Analysis of the Federal and State Roles in the Immunization of Preschool Children

摘要

The goals of the project are to explain vaccine acquisition and distributionpolicies at the federal and state levels; to explore reimbursement policies for childhood vaccines, especially Medicaid policies; to describe how states use federally purchased vaccines to assist Medicaid and other providers; and to determine the barriers that limit access to vaccines. The project involved literature reviews, case studies of eight states and cities, and interviews with government officials, including those from the Centers for Disease Control (CDC) and Medicaid. First, the study finds that there are systemic barriers to immunization, such as clinics that offer vaccinations by appointment only or do not make the public aware that immunizations can be received free of charge. Second, there are no clearly defined rules for distributing CDC vaccine grants, and the responsibilities of the agencies and levels of government in charge of immunizing children are not well defined. Third, the most cost-effective way to provide public payment for vaccines for poor children may be a Medicaid vaccine replacement program that purchases vaccines at the low public-sector price and provides them to clinics for use on non-Medicaid poor children. Fourth, the supply of vaccines is adequate to meet the needs of the nation's children. Finally, many parents do not perceive that the benefits of immunization outweigh the costs.