Vaccines for Children:

Critical Issues in Design and Implementation

PEMD-94-28: Published: Jul 18, 1994. Publicly Released: Jul 19, 1994.

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Pursuant to a congressional request, GAO reviewed the Centers for Disease Control's (CDC) implementation plans for the Vaccines for Children (VFC) Program, focusing on: (1) how CDC plans to implement the VFC Program; and (2) the likelihood that CDC will meet its program goals.

GAO found that: (1) as of July 5, 1994, only 4 of the 15 contracts with vaccine manufacturers had been awarded; (2) as of June 28, 1994, only 5 of the immunization projects surveyed had mailed VFC enrollment forms to potential vaccine providers; (3) although VFC provides for free vaccines, providers may charge administration fees; (4) to ensure physician participation, CDC has established a maximum administration fee schedule for vaccine providers based on physicians' prevailing charges; (5) the CDC pay schedule appears to be inconsistent with VFC goals and could impose a financial burden on some VFC recipients; (6) although CDC arrangements for training state staff in the use of vaccine-ordering software appear to be on schedule, some states have not yet hired or selected the staff who will be using the software; (7) CDC did not conduct a systematic review of private distribution options before choosing the General Services Administration (GSA) for vaccine distribution services; (8) states bear primary responsibility for developing mechanisms to ensure accountability for federally-purchased vaccines; (9) CDC does not have an evaluation plan to assess the cost and effectiveness of the VFC Program; (10) CDC has failed to ensure that the components of the program are properly integrated; and (11) CDC needs to take overall responsibility for ensuring that the vaccine is distributed in a timely manner.

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