In 2000, the Institute of Medicine (IOM) produced a report Calling the Shots: Immunization Finance Policies and Practices (IOM, 2000a) that illustrated the uncertainties and instability of the public health infrastructure that supports U.S. immunization programs. The IOM report proposed several strategies to address these concerns and to strengthen the immunization infrastructure. In March 2002, a group of 50 health officials, public health experts, health care providers, health plan representatives, health care purchasers, and community leaders met at The National Academies in Washington, DC to explore the implications of the IOM findings and recommendations for the federal and state governments. Private health plans and business sector representatives also participated in the meeting to discuss their role in fostering high levels of immunization coverage. The one-day workshop was the fourth and last in a series of meetings organized by IOM with support from the CDC to foster informed discussions about future financing strategies for immunization and the public health infrastructure. This report of the Washington, DC workshop summarizes the findings of the IOM study, reviews the implementation of the IOM recommendations, and highlights continuing immunization finance challenges for the nation as a whole as well as state and local health departments.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON THE IMMUNIZATION FINANCE DISSEMINATION WORKSHOPS
• REVIEWERS
• ACKNOWLEDGMENTS
• Executive Summary
• Introduction
• A National Perspective on the Immunization System
  • THE NATIONAL IMMUNIZATION PARTNERSHIP
  • THE INSTITUTE OF MEDICINE STUDY
  • RESPONSE FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION
• Building the Immunization Infrastructure
  • STATE PERSPECTIVES
  • LOCAL PERSPECTIVES
  • NATIONAL SURVEY OF STATE-LEVEL IMMUNIZATION POLICIES, PROGRAMS, AND PRACTICES
  • CASE STUDY FINDINGS
• Private-Sector Roles in the National Immunization Partnership
  • IMMUNIZATION AND PEDIATRIC PRACTICE
  • HEALTH PLAN INCENTIVES FOR PROVIDERS
  • BUSINESS-SECTOR ROLES
• Unresolved Problems and Future Challenges
  • INCREASING VACCINE COSTS
  • CHANGING PARTNERSHIPS
  • IMMUNIZATION AND HEALTH SECURITY
  • SIMPLIFYING THE IMMUNIZATION SYSTEM
  • STABLE FUNDING
• Final Observations
• References
• Appendixes
  • A Workshop Agenda
  • B List of Workshop Participants
  • C Website Referrals

Support for this project was provided by the Centers for Disease Control and Prevention. The views presented in this report are those of the Institute of Medicine Committee on the Evaluation of Vaccine Purchase Financing in the United States and are not necessarily those of the funding agencies.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.