The Institute of Medicine (IOM) has reported that too many U.S. citizens are not getting the vaccinations they need and that the number of companies making vaccines has fallen to a dangerous level. The IOM has proposed a federal mandate for all health plans to cover immunizations, as well as a subsidy to defray the cost for private insurers and vouchers for the uninsured. The federal government already spends $1 billion per year on vaccinations, and most private health plans already cover them. Only five companies currently manufacture vaccines, but the trend may be reversible by relying on greater demand to raise prices. The proposals, if implemented, could reduce suffering, save money, and improve public health.