BACKGROUND:
Federal evaluators are increasingly requiring federally-supported programs to demonstrate a link between program efforts and outcomes. National immunization programs may struggle to demonstrate this link because national vaccination measures are determined by the individual efforts of jurisdictional immunization programs.

OBJECTIVE:
This study uses a fixed-effects model to test the effectiveness of the Section 317 immunization grant program in raising vaccination coverage rates, while controlling for jurisdictional differences.

METHOD:
Using a fixed effects model, we evaluated the changes in the vaccination coverage associated with changes in 317 financial assistance allocations, controlling for changing demographic tendencies, time, and differences between jurisdictions over the years 1997-2003. Using an interaction term, we also assessed whether the impact of funding changed in 2002-2003 compared to earlier years. Data was collected from three sources. The annual percentage of children aged 19-35 months that completed the 4:3:1:3:3 vaccine sequence for 56 US jurisdictions was obtained from the National Immunization Survey. 317 FA funding allocations were obtained from the CDC's National Immunization Program. Demographic information was obtained from the Current Population Survey, March Supplement.

RESULT:
A 1% increase in 317 financial assistance allocations was associated with a 3.31% (p<.01) increase in vaccination coverage rates. The impact of funding did not significantly differ between the early and the later time periods.

CONCLUSION:
The 317 financial assistance grant program has been effective in increasing 4:3:1:3:3 vaccination coverage rates over the years 1997-2003. Significant differences may exist in program performance across jurisdictions and additional research should examine the cause of these differences.

LEARNING OBJECTIVES:
To understand the OMB PART mechanism and the issues involved in responding to its evaluation criteria. To understand how a fixed-effects model was specified to respond to the questions of OMB PART. To understand how federal funding was linked to improvements in coverage, while recognizing limitations of the methodological approach.