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Program on Preventive Health Services Research, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, USA.
To address the issue of low immunization rates, President Clinton in 1993 introduced the Child Immunization Initiative (CII). One part of the CII is the Vaccines for Children (VFC) program, a federally-funded and state-operated vaccine supply program. Recently, congress has raised concerns regarding the extent to which noneligible children may be receiving VFC vaccine. This article explores, from several perspectives, the major issues related to VFC accountability. The two major accountability systems under consideration, benchmarking and vaccine replacement, are reviewed and analyzed for their potential accuracy, their effects on physician office practice, and their impact on the entire VFC program.
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