educational activities and information dissemination, particularly provider education, in 31 states. Statewide and/or local immunization coalitions are significant contributors to immunization efforts, particularly outreach activities, in 19 states. Twelve states have supported statewide registry development by All Kids Count grants from the Robert Wood Johnson Foundation, and another 11 states have received such grants for local registry efforts. Seven states have received support from insurers, managed care organizations, or other organizations (e.g., Rotary Clubs, McDonald’s, or private foundations) for specific initiatives, such as registry efforts, vaccine purchase, or outreach and education.

These other funding sources are not sufficient to maintain a viable immunization program within each state, however, and the increasing data management and service coordination demands placed on state programs exceed their current capacity:

  • Many states have discontinued funding for local organizations engaged in immunization outreach activity. Almost all program managers have reported substantial cuts in contracts with local health departments, even though they believe the most effective and critical outreach activities take place at the local level.

  • The ability of states to partner with local agencies has diminished, earlier initiatives cannot be maintained, and innovative strategies cannot be implemented.

  • Staff have increased responsibilities with little support or time to carry out their functions.

  • Several states have expressed concern that they do not have the workforce capacity to investigate disease outbreaks, work with providers, or continue registry development.

  • State officials have expressed concern that continued outreach efforts may be futile if services are not available within public health clinics to provide up-to-date vaccinations for individuals who are incompletely immunized and are not covered for such services.

Question 3: What are the current and future funding requirements for immunization activities, and how can those requirements be met through a combination of state funding, federal Section 317 immunization grant funding, and funding available through SCHIP? (Supported by Findings 2–1 through 2–4 in Chapter 2; Findings 3–2 through 3–6 in Chapter 3; and Findings 5–6, 5–7, 5–10 through 5–12, 5–15, 5–16, and 5–18 in Chapter 5.)

The funding requirements for immunization activities fall into two broad categories: vaccine purchase and infrastructure support.

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