Vaccines for Children:

Reexamination of Program Goals and Implementation Needed to Ensure Vaccination

PEMD-95-22: Published: Jun 15, 1995. Publicly Released: Jun 15, 1995.

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Pursuant to a congressional request, GAO reviewed vaccine delivery to children, focusing on: (1) implementation of the Vaccines For Children (VFC) Program; (2) evidence that vaccine cost has prevented children from being immunized on time; and (3) options for improving vaccine delivery.

GAO found that: (1) the cost to parents of vaccines has not been a major barrier to children's timely immunization; (2) immunization rates for preschool children before the VFC Program were at or near the 90-percent national goals; (3) VFC implementation remains incomplete in six of the seven critical areas, including provider enrollment, provider reimbursement policy, order processing and automation arrangements, vaccine distribution systems, accountability provisions, and evaluation planning; (4) the Centers for Disease Control and Prevention (CDC) cannot ensure that VFC will reach high-risk populations; (5) CDC-funded studies have shown promise for improving immunization rates by coordinating immunization services with large public programs such as the Special Supplemental Food Program for Women, Infants, and Children and Aid to Families with Dependent Children Program; and (6) research has linked improved immunization with provider-based strategies, such as assessing clinic immunization practices, obtaining feedback, and implementing recall systems, which can reduce the number of missed opportunities for immunization.

Matters for Congressional Consideration

  1. Status: Closed - Implemented

    Comments: House and Senate bills call for the discontinuation of the program.

    Matter: Congress may wish to consider refocusing VFC's goal from the improvement of general immunization rates to the achievement of higher immunization rates in pockets of need, where conditions are ripe for disease outbreaks among underimmunized children.

  2. Status: Closed - Not Implemented

    Comments: No action has been taken.

    Matter: In conjunction, Congress may wish to adjust enrollment, accountability, automation, and evaluation efforts to focus on children who are at greatest risk for delayed immunization.


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