About the Vaccines for Children Program (VFC)

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The Vaccines for Children (VFC) Program provides vaccines to children whose parents or guardians may not be able to afford them. Serving as one of the nation’s most important contributors to health equity, the program helps ensure that all children have a better chance of getting their recommended vaccinations on schedule and staying healthy.

History of the VFC Program

In 1989 – 1991, a measles epidemic in the United States resulted in tens of thousands of cases of measles and hundreds of deaths. When this epidemic was investigated, the Centers for Disease Control and Prevention (CDC) found that more than half of the children who had measles had not been vaccinated against measles, even though many of them had seen a healthcare provider[1][2][3]. Cost of the vaccine was found to be a primary reason for children going unvaccinated even in families with a regular health care provider.

In response to this measles epidemic, Congress passed the Omnibus Budget Reconciliation Act (OBRA) on August 10, 1993, creating the VFC Program. The VFC Program became operational October 1, 1994. Known as Section 1928 of the Social Security Act, the Vaccines for Children Program is an entitlement program (a right granted by law) for eligible children, ages 18 and younger. The program was an unprecedented approach to improving vaccine availability nationwide by providing vaccine at no cost to VFC Program-eligible children through VFC Program enrolled public and private health care providers. Additional information on the history and benefits of the VFC Program.

How the VFC Program is Funded

The Office of Management and Budget (OMB) approves funding for the VFC Program, then allocates the funds through the Centers for Medicare & Medicaid Services (CMS) to CDC. After receiving the funds, CDC buys the vaccines at a discount and distributes them to VFC Program providers at the direction of awardees (i.e., the 61 state, local, and territorial immunization programs who receive operational funding from the CDC to implement and oversee their VFC Programs). The legislation for the VFC Program provides general guidance for VFC Program policy development—including eligibility, provider recruitment, and considerations for negotiating contracts with manufacturers.

The VFC Program Benefits the Nation

The goal of the VFC Program is to ensure that a VFC Program-eligible child does not contract a vaccine-preventable disease because of their parent or guardian’s inability to pay for the vaccine. As a primary driver of health equity in public health, the VFC Program supports improved immunization coverage levels among eligible children by:

  • Protecting children’s health:
    • Automatically covers vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) and approved by the CDC, which includes all vaccines for children ages 18 years and younger
    • VFC Program-provided vaccines protect against 19 different diseases
    • Prevents 472 million illnesses and 29.8 million hospitalizations
  • Providing free vaccines:
    • Provides public-purchased vaccines for eligible children at no charge to VFC Program-enrolled public and private providers in all states and U.S. territories
    • Eliminates or reduces vaccine cost as a barrier to vaccinating eligible children
  • Saving money:
    • Saves parents and enrolled providers out-of-pocket expenses for vaccine
    • Provides cost savings to states via bulk purchases of vaccines through CDC’s contracts at lower prices while eliminating state-to-state variations in price
    • Saves nearly $2.2 trillion due to the prevention of illnesses
  • Minimizing barriers to vaccination:
    • Eliminates cost as a barrier to vaccinating children
    • Provides opportunities for vaccinations at over 37,000 healthcare providers and locations, extending the reach of the VFC Program
    • Enrolled providers increase the potential number of children vaccinated in an awardee’s jurisdiction and allow VFC Program-eligible children to stay in their medical homes for comprehensive health care
    • Reduces racial, ethnic, and socioeconomic disparities in child vaccination rates, improving equity.
    • Discourages the practice of referring children from the private sector to the public sector for vaccination
  • Improving private-public collaboration:
    • Allows enrolled private providers to receive publicly purchased vaccine.
    • Coordinates with public agencies—including state health departments, state Medicaid programs, and programs serving families and children—to recruit and retain a network of VFC Program providers.

How Public Programs and Federal Agencies Support the VFC Program

VFC Public Program Collaborators

The success of the VFC Program is in large part due to a network of public programs and organizations that work to create policies and manage immunization programs at the local, state, and national levels. Collaborators include:

Centers for Disease Control and Prevention

The National Center for Immunization and Respiratory Diseases (NCIRD) at CDC is responsible for VFC Program:

  • Policy development;
  • Operational oversight; and
  • The provision of technical assistance to projects for the VFC Program.

State Departments of Health

State health department immunization programs manage the VFC Program at the state and local levels. The requirements and procedures of the VFC Program are applicable to all state, city, and territorial immunization programs.

Other Government Agencies and Public Health Associations

Successful implementation of this program at the national, state, and local levels requires close collaboration and participation by a variety of programs and agencies including but not limited to:

Centers for Medicare and Medicaid Services (CMS)

Policies are formulated after close consultation with CMS’s Medicaid program, public and private health care organizations, and vaccine manufacturers. Active involvement by the Medicaid program is particularly essential because a majority of VFC Program-eligible children are also eligible for Medicaid, and the Medicaid office staff has extensive experience in providing preventive care through other programs (e.g., Early and Periodic Screening Diagnostic, and Treatment (EPSDT) program, etc.).

American Academy of Pediatrics (AAP)

Pediatricians play a crucial role in immunizing children with being a trusted source for vaccine information, and the AAP supports policy recommendations and laws surrounding immunization for infants, children, adolescents, and young adults. Recommendations from the AAP help inform parents/guardians on which vaccines are offered through the VFC Program for on-time routine immunization of all children and adolescents according to the Recommended Child and Adolescent Immunization Schedule from the Advisory Committee on Immunization Practices (ACIP).

Departments Of Health

State and local health departments and Medicaid agencies are pivotal in recruiting physicians for the program and informing parents and guardians of eligible children that vaccines are available through the VFC Program. Immunization programs within state and local health departments are also responsible for providing enrolled providers with training, education, and technical assistance and monitoring provider implementation of the VFC Program.

Other Public Partners

The Women, Infants, and Children (WIC), Maternal and Child Health (MCH) programs, National Association of Community Health Centers (NACHC), and the federally qualified health centers operating within the Health Resources and Services Administration’s (HRSA) Bureau of Primary Health Care (BPHC) also have extensive contact with families whose children may be eligible for the VFC Program and are therefore gateways to children’s access into the program.

Footnotes

1CDC. Measles – United States, First 26 Weeks, 1989.MMWR 1989; 38(50): 863-866,871-872

2CDC. Current Trends Measles – United States, 1989 and First 20 Weeks 1990. MMWR 1990; 39(21): 353-355,361-363

3CDC. Current Trends Measles – United States, 1990. MMWR 1991; 40(22): 369-372

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