VFC-eligible kids miss vaccines because parents don't know VFC exists

The Vaccines for Children (VFC) program provides free vaccines to uninsured, underinsured, Medicaid-enrolled, and American Indian/Alaska Native children under 19. But many eligible families do not know the program exists. A parent without insurance assumes vaccination will cost hundreds of dollars and skips the appointment. So what? The child misses scheduled doses during the critical first two years of life when the vaccination schedule is most dense. So what? Catching up later requires extra visits, which means more time off work for the parent and more scheduling complexity. So what? VFC-eligible children living below the poverty level have measurably lower vaccination coverage for multi-dose series like rotavirus and the combined 7-vaccine series compared to VFC-eligible children above the poverty level -- proving that even within the eligible population, cost perception and access barriers suppress uptake. So what? These under-vaccinated children concentrate in low-income communities, creating pockets of vulnerability precisely where outbreak containment resources are thinnest. Why does this persist? VFC is a provider-enrollment program, not a consumer-facing one. There is no public-facing VFC enrollment portal for parents. Parents must find a VFC-enrolled provider (not all providers participate), and even then, the provider may charge an administration fee for the office visit. The program's existence is communicated primarily through provider networks, not directly to families.