The US Congress should require all public and private health insurance plans to cover immunisations recommended by the government, says a report from an expert panel of the National Academy of Sciences.
The study was carried out in response to recent shortages of some vaccines and a reduction in the number of manufacturers of vaccines.
"Immunisation is too important to the nation for anyone to be left uncovered," said the panel's chairman, Professor Frank Sloan, of Duke University, North Carolina.
The panel's mandate would provide coverage for all insured children, Medicare beneficiaries, and some vulnerable people aged 18-64.
The federal government spends $1bn (£622m; €884m) on the vaccines for children programme and $300m to buy vaccines for state governments. Rather than buying vaccines the government should provide "a fixed subsidy" that would pay for each vaccine and the cost of administering it.
"Arbitrary government pricing would be devastating to vaccine research and development," the panel said in its report.
It says that the government should offer vouchers to people without insurance that could be used to obtain vaccinations from any doctor or clinic.
The panel also said in its report that "one in four children under age 2 is not up-to-date on recommended vaccines" and that immunisation rates were lower among adults, including among people with chronic illnesses. For example, in Florida only 74.5% of children aged 19 to 35 months have had the recommended vaccinations for nine diseases.
The cost of immunising children with the recommended doses of vaccine, at discounted government prices, has risen from $200 in 1997 to $435 today, and the cost to private purchasers is approaching $700.
Dr Donald Young, president of the Health Insurance Association of America, which represents the nation's private healthcare system said, "Health insurers agree that a properly immunised population is a worthy societal goal. But we believe [the] best health benefit design emerges from conversations among employers, employees, and health plans. Many health plans already cover some or all the cost of immunisation. To the extent that some health insurance fails to completely cover the costs of vaccinations, it is because employers and consumers have chosen not to include them in their benefits.
"The proposal for a fully funded mandate for vaccinations is an interesting concept worthy of further consideration. However, it seems at first blush to be a complicated approach to encouraging consumers to get the shots they need and supporting vaccine manufacturers in the development of new vaccines. We are concerned that the federal funding for the subsidy might evaporate over time, leaving behind the residue of another insurance mandate, which will drive up premiums and cause some consumers to lose their current coverage."
