Vaccination Paper

Vaccine manufacturers are central stakeholders in the US immunization enterprise. Because vaccine development is a complex, lengthy, costly process, manufacturers rely on the ability to price vaccines to produce positive returns on their investment and to invest those returns, in part, in research on and development of new vaccines. After licensure by the Food and Drug Administration, vaccines are purchased and delivered through a mixed public/private-sector system (DiMasi, 2003, 151-185). Immunizations for most children and adolescents through 18 years of age in the United States are covered by commercial private insurance or the public sector Vaccines for Children (VFC) program. VFC is an entitlement for children through age 18 who are served by Medicaid, who are without health insurance, or who are American Indian/Alaska Native. Under VFC, vaccines are provided to VFC providers free of charge and are administered without cost to the patient. Medicaid provides an administration fee to providers who serve Medicaid-enrolled children in VFC (www.alternative-doctor.com). Although providers can request payment for vaccine administration for VFC patients who are not enrolled in Medicaid, VFC vaccines legally cannot be withheld because of inability to pay an administration fee (DiMasi, 2003, 151-185). Although most US children and adolescents have immunization benefits through public or private insurance, not all have coverage for all vaccines (www.alternative-doctor.com).

Underinsured children are children who are enrolled in and entitled to benefits under a health insurance plan but for whom benefits are not available with respect to the cost of 1 vaccine. Children whose insurance covers only selected vaccines are considered underinsured with respect to the vaccines not covered and are VFC-eligible for those no covered vaccines only. Children whose insurance caps coverage for vaccines at a certain amount is considered underinsured once that amount is reached. In the private sector, children with commercial health insurance may be enrolled in plans that do not cover all recommended vaccines. In the public sector, VFC provides vaccines to underinsured children only at federally qualified health centers and rural health clinics, which have limited capacity and geographic reach. Many states attempt to address the underinsured gap through state funding and federal funding through the Section 317 grant program to the states; however, such funds are discretionary and have not kept pace with the costs of new vaccines (www.medicalnewstoday.com).

In 1995, the federal contract price to vaccinate a child fully through age 18 was $22.In 2008, the vaccine for human papillomavirus became available and was recommended for use for girls. Including human papillomavirus vaccine, the cost to vaccinate a child through age 18 in 2008 was $1105 for boys and $1407 for girls. This represents 396% and 531% increases from 1995 for boys and girls, respectively (www.medicalnewstoday.com). These increases are attributable in part to the greater number of vaccines on the routine schedule and to the higher prices of newer vaccines (www.time.com).

These increased costs have raised concerns about the ability to provide vaccines to all children through both public-sector and private-sector delivery systems, particularly because private sector providers have asserted that the ...