Vaccines for Children Program

In 1993, the Childhood Immunization Initiative was developed in response to the measles resurgence, which disproportionately affected racial/ethnic minority children. The initiative seeks to address the major gaps in vaccination coverage among young children in the United States, and one strategy was to eliminate the cost of vaccines as a barrier to vaccination. In 1994, this led to the creation of the Vaccines for Children program (VFC). VFC is the largest entitlement program managed by the CDC and is a policy and programmatic intervention. CDC purchases discounted vaccines and distributes them at no cost to private physicians' offices and public health clinics registered for VFC. Children 18 years or younger are entitled to receive VFC vaccines through their VFC-enrolled provider if they are Medicaid-eligible, American Indian/Alaska Native, uninsured, or underinsured and vaccinated at a Federally Qualified Health Center or a Rural Health Clinic. Among all children eligible for VFC in 2011, 52.1% were of a racial/ethnic group other than non-Hispanic White.

Vaccines for Children was designed to ensure that eligible children do not contract vaccine-preventable diseases because of inability to pay for vaccine.

Racial and ethnic disparities in vaccination coverage between non-Hispanic white children and children of other groups have declined for vaccines that have been recommended since 1995. By providing increased access, VFC has increased protection for all children from vaccine-preventable diseases.

Measles-mumps-rubella (MMR); poliovirus; and diphtheria, tetanus and pertussis–containing vaccines (DTP/DTaP) were recommended prior to VFC's establishment and were evaluated in terms of child coverage from 1995-2011. Compared with non-Hispanic white children, disparities in vaccination coverage for Hispanic, non-Hispanic black, and American Indian/Alaska Native children have been nonexistent for MMR since 2005. The same disparities were absent in poliovirus vaccination since 2003. Depending on the racial/ethnic group examined, disparities in DTP/DTaP coverage were absent, declining, or inconsistent during 2005-2011. Reduction of disparities for these vaccines demonstrates that the strengthening of the immunization program since 1994 reached all groups of children.

From 1995 to 2005, Hispanic children had significantly lower DTP/DTaP coverage than non-Hispanic white children, except in 2001 when the difference was not statistically significant. Since 2003, estimated DTP/DTaP coverage among Hispanic children has been >80%, and the number of statistically significant disparities has decreased since 2005. The disparities in vaccination coverage between non-Hispanic black and non-Hispanic white children did not decrease significantly during 1995–2011. DTP/DTaP coverage did not differ significantly for non-Hispanic Asian children and non-Hispanic white children, except in 2008 and 2011, when coverage was higher for the former. Disparities between non-Hispanic white children and non-Hispanic American Indian/Alaska Native were inconsistent and sporadic, and those disparities did not decline significantly during 1995-2011. Estimated DTP/DTaP coverage did not reach the Healthy People target of 90% for any ethnic or racial group.