Reaching more children: When the VFC legislation was passed 30 years ago, it was a historic step in improving the lives of children. Despite these successes, there is continued need to reach children who lack insurance and children in families with lower incomes. Healthcare providers that serve VFC-eligible children are critical to the VFC program, providing children easy access to vaccination services.

There are still opportunities to increase vaccination coverage (the proportion of children vaccinated) with all recommended vaccines for VFC-eligible children. Combined coverage for 7 selected vaccines (the “combined 7-vaccine series”) was just over 61% for VFC-eligible children born in 2020. For individual vaccines, uptake was highest (around 90%) for first doses of vaccines and vaccines given earlier in life. Coverage was lowest for vaccines that require multiple doses, with additional doses recommended after 12 months of age. This suggests VFC-eligible children face challenges to receiving vaccines that require multiple doses as well as in their second year of life.

Healthcare providers can help reduce missed opportunities for vaccination by giving multiple childhood vaccines at well-child visits. Robust communication efforts to reach parents of those eligible for the VFC program will help them be aware of, have confidence in, and able to access recommended vaccines for their children.

Insurance status: Vaccinations were lower among uninsured children than for children insured by Medicaid. This is consistent with data on vaccinations among uninsured adolescents and adults. Uninsured children are more likely to live below the poverty level and are less likely to have seen a healthcare provider in the past year. They are also less likely to complete vaccine series that require multiple doses. Efforts to connect children to health insurance can contribute to increased vaccinations.

Reaching low-income households: VFC-eligible children living below the poverty level had lower vaccination coverage for rotavirus vaccine and the combined 7-vaccine series compared with VFC-eligible children living at or above the poverty level. Although the VFC program provides vaccine at no cost, there may be fees for an office visit or non-vaccine services received during the visit. Healthcare costs beyond vaccination cost may be potential barriers for low-income households in addition to other barriers affecting access to vaccinations. Making sure all children have an established medical home increases the potential to be up to date with recommended vaccines.