PRESIDENT'S BUDGET REQUEST: FY23

On March 28, 2022, the Biden Administration released the President’s FY 2023 budget. The Centers for Disease Control and Prevention (CDC) budget request for FY23 includes $10.675 billion in discretionary budget authority, Public Health Service evaluation funds, and Prevention and Public Health Funds, which is $2.3 billion over the FY22 appropriation. In addition, the CDC budget includes new proposed mandatory funding to establish a Vaccines for Adults (VFA) program and to invest in pandemic preparedness. This budget request will enable the Agency to invest in the core infrastructure of our country’s public health system.

 

The FY23 budget proposes significant investments in the discretionary Section 317 Immunization program, as well as legislative changes to expand the Vaccines for Children (VFC) program and to establish a new mandatory VFA program. In addition to an estimated $5.9 billion in mandatory resources for VFC under proposed law, and an estimated $2.1 billion in mandatory resources for the new VFA program under proposed law, the FY23 budget includes $1.3 billion, an increase of $383 million above FY22 enacted, in discretionary resources for Immunization and Respiratory Diseases. This includes $994 million for the discretionary Section 317 Immunization program, which will help transition to a sustainable program to support COVID-19 vaccination in the future, continue research related to long COVID19 conditions, and enhance support in the human papilloma virus (HPV) vaccination efforts in alignment with the Administration’s Cancer Moonshot Initiative priorities. 

 

Within the discretionary total, the FY23 budget also includes $251 million to enhance support for CDC’s influenza program, with a focus on increased surveillance of novel influenza viruses. The FY23 budget proposes to leverage the success of the VFC infrastructure by expanding the program to include all children under age 19 enrolled in Children’s Health Insurance Program (CHIP) and make program improvements, such as updating the provider administration fee structure to increase provider capacity and eliminating cost-sharing for eligible children. Legislation would have to be introduced and passed to accomplish.  

 

CDC is submitting a mandatory proposal for legislative authority and funding to establish the VFA program to provide uninsured individuals access to Advisory Committee on Immunization Practices (ACIP) recommended routine and outbreak vaccines at no cost. The VFA program would be modeled on the successful VFC program and tailored to adults. The VFA program would provide funding for the purchase of ACIP-recommended vaccines for eligible adults, provider fees, and program operations. As a complement to VFA program operation funding, CDC will also work with jurisdictions to leverage base immunization funding and other resources to support associated program operations costs and vaccine confidence and equity activities. The goal is to reduce the spread of preventable disease by building an adult immunization program to support high vaccination coverage among all adults. Ultimately, the program aims to reduce vaccination coverage disparities, improve outbreak control of vaccine-preventable diseases, and enhance and maintain the infrastructure needed for responding to future pandemics. 

 

Also, within the immunization programs, the request includes an additional increase of $25,000,000 for CDC to continue activities to address Long COVID, and an additional increase of $5,000,000 as part of the Cancer Moonshot to encourage the use of HPV vaccine. Additionally, the request also includes an increase of $50,000,000 above the FY22 Annualized CR for influenza planning and response where half will be dedicated to increasing surveillance of spillover viruses. These funds will continue to support the prevention of vaccine-preventable diseases (VPDs) across the lifespan by sustaining high vaccination coverage rates for routine immunizations, including influenza, and efforts to combat the ongoing COVID-19 pandemic.

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