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