CALLING THE SHOTS Immunization Finance Policies and Practices Committee on Immunization Finance Policies and Practices Division of Health Care Services and Division of Health Promotion and Disease Prevention INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, DC NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.      Support for this project was provided by the Centers for Disease Control and Prevention (Award No. 200199900023). The views presented are those of the Institute of Medicine's Committee on Immunization Finance Policies and Practices and are not necessarily those of the funding organization. Library of Congress Cataloging-in-Publication Data Calling the shots : immunization finance policies and practices / Committee on Immunization Finance Policies and Practices, Division of Health Care Services and Division of Health Promotion and Disease Prevention, Institute of Medicine.           p. cm.      Includes bibliographical references and index.      ISBN 0-309-07029-5      1. Immunization--Government policy--United States. 2. Immunization of children--Government policy--United States. 3. Immunization--United States--Finance. 4. Immunization--United States--Planning. 5. Medicine, Preventive--United States. I. Committee on Immunization Finance Policies and Practices (U.S.). II. Institute of Medicine (U.S.). Division of Health Care Services. III. Institute of Medicine (U.S.). Division of Health Promotion and Disease Prevention. RA638 .C35 2000 614.4´7´0973--dc21                                                                         00-046277      The full text of this report is available on line at www.nap.edu.      Additional information about this report and America's vaccine safety net is available online at www.nationalacademies.org/includes/shots.htm.      For more information about the Institute of Medicine, visit the IOM home page at www.iom.edu. Copyright 2000 by the National Academy of Sciences. All rights reserved. Printed in the United States of America      The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.