Vaccines for Children Program

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The Vaccines for Children Program (VFC) is a federally funded program in the United States providing no-cost vaccines to children who lack health insurance or who otherwise cannot afford the cost of the vaccination. The VFC program was created by the Omnibus Budget Reconciliation Act of 1993 and is required to be a new entitlement of each state's Medicaid plan. The program was officially implemented in October 1994.[1]


From 1989 through 1991, a measles epidemic in the United States resulted in several tens of thousands of cases of measles and hundreds of deaths. Upon investigation, CDC found that more than half of the children who had measles had not been immunized, despite seeing a health care provider.[2]

In partial response to that epidemic, Congress passed the Omnibus Budget Reconciliation Act (OBRA) on August 10, 1993, creating the VFC Program. It became operational October 1, 1994 and is known as section 1928 of the Social Security Act, the VFC program is an entitlement for eligible children, age 18 and below.[3]

Aiming to address the barrier of cost to families, the Vaccines for Children program represented a major vaccine finance reform, working as a state-operated federal entitlement program that supplied both public and private providers with federally purchased vaccines.[4] This integration of both the public and private sector benefitted all providers. Because private providers now had a role in the nation's immunization program, they, along with the public health sector, benefitted from the supply of vaccines at no cost, educational opportunities, and the ability to provide immunization services to patients without a need for referral.[4]


The VFC program is funded through an approval by the Office of Management and Budget (OMB), and the funds are allocated to the Centers for Disease Control and Prevention (CDC). The CDC buys vaccines at a discount directly from manufacturers and distributes them to state health departments and certain local and territorial public health agencies. The agencies then redistribute the vaccines at no cost to those private physicians' offices and public health clinics that are registered as VFC program providers.[1]

Patient eligibility[edit]

Children and adolescents are eligible if it is before their 19th birthday and they meet one or more of the following criteria:[5]

  • Medicaid-eligible
  • Uninsured (lacking health insurance)
  • American Indian or Alaska Native
  • Underinsured, that is, a child that is covered by some type of health insurance, but the insurance either does not cover any vaccines, covers only certain vaccines, or does cover some vaccines, but has a cap on the annual cost for vaccines.*
  • Children are eligible up through 18 years of age.

*For underinsured children and adolescents, VFC vaccines may still be provided, but only at sites that are federally qualified health centers (FQHCs) or rural health clinics (RHCs).[6]

Covered vaccines[edit]

The Advisory Committee on Immunization Practices (ACIP) makes recommendations to the VFC program as to what are the most appropriate selection of vaccines and related agents for control of vaccine-preventable diseases in the civilian population of the United States.[7] VFC resolutions passed by the ACIP form the basis for VFC program policies on vaccine availability and usage. They may not necessarily match the general usage recommendations of the ACIP, but rather represent the rules that providers must follow for administering each specific vaccine under the VFC program.[8]

The following vaccines are included in the VFC Program:[9][10]

Latest changes[edit]

The VFC program has implemented several regulations to address the changing needs of grantees:

In attempts to address fraud and abuse, grantees must now submit a copy of the newly written fraud and abuse policy, which includes identification of staff responsible for these issues, to the CDC no later than December 31, 2007.[11]

The VFC program is also requiring the update of user profiles. Rather than having grantees do this task, the goal is to improve accountability and ensure accurate information about the population of eligible children.[11]

A larger and more recent enhancement aiming to improve vaccine management at multiple levels (federal, state, local) is the initiation of the Vaccine Management Business Improvement Project (VMBIP). This project aims to simplify the ordering and distribution projects of vaccines, implement a more efficient supply system, and enable direct delivery of vaccines to providers.[11]


  1. ^ a b "Vaccines for Children Program (VFC)". Vaccines & Immunizations. Centers for Disease Control and Prevention. Retrieved 2011-03-24.
  2. ^ Dales LG, Kizer KW, Rutherford GW, Pertowski CA, Waterman SH, Woodford G (October 1993). "Measles epidemic from failure to immunize". West. J. Med. 159 (4): 455–64. PMC 1022280. PMID 8273330.
  3. ^ Hinman, Orenstein, Schuchat, Alan R., Walter A., Anne (October 7, 2011). "Vaccine-Preventable Diseases, Immunizations, and MMWR". Centers for Disease Control and Prevention. Retrieved November 15, 2011.
  4. ^ a b Santoli, MD, MPH*; Rodewald, MD*; Maes, PhD‡; Battaglia, MA§; and Coronado, MD, MPH‡, Jeanne M.; Lance E; Edmond F.; Michael P.; and Victor G. (1999). "Vaccines for Children Program, United States, 1997" (PDF). Pediatrics. 104: 9 – via AAP News & Journals.
  5. ^ "Which children are eligible?". Retrieved 2011-03-24.
  6. ^ Lindley MC (MPH), Shen AK (MPH), Orenstein WA (MD), Rodewald LE (MD) and Birkhead GS (MD, MPH) (2009). "Financing the Delivery of Vaccines to Children and Adolescents: Challenges to the Current System" (PDF). Pediatrics. 124: 12 – via AAP News & Journals.
  7. ^ "About the ACIP". Vaccines for Children Program (VFC). Centers for Disease Control and Prevention. Retrieved 2011-03-24.
  8. ^ "Adding Vaccines to the VFC Program". Vaccines for Children Program (VFC). Centers for Disease Control and Prevention. Retrieved 2011-03-24.
  9. ^ "Vaccines Included in the VFC Program" (PDF). Vaccines for Children Program (VFC). Centers for Disease Control and Prevention. Retrieved 2011-03-24.
  10. ^ "Vaccines: VFC/ACIP-VFC Resolutions". Vaccines for Children Program (VFC). Centers for Disease Control and Prevention. Retrieved 2011-03-24.
  11. ^ a b c Ching, Pamela L.Y.H. (2007). "Evaluating Accountability in the Vaccines for Children Program: Protecting a Federal Investment" (PDF). Public Health Rep. 122: 718–24. PMC 1997239. PMID 18051664.

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