During 20032004, the NVAC working group conducted a series of discussions and meetings leading to a proposal for substantial, but incremental, changes to the current system that the group feels would go a long way toward stabilizing the financing of immunizations in the United States. In contrast to the IOM recommendation to replace the current immunization financing system with an insurance mandate and system of subsidies and vouchers, the NVAC would like to see "expanded and stable funding for the existing immunization grant program, expansion of the Vaccines for Children program, regulatory harmonization, promotion of 'first dollar' insurance coverage for immunizations, and the assurance of adequate reimbursement for the administration of vaccines."
When the IOM recommended, among other things, that insurers be required to cover immunizations, that vaccine prices be set in advance of their development, and that vaccine coverage decisions include societal benefits and costs, including consideration of the impact of the price of a vaccine on recommendations for its use, there were widespread and varied responses. Editorials in the Wall Street Journal and the New York Times helped raise awareness of the complexities surrounding the vaccine industry. A briefing was held at the American Enterprise Institute at which reservations were expressed by many stakeholders about the Commi