Calling the shots: immunization finance policies and practices

摘要: Federal, state, and private-sector investments in vaccine purchases immunization programs are lagging behind emerging opportunities to reduce the risks of vaccine-preventable disease. Although federal assistance states for data collection efforts rapidly expanded early part 1990s, significant cutbacks have occurred last 5 years that reduced size state grant awards by more than 50% from their highest point. During this same period, delivery system children adults has become complex fragmented. This combination new challenges resources led instability public health infrastructure supports U. S. system. Many scale currently lack adequate strength areas such as among at-risk populations, strategic planning, program coordination, assessment status communities served multiple care providers. If unmet needs not identified addressed, will difficulty achieving national goal 90% coverage year 2010 completion childhood series young children. Furthermore, rates, which reached record levels vaccines widespread use (79%, 1998), can be expected decline preventable disease outbreaks may occur a result, particularly persons who vulnerable because underimmunization status. The Institute Medicine (IOM) Committee on Immunization Finance Policies Practices therefore concluded renewal strengthening partnership is necessary. renewed prevent infectious disease; monitor, sustain, improve rates child adult populations within numerous increasingly diversified settings; respond vaccine-safety concerns. To achieve renewal, require consistent strategy, additional funds, multiyear finance plan help expedite vaccines; strengthen assessment, assurance, policy development functions each state; adapt serve age groups (especially with chronic diseases) different environments. IOM committee recommends governments adopt strategy would allocate $1.5 billion over first immunization-an annual increase $175 million current spending levels. These consist $200 per grants awarded Centers Disease Control Prevention (the Section 317 program) an $100 increased contributions. also Congress replace discretionary formula approach targeting stability grants. should provide base level support all states, well amounts related state's need, capacity, performance. further introduce match requirement receipt funds stabilize long-term efforts. (ABSTRACT TRUNCATED)