. "Immunization Finance Policies and Practices." Calling the Shots: Immunization Finance Policies and Practices. Washington, DC: The National Academies Press, 2000.
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Calling the Shots: Immunization Finance Policies and Practices
TABLE 5–5 Annual Awards and Expenditures of Section 317 Financial Assistance (FA) Immunization Program Funds (in millions of dollars)
aFunds awarded in previous years but not obligated.
bBased on year-end unobligated balances for 1990–1997 reported to CDC as of December 21, 1998.
cCDC estimates for 1998 expenditures and percentage of 1998 award expended.
dProjected amounts for 1999.
eNot available.
SOURCE: Information provided by CDC.
to $261 million for 1995. By the end of the decade, newly awarded FA grants had declined to $116 million for 1998 and $111 million for 1999 (more than a 50 percent decrease). In FY 1999, expenditures for DA and FA were roughly comparable. Four factors affected the buildup and subsequent cutbacks in the Section 317 state infrastructure grants:
Implementation of a pockets-of-need strategy.
Use of incentive grants to improve immunization rates within the states.
The existence of significant carryover in the early years of the state infrastructure grant awards.
Initiation of the global polio eradication program.
Pockets of Need. Since numerous studies have demonstrated that low socioeconomic status is strongly associated with low immunization rates, CDC employed a strategy throughout the 1990s designed to enhance efforts to identify and provide vaccination interventions to underserved populations, particularly within large urban areas. In 1991, NIP identified
