

The director of one LA County chain of nursing homes, Dr. Karl Steinberg, told CNN: “It’s been so much worse than anybody expected. That light at the end of the tunnel is dim.”

Mississippi’s State Health Officer Dr Thomas Dobbs described the partnership between the pharmacy giants and the federal government as a “fiasco.”

President Donald Trump’s administration left the coordination of the vaccination’s overall rollout to states, as Insider’s Hilary Brueck reported

CVS and Walgreens became the sole contractors for vast chunks of the rollout under a deal announced by the Health and Human Services (HHS) department in October 2020. 

The companies’ name recognition and corporate heft is considered a boost to public trust in getting the vaccinations processed, as Business Insider’s Áine Cain, Irene Jiang, and Shelby Livingston reported

Without an overarching federal program for distribution, most states opted into the CVS-Walgreens partnership to get the vaccine into nursing homes. 

A January 6 company statement from CVS 6 said that the company is on track with its target, with incoming president Karen Lynch saying on January 15 that it had administered one million shots in nursing homes. In total, 1.7 million shots have been administered by CVS and Walgreens combined, The New York Times reported on January 16.

A spokesperson for CVS, Joe Goode, told CNN: “Everything has gone as planned, save for a few instances where we’ve been challenged or had difficulties making contact with long-term care facilities to schedule clinics.”

But it has been beset with problems, such as cumbersome bureaucracy and poorly-staffed centers, CNN reported. 

Speaking from Seattle, where Walgreens and CVS are administering the bulk of vaccines to care homes, NPR’s Will Stone said that nursing homes are “absolutely desperate to give out shots,” but they are “basically at the mercy of when CVS or Walgreens schedules them.”

Authorities that didn’t take up the partnership are moving much faster. West Virginia – a state that opted out of the program – is leading the country in the vaccine rollout to care homes, as the Associated Press reported

Care home vaccinations there started two weeks earlier than in most states, NPR reported.

Prof. Tinglong Dai, an operations specialist at Johns Hopkins University School of Nursing, writing for The Conversation, pointed out that the near-monopoly that CVS and Walgreens have gives them little reason to work faster. 

But in West Virginia, each care home is served by more than one pharmacy for the process, prompting more of a rush to reach out and organize the doses, he wrote. 

They also already have strong ties to the local community and its nursing homes, he wrote – an important factor in a process that requires explanation and consent with vulnerable people and their families. 

Krista Capehart, director of regulation for the state’s Board of Pharmacy, is leading the West Virginia distribution plan.

She told NPR: “When [the vaccine] got here, we already had pharmacies matched with long-term care facilities, so we were already ready to have vaccinators and pharmacists ready to go into those facilities and start providing first doses.”

On January 15, President-elect Joe Biden announced increased federal support for the process – which both Walgreens and CVS have welcomed. 

Lynch, the CVS executive, said in a statement that the federal assistance will enable the company to administer more than 1 million shots per day – vastly more than they have managed so far.

Neither company immediately responded to Insider’s request for comment. 

Read the original article on Business Insider

The biggest nursing home chain in the US is sounding off about a potentially messy COVID-19 vaccine rollout for seniors, as a patchwork of state vaccination plans emerges

pfizer vaccine distribution UK
A nurse prepares to inject staff with the Pfizer/BioNtech covid-19 vaccine at Bradley Manor residential care home in Belfast on December 9, 2020.

  • Under a federal program, pharmacy giants CVS Health and Walgreens will give COVID-19 vaccines to residents and staff at more than 50,000 long-term care facilities. 
  • Dr. Richard Feifer, chief medical officer of the country’s largest nursing home operator, Genesis HealthCare, sounded off about West Virginia’s decision to devise its own strategy for vaccinating long-term care facilities.
  • The adjutant general of the West Virginia National Guard and a leader in the state’s pandemic response said the federal program would limit West Virginia’s ability to vaccinate long-term care residents quickly.
  • CVS and Walgreens and preparing to vaccinate millions of vulnerable nursing home residents. The pharmacy chains said they would be ready to give shots at long-term care facilities within 48 hours of receiving Pfizer’s COVID-19 vaccine.
  • For more stories like this, sign up here for Business Insider’s daily healthcare newsletter.

The chief medical officer of the largest US nursing home operator, Genesis HealthCare, said the federal government’s decision to give states the final say in COVID-19 vaccination plans is complicating efforts to ensure the country’s most vulnerable people are vaccinated.

Dr. Richard Feifer, chief medical officer of Genesis, which operates more than 325 long-term care facilities in 24 states, said that while most states have agreed to allow pharmacy chains CVS Health and Walgreens to vaccinate their nursing home residents as part of a federal program, at least one state – West Virginia – is mulling its own strategy.

That could create problems for Kennett Square, Pennsylvania-based Genesis, which has 34 nursing homes in West Virginia. Nearly half of deaths from COVID-19 in the state are among nursing home residents.

“We’re concerned that they’re trying to reinvent the wheel and we don’t have time to waste,” Feifer said. “We’d much prefer fully leveraging the national model and we’re expressing those concerns in West Virginia.”

Residents and staff of long-term care facilities will be some of the first in the US to get a COVID-19 vaccine once it’s approved, a decision that’s expected to come in a matter of days for Pfizer and BioNTech’s vaccine. Large chain pharmacies CVS and Walgreens are preparing to vaccinate more than 50,000 of those facilities as part of the federal program, called the Pharmacy Partnership for Long-Term Care.

Long-term care facilities opted into that federal program, which is meant to relieve those facilities of the burden of storing the vaccines, giving the shots, and reporting vaccination data. But states ultimately decide where the first vaccines go and whether to stick with the federal government’s approach.

While state’s playbooks are evolving by the day and coronavirus vaccines have not yet gotten emergency clearance in the US, it’s clear that their strategies are diverging, creating a patchwork of vaccination plans across the country.

Inconsistent state approaches to managing the pandemic have complicated COVID-19 testing and efforts to source personal protective equipment, causing confusion and inefficiencies, Feifer said, adding that he worried variation among states would hinder efforts to vaccinate Americans quickly and end the pandemic.

“We have needed a more deliberate centralized model of managing the pandemic all along,” he said. “We can’t afford to make the same mistakes again around state-by-state variation.” 

Photo of Dr. Richard Feifer, chief medical officer of Genesis HealthCare
Dr. Richard Feifer, chief medical officer of nursing home operator Genesis HealthCare

West Virginia is developing its own plan for vaccinating long-term care residents that don’t rely on CVS or Walgreens, in hopes of doing it faster than the federal government

Maj. Gen. James Hoyer, the adjutant general of the West Virginia National Guard who is head of a task force leading the state’s pandemic response, told Business Insider that the state has decided to delay full implementation of the federal program to vaccinate nursing homes.

Instead, West Virginia is developing its own strategy to best fit its population. The state is prioritizing nursing home and assisted living residents and staff for the first vaccine shipments, along with healthcare workers that work with patients with COVID-19.

West Virginia placed an initial order to the US Centers for Disease Control and Prevention of 16,575 doses of the Pfizer vaccine.

Because many of the largely rural state’s pharmacies are not part of big chains, “we felt from a state perspective that we were limiting the ability to very rapidly, logistically distribute and administer vaccines to that population,” Hoyer said.

West Virginia’s goal is to vaccinate all nursing home and assisted-living residents and staff in less than 30 days of receiving the vaccines at five designated hospitals in the state. Hoyer said the state pharmacy board has put out a call to pharmacists in the state that want to participate in vaccinating the nursing homes.

Those pharmacies would include those that already have relationships with nursing homes or assisted-living facilities in their communities. They could include CVS and Walgreens.

“We believe that based on our primarily rural nature that pharmacies are going to be key to our distribution to our general citizen population, so this is helping us build the infrastructure long-term to vaccinate all West Virginians,” Hoyer said.

“We are using the approach that we think best fits us in West Virginia” he said. “I think everybody’s going to have a different approach based on idiosyncrasies and differences.”

Rebecca Snead, executive vice president and CEO of the National Alliance of State Pharmacy Associations, said there may be other states in addition to West Virginia that are opting out of or delaying implementation of the federal government’s program to vaccinate long-term care facilities. There will be variation not just among states, but also between each national partner and each facilities’ capacity and and requirements for t he clinics.

“Success will depend on meeting the needs of the individual facility, no matter if it is a federal partner or the state facilitating the vaccine distribution/administration,” Snead wrote in an email.

Read more: ‘This is game time’: Hospitals across the country are gearing up to give the first COVID-19 shots to millions of healthcare workers

Nursing home
FILE: A patient passes down the hall at St. Chretienne Retirement Residence in Massachusetts on August 26, 2020.

US officials said 36 states want vaccines shipped to long-term care facilities

The FDA could give emergency approval to a vaccine from drug company Pfizer within days. An expert panel is meeting Thursday to review the drug company’s application for emergency-use authorization.

A week later, it will review Moderna’s request for emergency approval of its vaccine. Bother require two doses given weeks apart.

US health officials have said millions of vaccines could be shipped out within 24 hours of one getting emergency approval. State governors and their health departments have been busy planning where COVID-19 vaccines will go.

Army Gen. Gustave Perna, who oversees the logistics of delivering COVID-19 vaccines to states, said during a media briefing Wednesday that 36 states had so far told the US Centers for Disease Control and Prevention that they want initial vaccines to ship to long-term care facilities.

North Carolina is one state relying on the federal government’s approach for vaccinating those facilities. Dr. Mandy Cohen, secretary of the NC Department of Health and Human Services, said during a media briefing Thursday that while vaccines for nursing homes will come out of the state’s vaccine allocation, Walgreens and CVS will be doing all the work of getting shots in arms.

Cohen said she expects the pharmacies to begin vaccinating long-term care facilities in the second week of the vaccine rollout, once the Moderna vaccine is authorized. Healthcare workers in contact with COVID-19 patients would be prioritized during the first week.

Most big long-term care companies are working with either CVS or Walgreens to vaccinate their residents and staff.  Signature HealthCare, which has 109 facilities in 10 states, is working with both CVS and Walgreens. Atria Senior Living, Sunrise Senior Living, Brookdale Senior Living are partnering with CVS.

Deaths in long-term care facilities, which include nursing homes, skilled nursing and assisted living facilities, account for 40% of all COVID-19 deaths in the US, though in some states that figure is much higher, according to the Kaiser Family Foundation.

Genesis, which reported $4.57 billion in revenue in 2019, chose to work with CVS to vaccinate its nursing homes in most states where it operates. But Feifer said it’s unclear if CVS would be able to vaccinate Genesis’ nursing homes in West Virginia, as that would require the state’s approval and “CVS supporting that outside of their direct contract with the CDC,” he said.

A spokesman for CVS said the company is unaware of any state opting out of the federal program, but said if a state were to opt out, CVS’ ability to vaccinate a long-term care facility in that state would depend on the state.

A CDC spokeswoman said that all states have opted into the federal pharmacy partnership for long-term care.

Read more: Pharmacies, doctor’s offices and hospitals are gearing up to give coronavirus vaccines to millions of Americans. Here’s how they’re preparing and how much they stand to profit along the way.

CVS and Walgreens will vaccinate at more than 50,000 long-term care facilities

Chris Cox, a senior vice president at CVS and the company’s liaison to Operation Warp Speed, said Friday that the pharmacy chain would vaccinate more than 30,000 long-term care facilities, which he estimated include roughly 3 million residents and staff.

The company is coordinating with the facilities while it waits for each state to decide where to send the first vaccines.

Walgreens, meanwhile, is planning to vaccinate more than 27,000 long-term care facilities, said Rina Shah, the pharmacy chain’s Group vice president of pharmacy operations and services.

Both CVS and Walgreens said they’ll be ready to give shots within 48 hours of receiving the vaccines at their designated hubs.

“When a vaccine is available, the state will let us know which are the priority groups within that population, and then we’ll begin the administration of those facilities,” Shah said.

A CDC committee recommended that states prioritize healthcare workers and nursing home residents for the first doses, but timelines could vary by state. Cox said the CDC is allowing states to “turn on” the federal program for all of long-term care, or they can start with vaccinating skilled-nursing facilities first and move to other facilities later.

Cox said some states may also choose to start vaccinating healthcare workers in hospitals before turning to long-term care facilities, for example. Others may opt to vaccinate long-term care settings right away.

Pfizer will ship its vaccines, which must be kept at a temperature of negative 70 degrees Celsius, directly to roughly 1,000 CVS pharmacies that are acting as “hubs.” Those hubs were chosen because of their proximity to the long-term care facilities that CVS will visit. Supply chain company McKesson will ship CVS the Moderna vaccines, which can be kept at regular freezer temperature.

Similarly, Walgreens will have vaccines shipped to certain stores that will then take the vaccine to long-term care facilities. Walgreens is working with the facilities now to understand how many patients and staff want vaccines ahead of setting up on-site clinics.

Cox said CVS intends to vaccinate all residents and staff in a single facility in one visit, rather than prioritizing who within the facility should be vaccinated if there’s limited supply. But if a state directs CVS to vaccinate all long-term care facilities, and there are limited vaccines, CVS plans to prioritize skilled-nursing facilities over other types of long-term care settings, as the patients are generally sicker. CVS will also take population size into account.


CVS will return to set up a second vaccine clinic a few weeks later to give the second dose, and will set up a third clinic for any new residents.

“We expect to get to all of them within three to four weeks of whenever the jurisdiction turns it on, so it’s not going to be a long wait for any of them,” Cox said.

Genesis’ Feifer said he’s concerned that vaccinating all nursing home staff on the same day could create staffing shortages if a large number of workers get side effects. Genesis has urged the federal government and CVS to consider staggering the vaccinations to reduce that risk.

The CVS spokesman said that for facilities concerned about staffing, CVS is willing to stagger dosing among its three clinics. Half the staff would receive the first dose on the pharmacy’s first visit, with the rest of the staff receiving it on the second visit, for example.

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