Rural Health Day 2025 – State of Alaska (.gov)

Report on the Vaccines for Children (VFC) Program and its Contribution to Sustainable Development Goals

The Vaccines for Children (VFC) Program is a critical public health initiative designed to ensure that all children receive recommended vaccinations according to schedule. This report outlines the program’s structure, eligibility, and operational framework, with a significant emphasis on its alignment with the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 1 (No Poverty), and SDG 10 (Reduced Inequalities).

Program Objectives and Alignment with SDG 3: Good Health and Well-being

The primary objective of the VFC Program is to provide vaccines at no cost to eligible children, thereby protecting them, their families, and their communities from preventable diseases. This directly supports SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages. By removing financial barriers to vaccination, the program is a key mechanism for achieving universal health coverage (Target 3.8) and ensuring access to essential medicines and vaccines for all (Target 3.b).

Eligibility Criteria and Support for SDG 10: Reduced Inequalities

The program’s eligibility criteria are specifically designed to reach vulnerable populations, thereby addressing SDG 10 by reducing health inequalities within and among countries. A child aged 18 years or younger is eligible if they meet one or more of the following criteria:

• Medicaid-eligible
• Uninsured
• American Indian or Alaska Native
• Underinsured

Definition of Underinsured Status

A child is considered underinsured if their health insurance policy exhibits any of the following characteristics:

• Provides no coverage for vaccines.
• Does not cover certain recommended vaccines.
• Includes co-pays, coinsurance, or deductibles for vaccines, lacking first-dollar coverage.
• Imposes a fixed dollar limit or cap on vaccine payments.

It is important to note that underinsured children are eligible for VFC vaccines exclusively at Federally Qualified Health Centers (FQHCs) or Rural Health Clinics (RHCs), which serve medically underserved communities.

Financial Framework and Contribution to SDG 1: No Poverty

The VFC Program’s financial structure is foundational to its success in promoting health equity. By providing vaccines at no cost, the program alleviates a significant financial burden on low-income families, contributing to the goals of SDG 1 (No Poverty).

Vaccine Costs and Administrative Fees

There is no charge for the vaccine product itself under the VFC Program. However, providers are permitted to charge an administration fee to offset operational costs. This fee is regulated at the state level. Crucially, a provider cannot refuse to vaccinate an eligible child if the family is unable to pay the administration fee, ensuring that cost is never a barrier to immunization.

Other potential charges may include:

• Fees for non-vaccine services provided during the same visit (e.g., eye exam).
• An office visit fee if other medical services are rendered.
  • For Medicaid-covered children, this fee is paid by Medicaid.
  • For non-Medicaid children, payment arrangements must be made with the provider.

Eligibility Verification

Formal proof of eligibility is not required from the family. However, healthcare providers must inquire about and document the child’s status regarding the following:

1. Medicaid enrollment
2. Health insurance coverage status
3. American Indian or Alaskan Native heritage

Scope of Coverage and Provider Network

The VFC Program ensures comprehensive protection by covering all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). This includes provisions for catch-up schedules for children who are behind on their immunizations, further strengthening the commitment to universal health coverage (SDG 3.8).

Nationwide Provider Access

An extensive network of over 37,000 enrolled providers ensures broad accessibility across the United States. This infrastructure is vital for the effective delivery of vaccines to all eligible children. VFC providers can be found in various settings:

• Private medical practices and clinics
• Hospitals, including birthing hospitals for newborn immunizations
• Public health clinics
• Community health clinics
• Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs)
• Schools (in some states)
• Pharmacies (in some states)

Analysis of the Article in Relation to Sustainable Development Goals

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • The article’s primary focus is the Vaccines for Children (VFC) Program, which aims to ensure children are vaccinated on schedule to protect them from preventable diseases. This directly aligns with SDG 3’s goal of ensuring healthy lives and promoting well-being for all at all ages. The text explicitly states, “Vaccinating on time means healthier children, families, and communities.”
2. SDG 10: Reduced Inequalities
   • The VFC Program specifically targets vulnerable and economically disadvantaged groups to ensure they have equal access to essential healthcare. The eligibility criteria mentioned—”American Indian or Alaska Native,” “Medicaid-eligible,” “Uninsured,” and “Underinsured”—demonstrate a clear effort to reduce health inequalities based on economic status and ethnicity, which is the core objective of SDG 10.
3. SDG 1: No Poverty
   • By providing vaccines at no cost, the VFC Program alleviates a significant financial burden on low-income families. The article states, “There is no cost for the vaccines given by VFC Program providers to eligible children.” This financial relief helps prevent families from incurring medical debt or choosing between healthcare and other essential needs, thereby contributing to the broader goal of ending poverty.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
   • The article details how the VFC Program provides “no-cost vaccines” to eligible children, directly addressing the need for affordable and accessible vaccines. It ensures financial risk protection by eliminating the cost of the vaccine itself and capping administration fees, noting that providers “cannot refuse to vaccinate your child if you are unable to pay the vaccine administration fee.” This embodies the principles of universal health coverage for the specified demographic.
2. Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, colour, ethnicity, origin, religion or economic or other status.
   • The program’s design promotes health inclusion by explicitly targeting children who are “Medicaid-eligible,” “Uninsured,” “Underinsured,” or “American Indian or Alaska Native.” By removing financial and insurance-related barriers, the program ensures that children from marginalized economic and ethnic groups are not excluded from receiving essential preventative healthcare.
3. Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard.
   • The VFC Program is a specific policy action designed to reduce inequalities in health outcomes. By guaranteeing access to vaccinations for vulnerable populations, it works to ensure that a child’s health is not predetermined by their family’s economic status or ethnic background, thus promoting equal opportunity for a healthy start in life.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicator for Target 3.8 (Implied): Proportion of the population with access to affordable essential medicines and vaccines on a sustainable basis.
   • The article implies this can be measured by tracking the number of children who receive vaccinations through the VFC program. The eligibility criteria (“Children ages 18 years or younger who meet at least one of the following requirements…”) define the target population. Progress can be measured by the vaccination coverage rate within this specific group.
2. Indicator for Target 3.8 (Implied): Density and distribution of health workers/facilities.
   • The article mentions that “Over 37,000 providers are enrolled in the VFC Program nationwide,” including private doctors, clinics, hospitals, schools, and pharmacies. It also highlights the role of “Federally Qualified Health Centers (FQHCs)” and “Rural Health Clinics (RHCs)” in serving “medically underserved areas.” The number and distribution of these enrolled providers serve as an indicator of the program’s reach and the accessibility of vaccination services.
3. Indicator for Target 10.2 (Implied): Proportion of people reporting having personally felt discriminated against or harassed on the basis of a ground of discrimination prohibited under international human rights law.
   • While not a direct measure of discrimination, the program’s success in reaching its target demographics serves as a proxy indicator for reducing systemic barriers. The article lists the specific eligibility groups (Medicaid-eligible, Uninsured, Underinsured, American Indian or Alaska Native). Tracking the number of children served within each of these categories would indicate the program’s effectiveness in promoting inclusion for these specific populations.

4. Summary Table of SDGs, Targets, and Indicators

Source: cdc.gov