Childhood Immunization: Opportunities to Improve Immunization Rates at Lower Cost

GAO discussed state and federal efforts to improve the childhood immunization rate, focusing on: (1) methods for reducing Medicaid costs for immunizing children; and (2) strategies to ensure that all preschool children receive vaccinations. GAO noted that: (1) state Medicaid programs can save on vaccination costs if low-cost vaccines are made available to health care providers who administer vaccinations to poor children; (2) state and local health departments currently purchase low-cost vaccines through Centers for Disease Control (CDC) bulk-purchase contracts and distribute those vaccines to public health clinics; (3) nine states purchase vaccines through CDC contracts by running vaccine replacement programs that provide free vaccines to Medicaid providers; (4) Medicaid programs in 32 states could have saved $14.2 million had they acquired vaccines at the CDC contract price, rather than the private-sector price; (5) states could also achieve substantial savings by requiring the use of combined vaccines that provide protection against multiple diseases, rather than providing Medicaid reimbursement for individual injections of single-antigen vaccines, which provide protection against only one disease; (6) raising adequate funding for purchasing and distributing CDC contract vaccines to Medicaid providers has been a major barrier in establishing a vaccine replacement program; and (7) the median immunization rate for preschool children was 66 percent for those states with integrated tracking, outreach, and education systems, and 58 percent for states without such systems.