TABLE 5–5 Annual Awards and Expenditures of Section 317 Financial Assistance (FA) Immunization Program Funds (in millions of dollars)

Year

New Funds

Re-awarded Fundsa

Total Award

Expenditures

Percentage of Total Award Expendedb

1990

36.9

0.0

36.9

25.8

70%

1991

37.0

6.3

43.3

32.2

74%

1992

92.3

5.9

98.2

43.0

44%

1993

98.2

42.2

140.4

81.8

58%

1994

227.6

27.3

254.9

135.4

53%

1995

261.4

75.2

336.6

195.4

58%

1996

179.7

191.4

371.1

247.7

67%

1997

158.6

121.7

280.4

241.1

86%

1998c

115.9

77.8

193.7

179.5

93%

1999d

110.6

17.8

128.4

128.4

NAe

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



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