cies and professional groups can also establish incentives to encourage more providers, including all physicians who provide health care to adolescents and adults, to participate in immunization programs such as the Vaccines for Children program (VFC). Local health care providers indicated that immunization finance and service delivery in Texas is at present a complicated patchwork of public- and private-sector activities. Workshop participants expressed interest in reducing the gaps and complexities within the current health care system while also building on the strengths of diversity and flexibility.

Many workshop participants also urged greater coordination among various agencies and organizations that periodically review health plan and provider records and better education of employers and health plan administrators regarding the distinction between required and recommended immunizations. Speakers and discussants explored the feasibility of developing annual reminder notices for high-risk children from vaccine registries as well as creating a universal vaccine purchase program that might draw on public funding from federal and state sources as well as private funding from health plans, insurers, employers, and other purchasers of health care services. The discussions among the IOM workshop participants also reflected the concerns about health security raised by the September 11, 2001, terrorist attacks, which occurred in the weeks just before the Austin workshop. Participants expressed a renewed appreciation of the importance of the public health infrastructure and highlighted the immunization system as a fundamental indicator of its strength. Although crisis can stimulate urgent action, participants observed that the achievement of immunization objectives requires sustained efforts, strategic goals, and long-term finance plans to maintain the public health infrastructure.

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