• Immunizations

    Access

    The American Academy of Family Physicians (AAFP) supports universal immunizations regardless of socioeconomic or insurance status, for all immunizations recommended by the AAFP, in collaboration with the Advisory Committee on Immunization Practices (ACIP), and current clinical vaccination guidelines.

    Cost of

    The AAFP supports and advocates for vaccination manufacturers and distributors to exercise fair and reasonable purchasing policies to minimize family physicians’ financial liability in maintaining a vaccine inventory.

    Government programs (e.g., Vaccines for Children [VFC], 317 Immunization Grants, or state “universal purchasing”) that subsidize the costs of vaccines at no cost to medical practices should be adequately funded by federal and state governments. Requiring clinicians to stock separate supplies of vaccines for the VFC Program and for persons covered by other payers can be burdensome and adds unnecessary administrative costs to practices. Therefore, the AAFP recommends states allow physicians to intermingle storage of VFC and other vaccine supplies, with appropriate documentation and cost accounting.

    Coverage and Payment

    The AAFP believes all public and private insurance should include as a covered benefit immunizations recommended for routine use by the AAFP and ACIP without copayments or deductibles, within all plans. This includes vaccine, counseling, and related administration fees. The AAFP supports the use of public/government funds to subsidize vaccinations for the uninsured.

    Public and private payers should pay for vaccines, their administration, and vaccine counseling codes in a fair and timely manner. Payment for immunization codes should account for all overhead costs including, but not limited to, acquisition, storage, inventory, insurance, spoilage/expiration, administration, supplies, etc. There should be no patient cost-sharing for vaccine administration or counseling codes. Further, when a significant and separately identifiable evaluation and management (E/M) service is provided during the same visit and properly documented, it should be paid in addition. The type of E/M visit, whether a preventive or problem-oriented visit, should also be paid by the insurer and not negated by the insurer in lieu of vaccine coverage.

    Distribution

    Family physicians play an instrumental role in caring for, counseling, and immunizing children and their families. Primary care physicians provide routine immunizations for children, adolescents, pregnant individuals, and other adults and have trusting relationships with patients that allow them to understand their unique health needs. The AAFP advocates for vaccine manufaturers/distributors and government-funded programs to deliver adequate, timely, and complete orders of recommended immunizations to family physicians in a prioritized manner to most effectively achieve universal vaccination of patients from their usual source of primary care. Doing so also supports public health vaccination efforts, increases vaccine confidence, and helps physicians meet quality measurement goals. In cases where government programs cannot properly supply physician practices with vaccines, the participating physician shall incur no penalties.

    Usual Source of Primary Care

    The AAFP recommends that patients receive all recommended immunizations from theirusual source of primary care. When recommended vaccines are provided outside of a patient's usual and continuous source of primary care, all pertinent vaccine related information should be submitted directly into the patient’s electronic health record and/or an immunization registry, so the patient’s primary care physician receives information in a timely manner to assure continuity of the patient’s medical record.

    The AAFP supports funding for data modernization, upgrades, and modifications to state immunization information systems (IIS). These resources are necessary for interoperability and bidirectional data exchange between IIS and those clinicians providing immunizations to reduce the administrative burdens that primary care physicians, pharmacists, and other clinicians face across the country.

    Supply

    The AAFP believes vaccine manufacturers/distributors should develop contingency plans for the timing and prioritization of vaccine supplies if an ample supply of recommended immunizations is delayed and/or reduced.

    (2008) (October 2023 COD)