Preliminary Considerations Regarding Federal Investments in Vaccine Purchase and Immunization Services: Interim Report on Immunization Finance Policies and Practices
SUMMARY
Immunization provides valuable individual protection and an essential community benefit by preventing serious disease. Even high levels of primary care, however, do not guarantee that individuals are immunized. Building and sustaining an effective delivery system that can uniformly and consistently achieve high levels of immunization coverage (> 90 percent) for increasing numbers of vaccines presents both clinical challenges as well as complex management tasks. Finance strategies to address this challenge must constantly adapt to new scientific developments; changes in social, health, and economic conditions (including population migrations); and shifting roles in the balance of federal, state, and local responsibilities in the administration of health care systems.
The Institute of Medicine (IOM) has been asked by the U.S. Senate Appropriations Committee to examine the nature and cost of the federal role in supporting a national immunization policy. The IOM study, to be completed in May 2000, will review the impact of federal funds on immunization rates and will eventually recommend an appropriate level of future federal investment in achieving national immunization goals, especially in the area of infrastructure support beyond vaccine purchase and delivery. As part of this effort, the committee has been asked by the Centers for Disease Control and Prevention (the study sponsor) to address two specific concerns in an interim report: ( 1) the experience with carryover (unobligated funds) in the administration of the Section 317 program; and (2) the impact of the new Children 's Health Insurance Program on the need for federal Section 317 funds for both core function initiatives and vaccine purchase.
During the past decade Congress has reconfigured the federal involvement in national immunization policy through a series of initiatives focused on two objectives: (1) the improvement of vaccine purchase and delivery systems for disadvantaged children, and (2) the strengthening of infrastructure efforts in areas such as disease surveillance, public education, information management, public–private sector collaboration, and performance assessment. As a result of these initiatives, federal funding went through a major and rapid
