Elisabeth Rosenthal reports on the rising costs of vaccines, and the challenges pediatricians face in immunizing a nation of susceptible children:



There is little that Dr. Lindsay Irvin has not done for the children’s vaccines in her office refrigerator: She remortgaged her home to afford their rising prices. She packed them in ice chests and moved them when her office flooded this year. She pays a company to monitor the fridge in case the temperature rises.

“The security company can call me any time of the day or night so I can go save my vaccines,” said Dr. Irvin, a pediatrician. Those in the refrigerator recently cost $70,000, she said — “more than I paid for four years of medical school.”


Vaccines are expensive, and the expense is crushing to a pediatric practice’s cash-flow.  There are several reasons why vaccines cost so much.  Research, development, manufacturing, distribution, and storage are all costly, and there are very few companies worldwide that produce vaccines — essentially monopolizing the vaccine market.  The price of vaccines has gotten so high, in fact, that many pediatricians and pediatric groups have stopped providing immunizations in their offices:

Vaccination prices have gone from single digits to sometimes triple digits in the last two decades, creating dilemmas for doctors and their patients as well as straining public health budgets. Here in San Antonio and elsewhere, some doctors have stopped offering immunizations because they say they cannot afford to buy these potentially lifesaving preventive treatments that insurers often reimburse poorly, sometimes even at a loss.

To many pediatricians, not providing vaccines is as unthinkable as a baker not selling bread. Before they became widely available in the mid-20th century, tens of thousands of American children died each year from diseases like polio, whooping cough and diphtheria. “It’s up there with finding fire and the invention of the wheel,” said Dr. Irvin, 51, of vaccines.


This isn’t a new problem pediatricians face.  It’s an old problem that’s getting worse.  Vaccines are mandatory for school entry and attendance in most states, and the Affordable Care Act (ACA) now mandates that all childhood vaccines be covered at no out-of-pocket expense to families.  The unintended consequences of these positive policies is, unfortunately, hurting the most vocal and passionate advocates of vaccination —  pediatricians — and the very children we are all trying to protect.

Read more of Elisabeth Rosenthal’s NYT article here.