FIGURE 1 Six roles of the national immunization system.

program goals. Furthermore, with only a one-year grant period, many state immunization programs could not invest in multi-year programs with consultants or contractors to support long-term strategic planning or data collection efforts.

The committee also concluded that immunization policy should be national in scope but flexible enough to accommodate important political, socioeconomic, and structural differences among states and communities. Furthermore, federal and state governments share responsibility for supporting vaccine purchase and the infrastructure essential for achieving and sustaining national immunization goals. Data reviewed for the study showed that some states appeared to provide little or no state funding for immunization while others invested substantially more than they received from federal sources. Finally, the private sector, through health plans and individual health care providers, has the capacity to do more to ensure the delivery of appropriate immunization services to its members and patients, but such efforts do not replace the need for a more diverse public health infrastructure capable of assuring that the immunization needs of the whole population are addressed.