How $4 Billion in NIH Funding Shaped COVID-19 Research

Author: University of Virginia Health System
Published: 7 Jun 2024 - Updated: 4 Nov 2026
Publication Details: Peer-Reviewed | Informative

Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content

Synopsis

This research from the University of Virginia School of Medicine, published as two peer-reviewed papers in Open Forum Infectious Diseases, used machine learning to analyze more than 14,600 publications from over 2,400 National Institutes of Health grants awarded between January 2020 and December 2021, worth more than $4 billion. The top topics were clinical trials and outcomes research, heart and lung damage from the virus, and transmission, with funding also covering vaccine hesitancy, distribution and health disparities. About half of the money went to five states, and most of the more than 1,800 clinical trial sites were in large cities. The findings matter for planning the next pandemic response, and for rural residents, people with disabilities and other groups who may be left out when research and trials cluster in urban centers.*

At a Glance

• 1 - Five states received about half of the emergency funding.
• 2 - Clinical trials and outcomes research made up the largest share of papers, at 8.5 percent.
• 3 - Preprints let scientists share early results quickly, but they have not been peer reviewed.
• 4 - The team urges similar studies of other funding sources such as private philanthropy and the Department of Defense.

Topic Definition

Preprint

A preprint is a complete scientific paper that researchers post publicly on an online server before it has been reviewed and accepted by a scientific journal. Preprints allow findings to be shared quickly and openly, which proved valuable during the COVID-19 pandemic, but because they have not yet been checked by independent experts, their results should be treated as preliminary and may change.

Overview

New University of Virginia School of Medicine research is shedding light on how federal funding helped scientists understand the COVID-19 virus, develop new treatments and deploy lifesaving vaccines in record time.

The UVA Health researchers used advanced "machine learning" - a form of artificial intelligence - to analyze the thousands of scientific publications that resulted from the National Institutes of Health's deployment of more than $4 billion to combat the pandemic. This analysis allowed the researchers to categorize the types of research the money supported and determine how and where the funding was used to launch clinical trials of treatments and vaccines.

"The COVID-19 pandemic presented an unprecedented public-health challenge. The scientific community needed to rapidly act to come up with solutions to not only combat the virus but understand how we can prevent something like this from happening again," said Taison D. Bell, MD, of UVA Health's Division of Pulmonary and Critical Care Medicine and Division of Infectious Diseases and International Health. "The NIH is the largest public funder of biomedical research, so we believe it was vital to study how $4 billion of NIH funding was allocated and used during the pandemic."

Acting Fast Amid the COVID-19 Pandemic

The UVA researchers used advanced tools they have developed over the last eight years to analyze more than 14,600 scientific publications funded by more than 2,400 federal grants awarded between January 2020 and December 2021. Most of the publications appeared in peer-reviewed scientific journals, but some appeared on what are known as "preprint servers." Preprint servers allow scientists to share their discoveries with their colleagues quickly, but, unlike peer-reviewed journals, the findings are not vetted by other scientists prior to publication.

UVA's machine-learning model determined that the top three research topics investigated by COVID-related publications were clinical trials and outcomes research (8.5% of papers), coronavirus-related heart and lung damage (7.3%), and COVID-19 transmission/epidemiology (7.2%). But scientists used the money to investigate not only science directly related to the virus itself, but also related areas such as vaccine hesitancy, effective vaccine distribution, health disparities and general virology (the study of viruses), the UVA researchers found.

Five states received approximately half of the $4 billion in emergency COVID-19 funding, the analysis reveals:

• North Carolina
• Washington
• New York
• California
• Massachusetts

Of the more than 1,800 clinical trial sites testing treatments and vaccines, most, unsurprisingly, were in major urban areas where COVID had stricken many people, the researchers found. (Clinical trials, in general, tend to take place in more urban areas where it is easier to recruit volunteers.)

The Importance of Preprints

In a new scientific paper outlining their findings, the UVA researchers note the rise of preprint servers during the pandemic:

"During the pandemic, this fast dissemination of basic science in preprint servers may have supported hypothesis generation and preliminary validation for groups to augment their research," they wrote.

"The higher proportion of cell/molecular studies in preprint servers indicates that researchers may have wanted to expedite access to highly valuable data early in the pandemic to foster further scientific inquiry and collaboration at the basic science level in areas such as SARS-CoV-2 transmission and vaccine development. There might also be an element of authors initially submitting to preprints if they believed their work could be subject to a long peer-review process because, perhaps, of a shortage of reviewers in their target journals during the pandemic."

The UVA researchers are urging additional research to do a deeper dive into what they found and to look at, for example, the results of other COVID funding sources, such as private philanthropy and the Department of Defense. By understanding how COVID research funding was used and the benefits it had, the country will be better prepared to respond to the next pandemic, they say.

"This work is the first to shed light on how billions of dollars in federal money were used to study and combat the COVID-19 pandemic," said researcher Ani Chandrabhatla. "The framework and software we developed to study NIH funding helped us understand where and how funding was deployed and, even more, what topics researchers were studying with that funding."

Findings Published

The researchers have published their findings in a pair of papers in the scientific journal Open Forum Infectious Diseases. The research team included Adishesh K. Narahari, Anirudha S. Chandrabhatla, Taylor M. Horgan, D. Chris Gist, Mark A. Lantieri, Paranjay D. Patel, Jeffrey M. Sturek, Claire L. Davis, Patrick E. H. Jackson and Taison D. Bell.

Frequently Asked Questions

NOTE: Researched FAQs by Disabled World (DW)

What is the National Institutes of Health?

The National Institutes of Health is the US government agency that conducts and funds medical research, made up of 27 institutes and centers focused on different diseases and areas of science.

How is peer review different from a preprint?

In peer review, independent experts check a study before a journal publishes it. A preprint is posted before that check, so its methods and conclusions have not yet been vetted.

Why are most clinical trials held in cities?

Large hospitals and research centers are mostly in cities, where it is easier to find staff, equipment and enough volunteers. This can make it harder for rural patients to take part.

Can people with disabilities take part in clinical trials?

Yes, many trials welcome people with disabilities, and researchers are encouraged to make studies accessible. Some trials still have rules that exclude people with certain conditions, so it is worth asking.

What is vaccine hesitancy?

Vaccine hesitancy is a delay in accepting or a refusal of vaccines despite their availability, often driven by concerns about safety, distrust or misinformation.

How were COVID-19 vaccines developed so quickly?

Years of earlier research on coronaviruses and mRNA technology, large public funding, overlapping trial phases and early manufacturing all helped speed development without skipping safety steps.

Where can I find studies funded by the NIH?

The NIH RePORTER database lists funded projects, and PubMed lists published research papers, many of which state their NIH funding.

What did NIH COVID-19 funding support beyond vaccines?

It also supported research on treatments, testing, long COVID, transmission, health disparities and the social effects of the pandemic.

Insights, Analysis, and Developments

Editorial Note: Public money paid for much of the science that brought COVID-19 vaccines and treatments to people in record time, and this analysis is one of the first attempts to trace where that money actually went. The concentration of funding and trial sites in a few states and big cities is a familiar pattern in research, but it matters because people who live far from those centers, including many disabled and older rural residents, have fewer chances to join trials or benefit early. The authors also show how preprints sped up sharing during the crisis while carrying the risk of unchecked results. Readers looking at pandemic-era research should check whether a study was later published in a peer-reviewed journal.*

Attribution/Source(s): This peer-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally issued as a press release by University of Virginia Health System and published on 7 Jun 2024. Last updated on 4 Nov 2026. This content may have been edited for style, clarity, or brevity.

* Editorial additions by Ian C. Langtree.