While childhood vaccinations have been the subject of much debate in recent years, most informed health professionals will tell you they are vital to a child’s good health and development.
Current guidelines in the United States suggest that children receive around 14 different vaccines by the time they reach 4 years of age. This includes their yearly flu vaccine and all of the other single and multi-dose vaccines in the childhood immunization schedule.
Barriers and Challenges
Although the Affordable Care Act mandates coverage of all recommended childhood vaccines for all Marketplace plans and most private insurance plans without copayment or coinsurance, there are still policies that don’t cover certain recommended vaccines or any vaccines at all.
For children who are underinsured, there are a number of public and non-profit services designed to help low-income families access vaccines at little to no cost.
Federal Assistance Programs
It may surprise you that there are actually a great many places that offer free vaccinations to children. Some of these do charge a small administration fee ranging from $5 to $15 per vaccine or visit. Others waive the costs entirely for families who fall beneath a certain annual income threshold (typically measured by the annual Federal Poverty Level, or FPL).
If your family is uninsured or underinsured, you can often access free vaccines from doctors who participate in the Vaccines for Children (VFC) program. This federally funded initiative is designed to provide vaccines at no cost to qualified clinics with the aim of distributing them to the children most in need.
Vaccines distributed by the VFC can be administered by enrolled providers, including doctors, hospitals, and public or community health clinics. Children eligible for VFC include those who are uninsured, underinsured, Native American, or enrolled in Medicaid.
It is also important to check if your family qualifies for the Children’s Health Insurance Program (CHIP), which covers many childhood vaccines. CHIP provides low-cost coverage to children of families that earn too much money to qualify for Medicaid. Eligibility criteria vary by state. To find out more or to apply, call 1-800-318-2596 (TTY: 1-855-889-4325).
Manufacturer Assistance Programs
If your child is not eligible for VFC, some manufacturers offer patient assistance programs (PAPs) to qualified families. Most are based on annual incomes that range anywhere from four to five times the annual FPL.
For example, the FPL for a family of three in 2021 was $21,720. To qualify for most PAPs, the annual family income would need to be beneath $86,800 to $108,600.
In addition to meeting income requirements, most PAPs require that you either have no insurance or no insurance benefit for the prescribed medication. You don’t necessarily need to be an American citizen, but you must be a legal resident.
Available Patient Assistance Programs
Not every recommended vaccine has an associated PAP. Generally, those that are more expensive do (but not always). Those that currently have a PAP include:
According to the Centers for Disease Control and Prevention (CDC), the cost of all vaccines by 18 months is about $1,200 through CDC-subsidized programs and $1,600 through the private sector.
That doesn’t include the cost of a pediatric visit or the standard markup at your local pharmacy. Those kinds of costs would be considered excessive for most low- and middle-income Americans.
If forced to pay out of pocket, take time to shop around, and ask if there are any discounts or alternatives for families who cannot afford to pay.
Moreover, don’t assume that there is one price for a vaccine and one price alone. Costs can vary dramatically, so take every opportunity to do some comparison shopping.
There are a number of online tools that can help. One of the best is a free service called the HealthMap Vaccine Locator, which not only tells you which vaccines you need but uses your zip code to locate all relevant clinics and pharmacies in your area.
While retail pharmacies predominate the site, HealthMap does include an array of public clinics and health centers that offer free or low-cost vaccination services as well.
Pharmacy Discount Cards
Also, be sure to look into free pharmacy discount programs, like GoodRx, that offer discounts on many child and adult vaccines. Many retail chains like Walgreen’s offer their own programs that can reduce the cost of vaccination by anywhere from 5% to 20%.
A Word From Get Meds Info
If none of these options work for you, contact your child’s school and ask about any immunization opportunities sponsored by local hospitals, churches, or non-profit organizations. Schools are often the first places to know. School nurses may also be able to help in making local inquiries on your behalf.