HARDBACK
$49.95
to disadvantaged populations, 216
to final 10 percent of population, 47–50
full immunization, 94
local determinants of, 50
Medicare reimbursement, 24, 86–87
obstacles to monitoring, 24–25, 122, 148
reimbursement issues, 63
VFC spending, 78
Cost of vaccines
client out-of-pocket costs as barrier to immunization, 129– 130
determinants of, 100 n.1
Medicaid coverage, 78
pneumococcal, 21, 89, 205, 227 n.4
public-sector discount, 21
Council of State and Territorial Epidemiologists, 107
Coverage levels 1996 goals, 165
access to services as factor in, 133
accomplishments of national immunization program, 66
accountability issues, 150, 151
adult immunization, 4, 29, 69, 87, 217–220
among immigrant populations, 59–60
CDC pockets-of-need strategy, 178–180
challenges to improving, 4, 32, 146–148
client awareness intervention to improve, 136–138
cost determinants, 50
cost of achieving current levels, 19–29
current child levels, 19
current inadequacy, 3–4, 67–70
data sources, 110
disparities in adult vaccination, 69–70, 87, 218
disparities in childhood vaccination, 4, 29–31, 67–69
expanding access to services to improve, 129–133
extent of insurance coverage and, 74, 76–77, 144–146
focus on 2-year-olds, 19–21
impact of budget reductions, 185
improving, 47
measurement methodologies, 110–115
in metropolitan areas, 4, 29–31
needs and performance measures, 17, 123, 146, 210, 226–227
NVAC recommendations to improve, 145
perceived acceptable levels, 108– 109
potential scope of federal programs, 81–83
private-sector immunization delivery and, 9, 151
as private-sector performance measure, 146
provider-based interventions to improve, 133–136
reducing client costs to improve, 129–130
role of national immunization system, 6, 43–46, 47
role of registries in documenting, 116–117
role of registries in improving, 117
strategies to improve, 47, 128–129, 138–139, 151, 154
system-level interventions to improve, 139–140
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