The impact of the vaccine for children's program on child immunization delivery. A policy analysis.

The Vaccine for Children (VFC) program was proposed as part of President Clinton's 1993 Childhood Immunization Initiative. It is a federal vaccine-financing program that pays for and distributes free vaccine to providers serving 4 classes of children: (1) Medicaid insured, (2) uninsured, (3) children with private insurance that does not cover immunizations, and (4) American Indian and Alaskan Native children. Despite support from major professional organizations, the VFC program has come under intense criticism, with critics arguing that the cost of vaccines is not a major barrier to immunization receipt. In this article, we analyze how the VFC program will influence the receipt of immunizations by children under different child health care delivery and financing systems. We conclude that the impact of VFC on access to immunizations will be uneven; however, VFC could significantly improve access to immunizations for the over one third of US children who are either uninsured or covered under Medicaid fee for service. With further augmentations and refinements, VFC could be fashioned to overcome significant and persistent barriers to the timely delivery of immunizations in our disjointed child health financing and delivery systems.