IOM Report Calls for Increased Funding for Immunizations

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Although vaccination rates are at record high levels, a recent study by the Institute of Medicine (IOM) raises concerns about the ability of state and local health departments to sustain vaccination rates with decreasing federal support for vaccination programs. Entitled Calling the Shots, the report calls for a $1.5 billion increase in funding during the next 5 years to strengthen the public health infrastructure that manages immunization. Without increased funding for strategic spending on immunization programs, the IOM contends that "the states will have difficulty in achieving the national goal of 90% coverage by year 2010 for completion of the childhood vaccination series for young children."

The IOM identifies three trends contributing to the fragility of the infrastructure underlying the national immunization system: 1) Rapid increases in vaccine research and production, 2) "increasing complexity of the health care services environment," and 3) reductions in federal immunization grants to the states. Additionally, the report states that the long-term maintenance of immunization records for the 11,000 US infants born each day is costly but essential to ensuring full coverage.

The report also notes that current government figures show continuing disparities in the vaccination levels for children living above and below the poverty line. Other challenges include low rates of vaccination for adults, racial and ethnic disparities in adult vaccination rates, and the occurrence of between 50,000 and 70,000 adult deaths and 300 child deaths from vaccine-preventable diseases.

In addition to increasing federal and state funding to strengthen the infrastructure for child and adult immunization, the IOM committee recommends improving the targeting and stability of federal immunization grants, increasing federal and state spending for vaccines (particularly for low-income, chronically ill adults and the underinsured), and developing consistent measures for monitoring the vaccination status of children and adults enrolled in public and private health insurance plans.

Institute of Medicine. 2000. Calling the Shots: Immunization Finance Policies and Practices. Washington, D.C.: National Academy Press. Available at by clicking the book icon on the left side of the screen.

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.