Outline n n Overview of VFC and 317

317 DA Vaccine Funding 2001 – 2004 19. 9 12. 5 10. 9 5.

VFC Vaccine Funding Trends 2001 – 2004 100. 2 25. 6 756. 9 15.

Why Change Methodology? n n n Grantee Shortfalls Funding Disparities VOFA Projections Assume 100%

Funding Principles: 317 Vaccine n n n Equity in funding across grantees Vaccine need

Funding Principles: 317 Vaccine n n State vaccine funding contributions will not be considered

Funding Principles: 317 Vaccine – Next Steps n NIP Internal Workgroup exploring various population

Funding Principles: VFC Vaccine n n Equity in funding across grantees VOFA estimates based

Funding Principles: VFC Vaccine n n VFC funds limited to vaccines approved by ACIP

Enhanced VFC Funding Methodology n n Current VOFA methodology National Immunization Survey (NIS) collected

Data Sources n n National Immunization Survey (NIS) Insurance Module u VFC coverage levels

VFC Population Adjustments AGE Percent of VFC Eligibles from PES (2002) <1 63% 1

Assumptions n n n 10% additional funding to target unvaccinated children Wastage Rate -

NIS Coverage for VFC Eligible Children Vaccine Coverage 3+DTAP 4+DTAP 93% 77. 4% 3+HIB

Projected Funding New Methodology VOFA 2005 Projections $1, 228, 280, 946 85% of VOFA

Next Steps - VFC n n Methodology applied at the individual grantee level Distribution

Our intent is to ensure to the best of our ability, an equitable distribution

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Outline n n Overview of VFC and 317 Vaccine Financing Rationale for Changing Methodology Guiding Principles for Change Enhanced VFC Vaccine Funding Methodology

317 DA Vaccine Funding 2001 – 2004 19. 9 12. 5 10. 9 5. 7 174. 4 216. 2 209. 1 205. 9

VFC Vaccine Funding Trends 2001 – 2004 100. 2 25. 6 756. 9 15. 3 0 28. 4 877. 8 902. 5 921. 5 26. 5 42. 6 12. 4

Why Change Methodology? n n n Grantee Shortfalls Funding Disparities VOFA Projections Assume 100% Coverage NIS Supplemental Insurance Module Study: Estimating Vaccine Dose Need

Funding Principles: 317 Vaccine n n n Equity in funding across grantees Vaccine need to reflect each grantee’s proportion of nation’s population under 65, excluding children and adolescents 0 -18 who are VFC eligible Funding will be consistent each year (subject to Congressional appropriations) minimizing dramatic shifts from one year to the next

Funding Principles: 317 Vaccine n n State vaccine funding contributions will not be considered in determining 317 DA vaccine need Grantees may update estimates for vaccine need based upon changes in ACIP recommendations, although overall Congressional funding unlikely to increase in the future

Funding Principles: 317 Vaccine – Next Steps n NIP Internal Workgroup exploring various population based funding options n Recommendations from AIM n Timeline

Funding Principles: VFC Vaccine n n Equity in funding across grantees VOFA estimates based on 100% vaccine coverage of eligible population but modified by actual NIS coverage and allowances for program growth Award estimates calculated annually, funds distributed in rounds Grantees may update estimates for vaccine need based upon changes in ACIP recommendations

Funding Principles: VFC Vaccine n n VFC funds limited to vaccines approved by ACIP for inclusion in the VFC Program AND for which there is a CDC contract If VFC funds are insufficient to meet grantees’ approved vaccine need, NIP will request additional funds from OMB Funds will be awarded only to grantees with an NIPapproved vaccine accountability plan NIP will monitor grantee spending patterns and vaccine inventory, and make adjustments as appropriate

Enhanced VFC Funding Methodology n n Current VOFA methodology National Immunization Survey (NIS) collected supplemental insurance coverage data from a sample of respondents between July, 2001 and December, 2002. Adjusted VFC eligibility data from approved Population Estimate Surveys using NIS VFC eligibility data Customized for each grantee

Data Sources n n National Immunization Survey (NIS) Insurance Module u VFC coverage levels u VFC eligibility Approved Population Estimates Survey Data Vaccine Ordering and Forecasting Application (VOFA) data u School Laws u Catch-Up Doses u Special Projects u Grantee Survey Data (FLU and TD) Consumer Price Index

VFC Population Adjustments AGE Percent of VFC Eligibles from PES (2002) <1 63% 1 -2 56. 4% 3 -6 Percent of VFC Eligibles from NIS Q 301 -Q 402 Percent of VFC Eligibles from PES (2005) Adjusted Total Pop from PES (2005) Adjusted 2005 VFC Pop 71. 5% 64. 3% 4, 132, 617 2, 656, 199 60. 5% 54. 4% 8, 122, 808 4, 417, 375 49. 5% 52. 9% 47. 5% 16, 164, 236 7, 685, 113 7 -18 40. 4% 43. 0% 38. 6% 50, 814, 924 19, 635, 557 Total 45. 1% 48. 3% 43. 4% 79, 234, 585 34, 394, 245 45. 0% Adjust Factor 89. 9%

Assumptions n n n 10% additional funding to target unvaccinated children Wastage Rate - 5% Additional Vaccine Doses from VOFA School Laws u Catch-Up Doses u Special Projects u

NIS Coverage for VFC Eligible Children Vaccine Coverage 3+DTAP 4+DTAP 93% 77. 4% 3+HIB 3+POLIO 1+MMR 3+HEP-B 91. 10% 88. 6% 90. 3% 88%

Projected Funding New Methodology VOFA 2005 Projections $1, 228, 280, 946 85% of VOFA 1, 442, 646, 197 2006 Projections $1, 272, 935, 823 Not Available

Next Steps - VFC n n Methodology applied at the individual grantee level Distribution to grantees in April Projected 2005 funding award u 2005 VOFA Spending Plan u n n Modification of 2006 VOFA Application of NIS Adjustment in 2006 Population Estimates Survey Review Process

Our intent is to ensure to the best of our ability, an equitable distribution of awards and to improve accountability among all projects and within NIP.