• Angela K Shen, Lance E Rodewald, and Guthrie S Birkhead.
• US Department of Health and Human Services, National Vaccine Program Office, 200 Independence Ave SW, Room 717H, Washington, DC 20201-0004, USA. angela.shen@hhs.gov
• Pediatrics. 2009 Dec 1;124 Suppl 5:S540-7.

ObjectiveThe goal was to understand vaccine manufacturers' perspectives on vaccine financing as a barrier to immunization.MethodsIndividual telephone interviews with representatives of the 6 manufacturers that produce routinely recommended vaccines for children and adolescents in the United States were conducted in November and December 2006.ResultsAlthough manufacturers acknowledged that the price of newer vaccines presents challenges to optimal vaccine use, they asserted that children and adolescents have access to vaccinations through public and private insurance. Respondents suggested that the system could be improved through adequate funding of the public-sector safety net. Respondents stated that providers should receive timely reimbursement for the full costs of vaccine purchase and administration, and manufacturers who sell directly to health care providers may provide flexible payment terms for vaccine purchases. Manufacturers supported targeted expansion of the Vaccines for Children program to allow children with incomplete insurance coverage for vaccines to receive vaccines at health department clinics. Manufacturers perceived delays in publication of Advisory Committee on Immunization Practices recommendations as a potential barrier to vaccine uptake. They viewed the perceived lack of public value for vaccines as a potential barrier to adequate reimbursement and optimal utilization. Respondents also maintained that their ability to negotiate vaccine prices through the private market is a crucial priority.ConclusionsManufacturers assert that children and adolescents have access to immunizations through public and private insurance. Manufacturers think that they have mitigated the challenge most directly in their control: the large financial outlays required for up-front vaccine purchases.

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