nization Managers, to develop criteria and weights for a funding formula. The proposal currently under consideration gives a weight of 12 percent to a funding base to cover minimum program needs, 78 percent to need as reflected in factors such as population size and immunization coverage rates, 5 percent to performance, and 5 percent to discretionary funding needs (e.g., responding to disease outbreaks).

CDC’s other major effort in response to the IOM recommendations is to improve the measurement of immunization coverage. Toward this end, CDC is working with the National Committee for Quality Assurance to modify immunization measures in the Health Plan Employer Data and Information Set (HEDIS) to better reflect immunization recommendations. New vaccines are to be incorporated into HEDIS measures within 3 years of their addition to the immunization schedule. A new HEDIS measure will reflect the recommendation for influenza immunization for adults ages 50 to 64. In addition, changes to the NIS will allow for greater comparability with HEDIS data and for the measurement of immunization coverage at more ages.

Dr. Orenstein ended his remarks by noting the conclusions in Calling the Shots regarding the federal and state roles in the immunization system. With states as the ultimate stewards of public health, state legislatures and state governments should be expected to sustain an immunization infrastructure. The federal role is to supplement and support state efforts. Thus, Dr. Orenstein hoped that the workshop would aid CDC in finding ways to help states fulfill their roles in the immunization system.

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