Number, cost of vaccines spur budget dilemma

Several states are asking insurers to pay for children they cover and investigating alternate financing strategies.

By Victoria Stagg Elliott, AMNews staff. Nov. 5, 2007.

As of Jan. 1, 2008, the North Dakota Dept. of Health will stop struggling to pay for many of the vaccinations for all the state's children and adolescents. The recommended list has gotten too long and too expensive, so officials are now asking insurance companies to pay to immunize the children on their rolls. If it is a covered service, they will be billed.

"When we gathered information on who was receiving vaccines, we discovered that nearly all '317 funds' (a Centers for Disease Control and Prevention immunization grant) were subsidizing insurance companies. That didn't seem to be right," said State Health Officer Terry Dwelle, MD, MPH.

Public health officials appreciate the opportunity to prevent more disease, but paying the tab for an ever-expanding childhood and adolescent vaccination schedule has become a significant challenge. It was also a focus of the first National Immunization Congress organized by the American Medical Association and the American Academy of Pediatrics earlier this year.

AMA policies support increased federal funding for vaccine purchase, the establishment of a national immunization strategy and encouraging health insurers to pay for this preventive service.

Uninsured children can get their shots through the federal Vaccines for Children Program, but more than half of states use other federal funds to attempt to do more. They use this money to broaden access to immunizations to those who do not fully qualify for this program, such as those whose insurance doesn't cover vaccines. A handful of states also attempt to give vaccines to all children to simplify administration, but this bill has become extremely hefty for many of these jurisdictions.