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Introduction
Pages 2-4

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From page 2...
... The implementation of the state Children's Health Insurance Program is in its early stages. Although the Cow program may bring larger numbers of disadvantaged children into the private primary care system for immunization services, it is too soon to determine the impact of this program on immunization coverage rates or the need for stand-alone vaccination services for uninsured children in the public sector.
From page 3...
... At the request of the U.S. Senate Appropriations Committee, the Institute of Medicine's Committee on Immunization Finance Policies and Practices is examining the nature and cost of the federal role in supporting a national immunization po~icy.3 The TOM study will review the impact of federal funds on immunization rates and will eventually recommend an appropriate level of future federal investment in achieving national immumzation goals, especially in the area of infrastructure support, which represents the set of diverse services and systems separate from vaccine purchase and delive~.4 In this interim report, the committee has been asked by CDC to examine two specific concerns regarding Section 317 of the Public Health Services Act, which provides federal Ends to the states for vaccines and immunization infrastructure efforts: the experience with carryover (unobligated funds)
From page 4...
... Our nation's inununization program originated in 1955, when Congress appropriated fiends to help states and local communities buy and administer the recently licensed inactivated polio vaccine. The adoption of the Vaccination Assistance Act in 1962, along with other policy changes, institutionalized a federal role in the area of childhood immunization and expanded this role to include vaccines against diphtheria, pertussis, tetanus, and measles as well as polio.5 In the late 1970s, the Carter Administration launched the Childhood Immunization Initiative consisting of new legislation, large public education programs, and support for the creation and enforcement of school entry immunization requirements.


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