Vaccines for Children: Major Implementation Hurdles Remain

GAO discussed the Centers for Disease Control's (CDC) implementation plans for the Vaccines for Children (VFC) program. GAO noted that: (1) as of July 1994, only 4 of the 15 contracts with vaccine manufacturers had been awarded; (2) although states are responsible for recruiting physicians into the VFC program, only 5 states had mailed VFC enrollment forms to potential vaccine providers; (3) although CDC arrangements for training staff in the use of vaccine-ordering software appear to be on schedule, its software testing schedule is questionable and some states have not yet hired or selected required VFC support staff; (4) CDC did not review private distribution options or validate its proposed shipping process before it chose the General Services Administration (GSA) for vaccine distribution services; (5) although the VFC program is designed to provide free vaccinations, CDC has allowed providers to charge an administration fee to ensure physician participation; (6) the CDC pay schedule appears to be inconsistent with VFC goals and could impose financial burdens on some VFC recipients; (7) states are primarily responsible for developing mechanisms to ensure accountability for federally-purchased vaccines; (8) CDC does not have an evaluation plan or the information necessary to assess the cost and effectiveness of the VFC program; and (9) it is unlikely that CDC will be able to fully implement the VFC program by its target date.