Table of Contents:
  • INTRODUCTION
  • Background
  • Conceptual framework for the study
  • Study process
  • Summing up
  • Organization of the report
  • ORIGINS AND RATIONALE OF IMMUNIZATION POLICY
  • Legislative history of vaccine policy
  • Shared federal and state responsibility for financing
  • Shared public and private responsibility for coverage
  • Public and private delivery systems
  • Private vaccine production
  • The setting national of vaccine policy
  • Findings
  • PUBLIC AND PRIVATE INSURANCE COVERAGE
  • Public insurance coverage
  • Private insurance coverage
  • Barriers to a well-functioning immunization finance system
  • Findings
  • THE DELIVERY SYSTEM
  • Delivery of adult and childhood vaccines
  • The work of immunizing
  • Provider reimbursement
  • Barriers to a well-functioning immunization delivery system
  • Findings
  • VACCINE SUPPLY
  • Size and growth of the vaccine market
  • Vaccine production
  • Cost structure
  • Research and development
  • Industry concentration
  • Regulation
  • Pricing
  • Shortages
  • Stockpiles
  • CDC contracting
  • Barriers to a well-functioning vaccine supply system
  • Findings
  • CONCLUSIONS AND ALTERNATIVE STRATEGIES
  • Conclusions
  • Alternative strategies
  • Weighing the alternatives
  • RECOMMENDATIONS
  • Final observations.