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Findings from case studies of state and local immunization programs.

G Fairbrother1, H Kuttner, W Miller

  • 1Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, New York, New York, USA.

American Journal of Preventive Medicine
|October 12, 2000
PubMed
Summary

Federal Section 317 grants are crucial for immunization infrastructure but their unpredictability hinders strategic planning. States need stable funding and clear authority to ensure lifelong immunization coverage.

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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.

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  • 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.