1966–1968 Partnership for Health Initiative (President Johnson)

  • Part of broader effort to reduce growing number of federal categorical programs in health

  • Section 317 program replaced with state block grants

  • Disease reports decline in four key categories (measles, polio, pertussis, and diphtheria)

  • Federal resources shifted away from state grants and measles vaccine to support purchase of rubella vaccine when license was approved (1969)

  • Compulsory school laws adopted by half of the states

1970 New Section 317 authority restored (President Nixon)

  • Reported measles cases increased sharply (1969–1971)

  • Reports of insufficient state funds, personnel, and activity in immunization programs other than rubella

  • Earlier block grant effort seen as weakening of federal effort, leading to disease outbreaks

1976–1978 National Childhood Immunization Initiative (President Carter)

  • Second measles outbreak in 1977

  • New initiative stimulated by Mrs. Betty Bumpers, wife of Arkansas Governor Dale Bumpers

  • Federal commitment made to increase and maintain immunization levels among school-aged children to 90% and above (coverage rates reported as 95%)

  • Growth occurred in federal grants for state immunization budgets ($5 million in 1976 to $35 million in 1979)

1986–1988 Continued Federal Support for State and Local Grantees (President Reagan)

  • Level of federal support remained stable but did not grow

  • New vaccines added to immunization schedule

  • Public health delivery system remained unchanged

  • National Childhood Vaccine Injury Act (1986) adopted

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