Findings from case studies of state and local immunization programs.

Area of Science:

• Public Health Policy
• Health Services Research
• Immunization Programs

Background:

• The Institute of Medicine (IOM) examined federal support for immunization services over the past decade.
• Eight state case studies and a two-county study in California reviewed the use of Section 317 grants.
• Section 317 grants support vaccine purchase and immunization program activities.

Purpose of the Study:

• To assess the impact of federal Section 317 grants on state and local immunization programs.
• To understand the evolving role of immunization infrastructure.
• To identify challenges and opportunities for strategic planning in immunization services.

Main Methods:

• Case studies involving interviews with health officials and analysis of administrative records.
• Site visits to local health departments in selected cities.
• Review of secondary sources on state-level trends and background factors.

Main Results:

• Immunization infrastructure is shifting from service delivery to broader roles like registries and coordination.
• Service delivery is increasingly managed by the private sector.
• Declining federal Section 317 support forces difficult choices between existing and new activities.

Conclusions:

• Immunization programs are integral to local healthcare systems.
• Unstable Section 317 grant funding impedes optimal strategic planning and state/local investment.
• Public health agencies' primary role is shifting to ensuring lifelong immunization, requiring adequate resources and collaboration.