Programs & Tools:
VFC: For Parents
Vaccines for Children Program Topics:
In 1989 - 1991, a measles epidemic in the United States resulted in tens of thousands of cases of measles and hundreds of deaths. Upon investigation, CDC found that more than half of the children who had measles had not been immunized, even though many of them had seen a health care provider.
In partial response to that epidemic, Congress passed the Omnibus Budget Reconciliation Act (OBRA) on August 10, 1993, creating the Vaccines for Children (VFC) Program. VFC became operational October 1, 1994. Known as section 1928 of the Social Security Act, the Vaccines for Children program is an entitlement program (a right granted by law) for eligible children, age 18 and below.
VFC helps families of children who may not otherwise have access to vaccines by providing free vaccines to doctors who serve them.
VFC is administered at the national level by the CDC contracts with vaccine manufacturers to buy vaccines at reduced rates.
States and eligible projects enroll physicians who serve eligible patients up to and including age 18 years and who provide routine immunizations.
Consult the next section "Which children are eligible?" to see the criteria that must be met in order to be eligible to receive a VFC vaccine.
Children through 18 years of age who meet at least one of the following criteria are eligible to receive VFC vaccine:
- Medicaid eligible: A child who is eligible for the Medicaid program. (For the purposes of the VFC program, the terms "Medicaid-eligible" and "Medicaid-enrolled" are equivalent and refer to children who have health insurance covered by a state Medicaid program)
- Uninsured: A child who has no health insurance coverage
- American Indian or Alaska Native: As defined by the Indian Health Care Improvement Act (25 U.S.C. 1603)
- Underinsured: A child who has commercial (private) health insurance but the coverage does not include vaccines, a child whose insurance covers only selected vaccines (VFC-eligible for non-covered vaccines only), or a child whose insurance caps vaccine coverage at a certain amount. Once that coverage amount is reached, the child is categorized as underinsured. Underinsured children are eligible to receive VFC vaccine only through a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC).
Children whose health insurance covers the cost of vaccinations are not eligible for VFC vaccines, even when a claim for the cost of the vaccine and its administration would be denied for payment by the insurance carrier because the plan's deductible had not been met.
The State Children's Health Insurance Program (SCHIP), known as Title XXI, enables states to expand health insurance coverage for uninsured children. Title XXI children enrolled in a separate State Children Health Insurance Program are not VFC-eligible because these children are considered insured. Title XXI children enrolled in a Medicaid-expansion SCHIP program are Medicaid eligible and entitled to VFC program benefits. Some states have implemented their SCHIP programs as a combination plan with some children becoming Medicaid eligible through an expansion plan and some children enrolled in a separate SCHIP. The Medicaid-eligible children are entitled to VFC program benefits, and the children enrolled in the separate SCHIP program are considered insured and are not entitled to VFC program benefits.
What is an FQHC?
An FQHC is a health center that is designated by the Bureau of Primary Health Care (BPHC) of the Health Services and Resources Administration (HRSA) to provide health care to a medically underserved population. FQHCs include community and migrant health centers, special health facilities such as those for the homeless and persons with acquired immunodeficiency syndrome (AIDS) that receive grants under the Public Health Service (PHS) Act, and "look-alikes," which meet the qualifications but do not actually receive grant funds. They also include health centers within public housing and Indian health centers.
What is an RHC?
An RHC is a clinic located in a Health Professional Shortage Area, a Medically Underserved Area, or a Governor-Designated Shortage Area. RHCs are required to be staffed by physician assistants, nurse practitioners, or certified nurse midwives at least half of the time that the clinic is open.
If your child meets one of the VFC eligibility criteria listed above, the vaccine must always be provided free of charge.
Free of charge means just that. The vaccines have already been paid for with federal tax dollars. This means that no one can charge a fee for the vaccine itself.
However, each state immunization provider has been granted (by law) the ability to charge what is called an "administrative fee." An administrative fee is similar to a patient's co-pay, in that it helps providers offset their costs of doing business.
The amount of the administrative fee differs from state to state, based on a regional scale determined by the Centers for Medicare and Medicaid Services (CMS).
These regional administrative charges are maximum fees that providers may ask patients to pay. That means that if a state's administrative fee is $15.00, a provider may charge a patient any amount up to, but not exceeding that $15.00 charge, for each vaccine administered. There is no lower limit, so providers have the option to charge what they feel is fair, including no charge at all.
Consult the official list, Approved Vaccines and Biologicals for the VFC Program. The diseases that these vaccines prevent include:
- Haemophilus influenzae type b (Hib)
- Hepatitis A
- Hepatitis B
- Human Papillomavirus (HPV)
- Meningococcal disease
- Pertussis (whooping cough)
- Pneumococcal disease
- Rubella (German measles)
- Tetanus (lockjaw)
- Varicella (chickenpox)
VFC vaccines can be administered by any enrolled VFC Program provider (private doctor, private clinic, hospitals, Public Health Clinic, Community Health Clinic, Schools, etc.).
Most pediatricians (doctors specializing in the treatment of children) in the United States and its Territories are now VFC enrolled providers. Additionally, many family practice providers are now enrolled, as well as general practitioners, and many other sub-specialty healthcare providers. In some States, schools are enrolled. Altogether, there are over 50,000 providers enrolled in the VFC Program nationwide.
Your State or Territory Health Department is responsible for managing the VFC Program where you reside. Your local County Health Department or Health District participates in coordination with the State or Territory.
Each State or Territory has a VFC Program Coordinator that is responsible for enrolling providers and monitoring the provider's participation in the program. Consult the complete list of State/Territory VFC Coordinators.
National Center for Immunization and Respiratory Diseases (NCIRD) website
Provides information about vaccines, including precautions and contraindications for immunization and vaccine shortages.
CDC Information Contact Center
- VFC Program in Brief
- Vaccine Information Statements
- VFC Contacts
- VFC Acronyms
- Recommended Child Immunization Schedule
- Catchup Schedule
- State Immunization Program Web Sites
Content last reviewed on November 1, 2007
Content Source: National Center for Immunization and Respiratory Diseases