BACKGROUND:
Women, Infants, and Children (WIC) -linked vaccination services are one of the most effective means to improve community pediatric vaccination rates among low income high risk children. However, additional resources from WIC are needed to implement these linkage strategies, especially with Monthly Voucher Pickup (MVP) in which the frequency of WIC visits are dependent on the child's vaccination status. Prior research indicates that direct costs and time required to conduct this strategy do not explain all barriers encountered from the WIC perspective, and that the financial structure within which local WIC programs operate may be the key factor.

OBJECTIVE:
To describe circumstances that promote or restrict the implementation of the MVP strategy promoting childhood vaccination services with local WIC programs.

METHOD:
Analysis of the programmatic costs and revenue streams associated with the implementation of WIC-linked vaccination services in urban and rural WIC programs.

RESULT:
While direct service costs for implementation of the MVP program are negligible, the financial contingencies within which WIC programs operate can unwittingly put sites in competition with each other.

CONCLUSION:
This study suggests that not only direct service costs but funding contingencies and the business environment within which vaccination programs exits must be analyzed to understand and support expansion of efficacious vaccination strategies.

LEARNING OBJECTIVES:
To describe circumstances that promote or restrict the implementation of the MVP strategy promoting childhood vaccination services with local WIC programs.