Vaccines for Children Program

Vaccines are a cost-effective means for disease prevention. It is estimated that for every dollar spent on routine childhood vaccines there will be a savings of 0.90 to 24.00 in direct medical expense. The rates of vaccination for children are well over 90%. This has been attributed to the requirements for proof of vaccination by states for enrollment into day care centers and school. Additionally, children (less than or equal to 18 years of age) may receive routine vaccinations free of charge through state health departments or other assistance programs, such as the national Vaccines for Children program. 

Gosse, M.E., Manocchia, M., and Nelson, T.F., Overview of US Pharmaceutical Development, 1980-1994, Tufts University Center for the Study of Drug Development, May, 1996. Grabowski, H.G. and Vernon, J., The search for new vaccines the errors of the vaccines for children program, American Enterprise Institute, Washington, 1994. 

Table 1 Vaccines covered by Vaccines for Children program...

Another important issue concerns the number of vaccines used for children under 2 years of age the vaccination program includes around 15 injections causing some discomfort not only to the children but also to their parents (Papaevangelou, 1998). It is therefore necessary to develop combined vaccines - live, inactivated or mixed with VLPs or other subunits - for which the allergic reactivity is minimal. 

In the USA, the National Childhood Vaccine Injury Act of 1986 established the National Vaccine Injury Compensation Program as a federal no-fault compensation system for individuals who may have been injured by specific vaccines. This compensation program relies on a Vaccine Injury Table that lists the vaccines that are covered by the program, as well as injuries, disabilities, illnesses, and conditions (including death) for which compensation may be awarded. To better reflect current scientific knowledge about vaccine injuries, the Vaccine Injury Table was revised in 1995 and has been subsequently further modified. The latest modification, which became effective on December 1, 2004, is shown in Table 7. This revision took into account a review of the literature on specific adverse consequences of pertussis and rubella vaccines performed and published by the lOM (SED-12, 817) (SED-12, 825). In addition to the seven vaccines (diphtheria, pertussis, tetanus, measles, mumps, rubella, and poliomyelitis) included in the first Vaccine Injury Table, the 1997 revision includes hepatitis B, Hemophilus influenzae type b, and Varicella vaccines, as well as any future licensed vaccine recommended by the Advisory Committee on Immunization Practices (ACIP) for routine administration to children (38). 

Qualifications for the VFC program are as stated here. Each state s children s health insurance qualifications are unique but can be found at their web site. ° Children through 18 years of age qualify to receive federally purchased vaccines under the VFC program if they are medicaid-enrolled, uninsured, or Native Amer-icans/Native Alaskans. Children who have insurance that does not cover immunizations also qualify to receive VFC vaccine at federally qualified health centers and rural health clinics. In addition, states may use their funds to purchase vaccines for additional groups of children. Contact the immunization program in your state for more information. 

However, infections from other viruses present significant risks. The hepatitis viruses (A, B, C, and D) became recognized as very real hazards for laboratory workers who handled human specimens, particularly blood. The risk of hepatitis infections from exposure to materials containing these viruses is much greater than the risk from HIV. Remarkably, a recent report indicated dramatic reductions in acute hepatitis infections, principally due to strong vaccination programs for children for hepatitis A and B—a clear illustration of the need for hepatitis vaccination for laboratory workers exposed to human specimens. See Special Topic 43.3.1 Chemical Analysis of Human Specimens. 

The US Health Resources and Services Administration asked the Institute of Medicine (lOM) to review a list of adverse events associated with 8 of the 12 vaccines covered by the National Vaccine Injury Compensation Program (VICP) ami to evaluate the scientific evidence about the event-vaccine relationship. The vaccines covered by VICP included all vaccines recommended by the Centers for Disease Control ami Prevention (CDC) for routine administration in children. Adults who have an adverse event after one of these childhood vaccines also are covered by the program. 

HepA is recommended for certain other groups of children, including in areas where vaccination programs target older children. SeeMWM// 2006 55(No. RR-7) 1—23. 

Three cases within a week in the same neighborhood means that the disease is spreading. The doctor fears an epidemic is under way. She immediately calls city health officials and tells them the problem. The health commissioner faxes a request to the Centers for Disease Control (CDC) in Atlanta for ten thousand doses of measles vaccine. The plan is to initiate a crash program of vaccinations in the immediate neighborhood so that spread of the disease will be damped. Infected children will be quarantined after the outbreak is contained, an educational program will be initiated to alert parents to the abiding... 

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