Financing Childhood Immunizations
Childhood immunizations remain as one of the most successful public health
interventions, but someone still must pay the bill. New vaccines, high
prices and costs for liability protection for manufactuers keep the cost of
immunizing the 11,000 babies born each day on the rise. Currently, it cost
more than $750 per child for private providers to buy the vaccines that are
included in the recommended childhood immunization schedule, which includes more
than 20 shots during the first two years of a child's life. The public
costs are less, but still cause concern.
Federal Programs
Federal funds pay for almost 90 percent of all publicly funded
vaccinations. The two sources of federal funds are:
Vaccines for Children Program (VFC) This program provides
free vaccines for children who are uninsured, Medicaid-eligible, underinsured
(if receiving immunizations in a federally qualified health center or rural
health clinic), Native American or Alaska Native. In 2003, the National
Immunization Program at the CDC awarded $975 million in VFC funds to state,
local and territorial public health agences for program operations and vaccine
purchase.
Section 317 is a federal program administered by the CDC and
provides grants to states and territories, commonwealth trusts, and several
cities for vaccine purchase and programs such as outreach and disease
surveillance.
State Programs
The majority of states depend primarily on federal resources to purchase
vaccines. jState funds purchased only five percent of the total pediatric
vaccine doses available in 2002. Federal programs do not cover all
children, so many states supplement these funds.
Universal Purchase: Nine states (Alaska, Idaho, Maine,
Massachusetts, New Hampshire, New Mexico, North Carolina, Rhode Island,
Washington), and the Virgin Islands have universal purchase policies hwere the
states or terrirory purchase all recommended vaccines for all hcildren,
includigng those who are fully insured. Five other states (Connecticut,
Nevada, NOrth Dakota, South Dakota and Vermont) purchase all recommended
vaccines for all children with the excpeiton of one or more vaccines. ONce
purchased, these vaccines are distributed to all publci and private providers,
who may charge an administration fee.
Insurance Mandates: At least 28 states and the District of Columbia require insurance companies to cover childhood immunizations. States vary on which immunizations are covered. Some require those vaccines recommended by the American Academy of Pediatrics or the Advisory Committee on Immunization Practices (ACIP). At least 13 states choose to include an immunization mandate as part of their "well-child" coverage. In this case, the requirement covers a wide variety of preventive services for children, which includes the recommended immunizations.
For more information:
National Immunization Program, Centers for
Disease Control and Prevention
Insurance Mandates
for Childhood Immunizations. (Available to legislators and legislative staff
only). For all others, this article is available for purchase by calling our
Publications Department at (303-364-7700).
Funding
Childhood Immunizations: An NCSL LegisBrief on how states are funding
childhood immunizations.
Vaccines for
Children: Investment in Immunizations Yields Big Dividends: NCSL State
Health Notes article on the federal Vaccines for Children (VFC)
program.
Childhood
Immunizations: States Tackle Costs, Education, Disparities: NCSL State
Health Notes article.
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