In an article published in the July issue of the American Journal of Preventive Medicine, a summary of the findings of the Vaccine Financing Workgroup of the National Vaccine Advisory Committee (NVAC) suggests several steps to improve the present situation. These recommendations differ from those of a recent Institute of Medicine (IOM) report.

During 2003-2004, the NVAC working group conducted a series of discussions and meetings leading to a proposal for substantial, but incremental, changes to the current system that the group feels would go a long way toward stabilising the financing of immunisations in the United States.

In contrast to the IOM recommendation to replace the current immunisation financing system with an insurance mandate and system of subsidies and vouchers, the NVAC would like to see "expanded and stable funding for the existing immunisation grant program, expansion of the Vaccines for Children program, regulatory harmonisation, promotion of 'first dollar' insurance coverage for immunisations, and the assurance of adequate reimbursement for the administration of vaccines."

When the IOM recommended, among other things, that insurers be required to cover immunisations, that vaccine prices be set in advance of their development, and that vaccine coverage decisions include societal benefits and costs, including consideration of the impact of the price of a vaccine on recommendations for its use, there were widespread and varied responses.

Editorials in the Wall Street Journal and the New York Times helped raise awareness of the complexities surrounding the vaccine industry. A briefing was held at the American Enterprise Institute at which reservations were expressed by many stakeholders about the Committee's recommendations.; Source: American Journal of Preventive Medicine