National Academies Press: OpenBook

Financing Vaccines in the 21st Century: Assuring Access and Availability (2004)

Chapter:Appendix C: Survey of State Vaccine Finace Practices

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Suggested Citation:"Appendix C: Survey of State Vaccine Finace Practices." Institute of Medicine. 2004. Financing Vaccines in the 21st Century: Assuring Access and Availability. Washington, DC: The National Academies Press. doi: 10.17226/10782.
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Page239
Suggested Citation:"Appendix C: Survey of State Vaccine Finace Practices." Institute of Medicine. 2004. Financing Vaccines in the 21st Century: Assuring Access and Availability. Washington, DC: The National Academies Press. doi: 10.17226/10782.
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Page240

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Appendix C Survey of State Vaccine Finance Practices In 2001, the IOM Committee on the Evaluation of Vaccine Purchase Financing in the United States commissioned a survey from Dr. Gary Freed and his colleagues at the Division of General Pediatrics, University of Michigan. The purpose of this survey was to describe how state health departments finance, purchase, and distribute vaccines; address vaccine shortages; regulate immunization insurance benefits; and allocate scarce resources among vaccine purchase, delivery, and infrastructure invest- ment. This survey was a follow-up to a prior survey of state immuniza- tion program practices regarding the scope, structure, financing, and op- eration of state immunization efforts, conducted by Dr. Freed for an earlier IOM committee (Freed et al., 2000~. The University of Michigan team contacted immunization program managers and project directors of the 50 states and the District of Colum- bia. Interviews were conducted via telephone and mail during the sum- mer of 2002 and were completed by 48 states. The CDC National Immuni- zation Program provided the names of immunization program managers and project directors in each state, and the IOM sent each a cover letter explaining the nature of the survey interview. CDC also provided state- level background information and documentation, such as copies of grant awards and site visit data. Topics addressed in the interviews included the following: · Breakdown of funds from VFC, Section 317, state, and any other resources used for vaccine purchase overall 239

240 FINANCING VACCINES IN THE 21ST CENTURY · Changes to the current system of vaccine financing or any new vac- cine financing strategies · Estimates of annual needs for public-sector purchase each year for the child, adolescent, and adult populations · Adequacy of VFC funding · Process by which vaccines are ordered from the federal contract · Purchases of vaccines outside the federal contract · Distribution to providers and provider choice for publicly pur- chased vaccines · Stockpiles and shortages The report on the survey, State-Level Perspectives on Vaccine Purchase Financing, is available through the IOM's public record file.

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The national immunization system has achieved high levels of immunization, particularly for children. However, this system faces difficult challenges for the future. Significant disparities remain in assuring access to recommended vaccines across geographic and demographic populations. These disparities result, in part, from fragmented public–private financing in which a large number of children and adults face limited access to immunization services. Access for adults lags well behind that of children, and rates of immunizations for those who are especially vulnerable because of chronic health conditions such as diabetes or heart and lung disease, remain low.

Financing Vaccines in the 21st Century: Assuring Access and Availability addresses these challenges by proposing new strategies for assuring access to vaccines and sustaining the supply of current and future vaccines. The book recommends changes to the Advisory Committee on Immunization Practices (ACIP)-the entity that currently recommends vaccines-and calls for a series of public meetings, a post-implementation evaluation study, and development of a research agenda to facilitate implementation of the plan.

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