**IHS Estimated Expenditures for Immunizations**

+--------------------+--------+--------+--------+----------+--------+
|                    | FY     | FY     | FY     | FY 2004  | In     |
|                    | 2001   | 2002   | 2003   |          | crease |
|                    |        |        |        | Estimate | or     |
|                    | Es     | Es     | Es     |          | De     |
|                    | timate | timate | timate |          | crease |
+--------------------+--------+--------+--------+----------+--------+
| Infants and        | \$10,3 | \$10,3 | \$10,3 | \$10     | +      |
| Children (\$)      | 72,296 | 76,548 | 86,519 | ,396,519 | 10,000 |
+--------------------+--------+--------+--------+----------+--------+
|                    |        |        |        |          |        |
+--------------------+--------+--------+--------+----------+--------+
| Adults (\$)        | 1,4    | 1,4    | 1,4    | 1        | +1,384 |
|                    | 35,384 | 36,760 | 38,140 | ,439,524 |        |
+--------------------+--------+--------+--------+----------+--------+
|                    |        |        |        |          |        |
+--------------------+--------+--------+--------+----------+--------+
| Alaska             | 1,4    | 1,5    | 1,5    | 1        | +      |
| Immunization       | 71,000 | 26,000 | 56,000 | ,580,000 | 24,000 |
| Program            |        |        |        |          |        |
+--------------------+--------+--------+--------+----------+--------+
|                    |        |        |        |          |        |
+--------------------+--------+--------+--------+----------+--------+
| Total              | \$13,2 | \$13,3 | \$13,3 | \$13     | +      |
|                    | 78,680 | 39,308 | 80,659 | ,416,043 | 35,384 |
+--------------------+--------+--------+--------+----------+--------+

The following method was used to estimate FY 2001 expenditures for
immunization services in the Indian Health Service (IHS). Since the IHS
patient care data system is not structured to measure itemized costs for
the treatment of various conditions, an indirect method was used to
compute this estimate. Included is the Hepatitis B and Haemophilus
Immunization Program in Alaska, which are actual appropriated figures
for that program.

Immunization costs were categorized into three target populations. These
include infants and children (3 to 27 months of age), adults (≥65 years
of age), and the Alaska Immunization project target population.

**By combining these three groups an estimate of \$13,278,680 is
calculated for IHS immunization expenditures in FY 2001, which is used
to estimate FY 2003 and 2004 expenditures.**

This amount is likely an under estimate for several reasons: 1)
Individuals outside these target groups are regular recipients of
immunizations (e.g. HBg immunization for health care workers and those
at specific risk for other immunizable diseases), however, there is not
a good way to estimate the size of these groups; 2) no measure is
available for the cost of monitoring (e.g., immunization registries);
and 3) no attempt was made to estimate indirect costs or administrative
overhead associated with the administration of immunizations, or
operation of the immunization program.