Health Center COVID-19 Vaccine Program (HCVP) After-Action Survey

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

HCVP After Action Survey Questions 4 1 22

Health Center COVID-19 Vaccine Program (HCVP) After-Action Survey

OMB: 0915-0212

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Health Center COVID-19 Vaccine Program

After Action – Survey Questions

Last updated 4/11/22

The Health Center COVID-19 Vaccine Program (HCVP) was developed to further ensure the equitable distribution of COVID-19 vaccines in the nation’s underserved communities and those disproportionately affected by COVID-19. Since the launch of this program, health centers have held nearly 60,000 community-based vaccination events in partnership with local community-based organizations, including schools, community centers, faith-based organizations, and have used mobile vans to bring vaccines to the community. The majority of doses administered by health centers have been provided to individuals from racial and ethnic minority populations. HRSA recognizes and appreciates the diligence of health centers in undertaking these efforts during the public health emergency and working to meet the goals of the HCVP.

HRSA is dedicated to capturing lessons learned from the work already completed by the HCVP in order to use the information for ongoing work in the HCVP and other HRSA Health Center COVID-19 Response Programs and to plan for any future public health emergencies.

You are receiving this survey because you are a key stakeholder in HRSA’s COVID-19 public health emergency response. This includes: health centers, Primary Care Associations, Health Center Controlled Networks, and National Training and Technical Assistance Partners. We would like to understand your particular experience with the Health Center COVID-19 Vaccine Program. The HRSA Bureau of Primary Health Care (BPHC) will use this information to inform future public health emergency response and programmatic planning where appropriate.

We request your response by [insert deadline]. If you have further questions, please submit a ticket to the Health Center Program Support or call 877-464-4772. 8 a.m. to 8 p.m. ET, Monday - Friday (except federal holidays).

[Platform for deployment: Salesforce Online Community]

[Timeline: late April 2022]


[Survey Questions]

  1. All - Please select your organization type: [required; select one]

    1. Health center or health center look alike

    2. Primary Care Association

    3. National Training and Technical Assistance Partner

    4. Health Center Controlled Network

  2. All - Did the HCVP help your health center (your organization) increase equitable access to COVID-19 vaccines? Yes/No, if no – why not and if yes, how so? [open field response box]

  3. Health Centers ONLY - In addition to the direct supply of vaccines, what other aspects of the HCVP did you find helpful?

    1. National coordination with public health systems

    2. Response and Technical Assistance

    3. Communication and information on medical response policies, processes, and activities

    4. Data informed decision-making

    5. Other: [text response box]

  4. Health Centers ONLY - Did the HCVP support new or strengthened collaborations with public health and community partners? Yes/No, if no – why not and if yes, how so? [open field response box]

  5. PCAs/HCCNs/NTTAPs ONLY - In addition to the direct supply of vaccines to health centers, what other aspects of the HCVP did you find helpful?

    1. National coordination with public health systems

    2. Response and Technical Assistance

    3. Communication and information on medical response policies, processes, and activities

    4. Data informed decision-making

    5. Other: [text response box]

  6. PCAs/HCCNs/NTTAPs ONLY - Did the HCVP support new or strengthened collaborations with public health and state/national partners? Yes/No, if no – why not and if yes, how so? [open field response box]

  7. PCAs/HCCNs/NTTAPs ONLY- Are there changes the HRSA Bureau of Primary Health Care should consider that would facilitate your ability to respond to future public health emergencies? Yes/No, if Yes, please share why you selected Yes. [required, open field comment]

  8. All - If you would like to provide HRSA with any additional information that is not already captured in the questions/responses above regarding the HCVP and/or HRSA BPHC support for planning for future public health emergencies, include here: [open field comment box]. 


[Include ‘Thank You ’ Submission Confirmation page using the message below]

Thank you! HRSA has received your submission. If you have further questions, please submit a ticket to the Health Center Program Support or call 877-464-4772. 8 a.m. to 8 p.m. ET, Monday - Friday (except federal holidays).

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorLe, Xuan (HRSA)
File Modified0000-00-00
File Created2023-12-15

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