By Marie Rosenthal, MS
Routine childhood vaccinations given through the Vaccines for Children (VFC) program have prevented an estimated 508 million cases of illness, 32 million hospitalizations and more than 1.1 million deaths among U.S. children born between 1994 and 2023, according to an Aug. 8 report by the CDC (MMWR Morb Mortal Wkly Rep 2024 Aug 13).
The program has also resulted in a societal savings of nearly $2.7 trillion, including a direct savings of $540 billion, according to Debra Houry, MD, MPH, the deputy director for Program and Science, and the chief medical officer, at the CDC.
“This means that every dollar spent on childhood immunizations results in a savings of approximately $11 in 2023. VFC distributed over 74 million doses of pediatric vaccines to participating healthcare providers. Anyone ages 18 or younger who is Medicaid eligible, uninsured, underinsured, or American Indian or Alaska Native can receive vaccines from VFC program providers at no cost,” Dr. Houry explained.
More than about 40 million children are eligible for VFC, but only about half of the children in the United States receive their vaccinations through the VFC program, according to Georgina Peacock, MD, the director of the CDC’s Immunization Services Division.
Both physicians discussed the program at a recent media briefing.
“CDC currently funds 61 state, local and territorial immunization programs to implement the VFC program at over 37,000 enrolled locations, providing all recommended childhood vaccinations against 19 different diseases,” Dr. Houry said. “This program serves as one of the nation’s most important contributors to health equity. It helps all children have a better chance of getting their recommended vaccinations on schedule.”
The Vital Signs report highlights some of the successes of the VFC program:
- Almost 90% of children eligible for free vaccines through the VFC program, who were born between 2011 and 2020, received the measles-mumps-rubella (MMR) vaccine, according to a new CDC Vital Signs report.
- There were no differences in receipt of the MMR vaccine found among VFC-eligible children born in 2020 by race and ethnicity, poverty status, or urban-rural residency.
- In addition, rates of routine childhood rotavirus vaccination increased from 65% to 71% among children born between 2011 and 2020, which shows progress toward achieving high vaccination coverage for all routine immunizations.
“These new data show the VFC program has helped ensure that all children can receive lifesaving vaccine,” Dr. Peacock said. “There are still opportunities to increase coverage with recommended vaccines for VFC-eligible children. Vaccination coverage among VFC-eligible children born in 2011 through 2020 was lower than that among children not eligible for VFC who were born in those same years.”
Only 61% of VFC-eligible children who were born in 2020 received the combined seven-vaccine series by 24 months of age. This series includes all recommended doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine, poliovirus vaccine, measles-containing vaccine, Haemophilus influenzae type b conjugate vaccine (Hib), hepatitis B vaccine (HepB), varicella vaccine and pneumococcal conjugate vaccine (PCV). Of these vaccines, coverage among VFC-eligible children born in 2020 was about 90% for the first doses of vaccines (varicella, MMR) and for series given earlier in life (poliovirus, HepB).
Vaccination coverage was lowest (74%-77%) for vaccines that require multiple doses, with at least one dose recommended after 12 months of age (DTaP, PCV and Hib), suggesting children face challenges to receiving vaccines that require multiple doses as well as doses in the second year of life.
“For children born in 2020, vaccination coverage was lower among VFC-eligible children who were uninsured compared to those who were enrolled in Medicaid,” Dr. Peacock said. Except for the MMR vaccine, “coverage was also lower for those living below versus at or above the poverty level.
“Although the VFC program provides recommended childhood vaccine at no cost, uninsured children and children living in poverty may face other barriers to vaccination,” she explained.
Although the VFC program provides recommended childhood vaccines at no cost, non-Medicaid VFC-eligible children, including those who are uninsured, can be charged a vaccine administration fee, and there may also be fees for an office visit or non-vaccine services received during the visit, according to the report.
Healthcare professionals can help reduce missed opportunities for vaccination by giving catch-up vaccinations to all children who are behind.
“Healthcare providers are our crucial partners to increase the number of children who complete their vaccine series and reach those children living below the poverty level and without health insurance,” Dr. Houry said. They “can promote vaccinations by encouraging all recommended childhood vaccines, strengthening family–provider relationships, educating parents about vaccine benefits and participating in the VFC program to provide vaccinations during routine appointments for those who qualify.
“Routine vaccinations are our best defense against illnesses that can make kids seriously ill, a key tool that can keep kids healthy in school and ready to learn,” Dr. Houry said. “Vaccines have saved lives for over 100 years, but serious disease is still a major threat to those unvaccinated.”
The VFC program is administered nationally by the CDC, which provides operational funding to 61 state, local and territorial immunization programs. Funding recipients implement and oversee the VFC program in their respective areas. The federal government purchases pediatric vaccines at a discount and ships them directly to enrolled VFC vaccine providers to ease the fiscal burden of vaccine purchase and distribution.
