VFC Childhood Vaccine Supply Policy

The Omnibus Budget Reconciliation Act (OBRA) created the Vaccines for Children (VFC) program as Section 1928 of the Social Security Act on August 10, 1993. As an entitlement program, the Office of Management and Budget approves funding for the VFC program. Funding is through the Centers for Medicare and Medicaid Services (CMS) to the Centers for Disease Control and Prevention (CDC) with awards made to eligible grantees.

The VFC program, which operationally began October 1, 1994, represents an unprecedented approach to improving vaccine availability nationwide by providing vaccine at no cost to VFC-eligible children through enrolled public and private providers.

For further details on the specific legislation and the associated Congressional "Statement of Managers" can be found in Part IV- Immunizations, Sec. 13631: "Medicaid Pediatric Immunization Provisions" of the Omnibus Budget Reconciliation Act.

The legislation provides general guidance for VFC program policy development, including eligibility, provider recruitment, and considerations for negotiating contracts with manufacturers.

Highlights

The VFC program:

• provides public purchased vaccine, for eligible children, at no charge to VFC enrolled public and private providers in all states, the Commonwealth of Puerto Rico, the Virgin Islands, American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands;
• automatically covers vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) and approved by the CDC;
• saves parents and enrolled providers out-of-pocket expenses for vaccine;
• provides cost savings to states by bulk purchase of vaccine through CDC's contracts at lower prices while eliminating state-to-state variations in price;
• eliminates or reduces vaccine cost as a barrier to vaccinating eligible children;
• discourages the practice of referring children from the private sector to the public sector for vaccination, keeping children in their medical home for comprehensive health care.

The policies and procedures are based on the premise that the VFC program should:

• keep provider enrollment, patient access and administrative accountability procedures simple by keeping forms, record keeping and other documentation to a minimum, while maintaining necessary requirements for vaccine accountability and program evaluation;
• integrate the VFC activities into existing immunization projects and systems;
• promote maximum participation by private providers and cooperation between the public and private health care sectors;
• promote close coordination among public agencies, including State Health Departments and State Medicaid programs, and programs serving families and children.

The VFC program allows enrolled private providers to receive publicly purchased vaccine. By eliminating cost as a barrier to vaccinating children and providing opportunities for vaccinations at many health provider locations, the VFC program supports improved immunization coverage levels among eligible children. The goal is to ensure that no VFC-eligible child contracts a vaccine-preventable disease because of his or her parent's inability to pay for the vaccine or its administration.

Coordination

The National Center for Immunization and Respiratory Diseases (NCIRD) (previously known as NIP) at CDC is responsible for policy development, operational oversight, and the provision of technical assistance to projects for the VFC program. State/project health department immunization programs manage the VFC program at the State and local levels. Successful implementation of this program requires close collaboration and participation by a variety of programs and agencies including:

• The Centers for Medicare and Medicaid Services (CMS) - State Medicaid Programs
• Health Resources and Services Administration (HRSA)
• Indian Health Services (IHS)
• Association of State and Territorial Health Officials
• Association of Immunization Program Managers
• National, State, and local organizations representing the private health care sector;
• Maternal and Child Health programs
• Women, Infants and Children (WIC) program
• State Children's Health Insurance program (SCHIP)
• Managed care and national and state health care organizations

Policies are formulated after close consultation with CMS's Medicaid program, public and private health care organizations, and vaccine manufacturers.

Active involvement by the Medicaid program is particularly essential because a majority of VFC-eligible children are also eligible for Medicaid, and the Medicaid staff has extensive experience in providing preventive care through programs such as the Early and Periodic Screening Diagnostic, and Treatment (EPSDT) program. State and local health departments and Medicaid agencies are pivotal in recruiting private physicians for the program, and informing parents and guardians of eligible children that vaccines are available through the VFC program.

The WIC, Maternal and Child Health (MCH) programs, and the federally qualified health centers operating within the Health Resources and Services Administration's (HRSA) Bureau of Primary Health Care (BPHC) also have extensive contact with families whose children may be eligible for the VFC program and are therefore gateways to children's access into the program.

The requirements and procedures of the Vaccines for Children Program are applicable to all State, City, and Territorial immunization projects.

As policy changes occur, Immunization Program Managers and VFC Coordinators in each project will be notified via all mechanisms of communication, including updating of this website.

Program managers are encouraged to routinely share this information with representatives of State Medicaid agencies.

Management Surveys

The data provided via these links are extracted from various VFC Management Surveys.

• CY 2009 Posted Oct 2010
• CY 2008
• CY 2007
• CY 2006
• CY 2005
  also available as slide Vaccine Supply Policy CY 2005 [PPT, 1 slide]