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Appendix C Survey of State Vaccine Finance Practices In 2001, the IOM Committee on the Evaluation of Vaccine Purchase Financing in the United States commissioned a survey from Dr. Gary Freed and his colleagues at the Division of General Pediatrics, University of Michigan. The purpose of this survey was to describe how state health departments finance, purchase, and distribute vaccines; address vaccine shortages; regulate immunization insurance benefits; and allocate scarce resources among vaccine purchase, delivery, and infrastructure invest- ment. This survey was a follow-up to a prior survey of state immuniza- tion program practices regarding the scope, structure, financing, and op- eration of state immunization efforts, conducted by Dr. Freed for an earlier IOM committee (Freed et al., 2000~. The University of Michigan team contacted immunization program managers and project directors of the 50 states and the District of Colum- bia. Interviews were conducted via telephone and mail during the sum- mer of 2002 and were completed by 48 states. The CDC National Immuni- zation Program provided the names of immunization program managers and project directors in each state, and the IOM sent each a cover letter explaining the nature of the survey interview. CDC also provided state- level background information and documentation, such as copies of grant awards and site visit data. Topics addressed in the interviews included the following: · Breakdown of funds from VFC, Section 317, state, and any other resources used for vaccine purchase overall 239
240 FINANCING VACCINES IN THE 21ST CENTURY · Changes to the current system of vaccine financing or any new vac- cine financing strategies · Estimates of annual needs for public-sector purchase each year for the child, adolescent, and adult populations · Adequacy of VFC funding · Process by which vaccines are ordered from the federal contract · Purchases of vaccines outside the federal contract · Distribution to providers and provider choice for publicly pur- chased vaccines · Stockpiles and shortages The report on the survey, State-Level Perspectives on Vaccine Purchase Financing, is available through the IOM's public record file.