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The central question of this research is whether state public health programs collaborate with other public and private institutions to promote public health goals. Public health administration is highly bureaucratized and dependent upon government support, but administrators can establish coalitions as adjunct to more traditional means of providing public health services. We explain how public health coalitions are beneficial to providing public health services and then assess whether administrators in state immunization programs collaborate with both the public and private sectors. The results of a 50 state survey of state immunization program officials suggest that coalitions between state immunization programs and institutions of the public and private sectors are common. Moreover, most state program officials think that the more extensive use of immunization coalitions is important for improving state immunization coverage. Our findings also indicate that some states have not yet maximized the potential involvement of the private sector to collaborate in public health efforts. [PUBLICATION ABSTRACT]