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Every Child By Two Highlights From February
2006 ACIP Meeting
Paul Offit Briefs Media On Vaccine Safety
Concerns Every Child By Two hosted a media conference call with Dr. Paul Offit to address vaccine safety concerns on March 15, 2006. During the call Dr. Offit addressed issues concerning the topics of Autism, mercury and thimerosal, the alleged link between thimerosal and Autism, and unproven and/or dangerous therapies for Autism. Below is a transcript of the media call including the questions and answers that followed the talk by Dr. Offit. Every Child By Two has a recording of the call, minus the question and answer section, available at http://72.32.4.217/ecbt/Media%20Call%20Offit_03-15_4871230.mp3. We have also set up the recording so that you may listen to it as a podcast on your IPod or similar device. If you would like to put the podcast on your IPod please copy the link http://www.ecbt.org/OffitBroadcast.rss into the appropriate place in your ITunes or other capturing software, download the podcast and then synchronize your player with your PC. We also
encourage you to share this media opportunity with the press in
your home towns across the nation in the hope that they will better
understand these issues and better present them to their viewers and
readers.
Guest Speaker: Dr. Paul Offit
Operator:
Amy Pisani: Good morning. Thank
you so much for joining us today. My name
is Amy Pisani and I have served as
the Executive Director of Every Child By Two for the past 10 years. Our program was founded 15 years ago by
former First Lady Rosalynn Carter and former First Lady of Arkansas
Our
co-founders have been
advocating for timely immunizations for more than 30 years and have
seen so
many successes. Our country now boasts
the highest immunization rates ever recorded even though there are
more
vaccines and a more complicated immunization schedule today. Vaccines have wiped smallpox from the face
of this earth and in the past three years both measles and rubella have
been
declared no longer endemic in the What’s very
troublesome to
Every Child By Two though is that two million – 2.1 million children
are still
not receiving timely immunizations leaving them vulnerable to diseases
like
whooping cough, hepatitis, meningitis, influenza and others. And although rates are at an all-time
nationally, there are many states that fall well below the safety range
and
pockets of vulnerable children, particularly in inner cities. We find that rates among African-American
children are 13 percentage points lower than white and Hispanic
children, and
due to insufficient funding from Congress, state health departments are
being
forced to turn away children seeking vaccines. Today we’re
here to discuss
vaccine safety and legislation that’s being introduced in many states
to ban
the use of thimerosal in vaccines. I'm
so pleased that Dr. Before I give
the phone over
to Paul I’d like to make it very clear that Every Child By Two trusts
the
conclusions of the scientific community that the evidence does not
point to a
connection to vaccines. And one fact we
all know, immunizations have saved the lives of millions of children,
and not
immunizing a child due to unproven accusation about vaccine safety puts
his or
her life in jeopardy. Currently the only
vaccine that continues to contain Thimerosal is some influenza vaccines. But each year approximately 36,000 people in
the And let me
turn the phone
over now to Dr.
Thanks, Amy. For
those of you who don’t know me, I'm the
Chief of Infectious Diseases here at Children’s Hospital, The first –
the first thing
is just – just without going through autism in detail – but it is – it
is a
significant disorder that effects children and can – is associated with
behavioral and language and communication deficits.
There has been a fair amount of study which I
think has clearly shown that the disease is at least – or at least has
a
genetic basis. Which is to say when
you're trying to figure out whether or not something is associated with
– or has
a genetic basis probably the best way to do that is with twin studies,
which is
to say you look at the incidence of the disease in, say, an identical
twin of
someone who has the disease as compared to a fraternal twin of someone
who has
the disease. And when you look at those
studies what you find is that about 90 percent of an identical twin who
has –
where one of the twins has autism also has autism, whereas when a
fraternal
twin has autism the chance that that other twin would have autism is
much less
than 10 percent. So that sort of takes
out the environmental influenza and just looks at genetics I think and
has – and
there has been study after study that has shown that there’s at the
very least
a genetic basis. But that – I
think the
question from the parents’ standpoint is, OK, let’s – even if – given
that
there’s a genetic basis or genetic predisposition, is it possible for a
toxic
or environmental agent to cause autism. And
I think the answer to that question is yes. There’s
a couple excellent studies that have
looked at that. The first was a study
looking at children whose mother took a sedative called thalidomide. This was a drug that was – that was licensed
and used much more so in Now, the
second piece of
evidence – and it’s consistent with the thalidomide data – is data on
congenital rubella syndrome. Rubella’s a
virus; it was a virus that swept through this country for the most part
causing
epidemics every three to four years. And
during those epidemics – and this was before the vaccine was introduced
in 1969
– before those – when those epidemics occurred, every year we would see
about
20,000 babies who would have ear or eye or heart abnormalities because
of
rubella virus. What’s interesting – and
many people didn't realize this – is that rubella virus, when it
infected the
mother during pregnancy and therefore consequently affected the baby,
also
caused autism. But, again, just as with
thalidomide,
in order for babies to get autism the mother had to be infected in the
first
trimester, early in pregnancy. When she
was infected in the second or third trimester or certainly when babies
were
infected postnatally with – or after birth with rubella, there was no
increased
incidence in autism. So, again,
consistent with the thalidomide data there appears to be this window of
vulnerability when children are at risk for a toxic or environmental or
in the
case of rubella a viral factor that could increase the risk of autism,
again
consistent with the notion that there are developmental proteins
expressed
early in utero, meaning when the child is in the womb, that are – that
put a
children at risk for autism if those genes are in any way disrupted. And also there are studies in experimental
animals
like mice that suggest that some of these genes make these
developmental
proteins such as so-called WTN1 gene and others. So
it’s all – that is all consistent. So the next
question is, OK,
well, how about if the fetus is exposed to mercury, does mercury cause
autism
as thalidomide and rubella did. And I think the answer to that question
is so
far all the evidence that we have is no. There
is a – there are a number of things that can happen
during
pregnancy where the mother will react to her baby’s blood cells,
so-called
blood group incompatibilities. The ones
you probably know about are the ABO incompatibilities.
But there are also other incompatibilities
such are RH factor incompatibilities. And
when that happens, when the baby’s RH type is
different than the
mother’s RH type, the mother can actually make an immunologic response
to her
baby’s red blood cells, kill those red blood cells, and cause the baby
to be
severely anemic and die. And that’s why
there was a product developed called Rhogam – R-H-O-G-A-M – which is
given to
the mother during pregnancy primarily in the second and third trimester
to
prevent her from recognizing her baby essentially as foreign and
responding to
her baby as if the baby’s foreign. And
Rhogam, at least previously although it doesn't anymore, but previously
Rhogam
contained ethyl mercury which is Thimerosal. And there is excellent –
there’s
an excellent study that was reported recently in March 2005 in Also
consistent with that is
a – it’s an unfortunate natural disaster that occurred in Iraq in the
early
1970s where grain that was fumigated with methyl mercury, which is the
environmental mercury and different – and I’ll explain how in a second
– to the
ethyl mercury that’s contained in vaccines – that’s Thimerosal as ethyl
mercury, environmental mercury is methyl mercury, and methyl mercury
actually
is much more likely to accumulate in the body because it’s excreted
less well
than is the more harmless form of mercury contained in vaccines. But in any case, the grain was fumigated with
environmental mercury, methyl mercury, that grain was made into bread,
it was
distributed free of charge to farmers, and it resulted in one of the
worst
single-source mercury intoxications I think of man when 6,000 Iraqis
were
hospitalized and 450 were killed by that mercury intoxication. It was
also true
at that time that pregnant women ingested that bread that was fumigated
with
mercury and they delivered babies who had a variety of neurological
problems,
including mental retardation and epilepsy, but not autism. So again
consistent
with the Rhogam data, even massive exposure of the baby to – during a
time when
the child is developing, during a time when the child is most at risk
of
presumably, you know, developing autism if those early expressed genes
are
affected, those – even those babies didn't – didn't develop autism. So then the
next question is,
OK, well, how about postnatally, once a child is born if they are
exposed to
Thimerosal is there evidence that they are more likely to develop
autism. And there are four studies that
now have been
published on three continents. The United States, the United Kingdom,
Denmark
have all looked at whether or not children who are – who are given
vaccines
that contain Thimerosal as compared to children who were given vaccines
that
contained lesser quantities of Thimerosal or children who are given
vaccines
that don’t contain Thimerosal, is there a difference in the incidence
of autism
among those three groups. And the answer
was clear and consistent and reproducible – no. So
again that’s consistent with what was found sort of
with the in utero
studies, the studies when the baby’s in the womb, looking at that Iraqi
disaster as well as the Rhogam study. Further
– and this was actually an excellent paper that
was published by
Karen Nelson and Margaret Bowman in “Pediatrics” in 2003 – what they
did was
they looked at the symptoms of mercury poisoning and compared them to
the
symptoms of autism with regard to a variety of specificities including
head
size, psychological problems, sensory, speech, vision, motor disorders.
And
what they found was there was a clear difference between mercury
poisoning and
autism. And I think that’s one thing in the media that occasionally is
stated
incorrectly, that mercury poisoning and autism have similar symptoms. Not true. This is
a wonderful study. I’d
be
happy to sort of give you the details of that study if you like. The other
point is that I
think people have the notion that by avoiding the ethyl mercury, you
know the
25 micrograms or so of ethyl mercury that’s contained in the influenza
vaccine,
that they therefore will be avoiding mercury in significant quantities. Not true. I mean,
mercury is part of our earth’s crust. I
mean, ever since that earth’s crust was
formed and we had things like, you know, the leeching of rocks by sort
of
continual flow of water or volcanoes or burning coal, we release
mercury into
the environment. So mercury is in the
water that we drink. Mercury – methyl
mercury, environmental mercury. And
because it’s in the water we drink it’s in the formula that we give to
our
babies and it’s in the breast milk that we give to our babies. It’s breast milk – and there’s been several
studies that have looked at this – contains between 1.4 to 1.7
micrograms of
methyl mercury per liter. And this level
– not surprisingly, the levels are similar in both developed and
developing countries
because the notion of burning coal or having volcanoes or leeching
rocks is the
same in developed and developing countries. If
you – if you assume that a baby is breast-fed
exclusively up till six
months of age, that baby will consume about 360 micrograms of methyl
mercury. That’s twice the quantity of
mercury that was ever contained in vaccines and obviously
logarithmically
greater than the 25 micrograms of ethyl mercury that’s contained in the
influenza vaccine. And, remember, ethyl mercury is excreted from the
body much
more quickly than methyl mercury. So a
typical breast-fed baby will ingest about 360 micrograms of methyl
mercury as
compared to a child, say, who gets the influenza vaccine who will be
injected
with about 25 micrograms of ethyl mercury – a form of mercury which
will be
excreted much more quickly. So the notion
that – and so,
one, you know, there’s no evidence obviously that drinking water or
ingesting
breast milk or ingesting infant formula increases one’s risk of autism. And so obviously one wouldn't recommend
stopping breast feeding or stopping infant formula or stopping drinking
water
any more than one would recommend not receiving an influenza vaccine
that contains
Thimerosal. So as Amy
pointed in her
introduction, the real question for I guess moms and dads who call our
center
and ask, you know – you know, I – and say to us, you know, we’re scared
about
getting that influenza vaccine, we’re scared to receive Thimerosal,” I
think
the question becomes where do the real risks lie and how do we educate
ourselves about where the real risks lie. And I would argue, as Amy did
in her
introduction, that, you know, we know that every year about 75 to 150
children
will die from influenza, we know that every year up to 140,000 children
less
than five will be admitted to the hospital – I'm sorry, will – yes,
about
140,000 children less than five will be admitted to the hospital with
fever or
croup or bronchitis or bronchiolitis or pneumonia secondary to
influenza. And we know that the influenza
vaccine is
likely to induce the immune response that’s going to protect those
children
against disease. And so I think that
what parents need to know is that a choice not to get a vaccine,
including a
Thimerosal containing vaccine like influenza vaccine, is not a
risk-free
choice, it’s just a choice to take a different risk and given all the
information that I’ve just given you I think a different and much more
dangerous risk. The last
point that I want to
make and then I’ll turn it over to your questions is I think that
things have
changed over the last few years in a very dangerous way.
And that’s why I'm glad that Amy asked me to
be on this conference call. In the past
when, you know – autism is an awful disease. I
think it’s very frustrating for parents. I
think they want desperately to find
something to make it go away. And in the
past that thing were things like gluten-free diets or magnetic clay or
even
secretin therapy, I mean all of which are silly and aren’t going to
make a
difference but are not harmless. I think
a few years ago we crossed an important line, because now what’s
happened is
we’re starting to give “chelation therapy,” which is to say medications
whose
task it is to bind heavy metals such as mercury and help them be
excreted from
the body more quickly. And because
mercury doesn't cause autism they're given chelation therapy which will
in no
sense lessen one’s risk of autism. But
chelation
is not benign. And as I'm sure many of
you read, there was a child – a five-year-old with autism who was
brought to a
doctor in suburban Pittsburgh, in Portersville, Pennsylvania, who
rolled up his
sleeve and the doctor, you know, injected that child with a sodium EDTA
– EDTA
is just a chemical that helps to bialate – helps to bind any sort of
what’s
called a divalent cation. So mercury is
such of a cation, meaning – if you remember that from chemistry in high
school
it’s the thing with the two pluses after it. But,
you know, mercury isn’t the only thing that has those
to pluses
after it. I mean, so is lead, which is
why EDTA is also used for – you know, for lead chelation – but so does
calcium.
And calcium is something that’s necessary for our heart to beat. When this child was given this sodium EDTA,
it bound to calcium, it caused his heart to stop beating, he had a
heart attack
and died. He died because he received a
therapy that had no chance of making him better. The second
thing – and this
is I think even more heinous – is there is a drug called Leuprolide. That’s the generic name. It’s
– what it is, is it’s a drug which
ultimately suppresses a child’s capacity to make testosterone which is
necessary for a child’s development into puberty, a boy’s development
into
puberty. There are a number of drugs that have trade names associated
with Leuprolide,
but probably the most famous is – or most well-known is one called
Lupron. So now there’s this notion that
because
autism occurs more commonly in boys that because autism may be sort of
a
representation I guess of extreme boyishness that by giving this Lupron
that
you're going to again in some way decrease a child’s risk of getting –
of
progressing in their autism or that one can lessen the symptoms of
autism by giving
Lupron. Well, Lupron is given as a
chemical castration therapy to sex offenders. It’s also
given for adult men
who have prostate cancer; it’s given to women who have endometriosis. And the way that now – just search any of
these blogs – I mean, the way that these folks who are – who are
desperate to
do something for their children with autism are responding is they're
getting
their doctors to write a prescription for Lupron claiming that the
child has
precocious puberty and that therefore needs to have their testosterone
lessened
when the child in fact doesn't have precocious puberty. And this drug
has now –
and it’s not a cheap drug. It’s given
intramuscularly;
it costs 100 – a couple hundred dollars a dose. So
it’s an expensive therapy. And
doctors are completely complicit in this and I think this is where,
frankly, we
fail as a profession. People – you know,
doctors have been willing to say that – you know that the child has
precocious
puberty, which then allows the drug to be paid for by insurance. And it’s a drug that when given to 10 or 11
or 12 or 13-year-old boys is going to delay their onset of puberty, I
mean
change their capacity to develop. And I think
it’s just – it is
just frightening that we participate in that. And
I think that – this is to me is malpractice, this is
negligence that
results in harm. And I think that what
we haven't been able to do as a medical profession is have, you know,
things
like ethical societies or professional societies or even licensing
agencies get
involved and take away the licenses of people that do this. I just think we’ve crossed a very important
line here. I understand parents’
desperate desire to make their children better, but there’s no evidence
that
this will make them better, there’s abundant evidence that it will do
harm. And I think we’ve done very little
to stop this. And I think this is when
it’s – you know, when bad information goes to the level of really doing
harm. So I’ll stop
right
there. Thanks for your attention. I’ll take your questions. Operator: Thank you.
The question and
answer session will be conducted electronically today. If you would
like to ask
a question, simply press the star key followed by the digit one on your
telephone keypad. Also, if you are using
a speakerphone, please make sure your mute function is turned off to
allow your
signal to reach our equipment. Once
again, press star one if you would like to ask a question or make a
comment. We’ll pause for just one
moment. Our first
question comes from
Maggie Fox, with Reuters. Please go
ahead, ma'am. Maggie Fox: Thanks for
doing this. As you know, the autism groups
have assembled
quite a lot of evidence against the vaccines. They
cite a recent report that shows ethyl mercury remains
in the brains
of monkeys for longer than had been anticipated. They
also say that you are prejudiced and
that the CDC and vaccine promoters are prejudiced and are influenced by
drug
companies. Do you have anything to say
to that?
Yes, so
there’s two
questions, Maggie. I’ll take the first
one first. The study that you refer to
is that Brubaker study out of the University of Washington that looked
at the –
whether or not ethyl mercury had the capacity to enter the central
nervous
system, as you said in brains, as compared to methyl mercury. And that study did show that ethyl mercury
could enter it, although it did – it was present both in blood and in
the
central nervous system at significantly lower levels than was methyl
mercury as
one would have expected. But, again, I
think – I mean, I think that – you know, there’s nothing as strong,
frankly, as
the epidemiologic studies. And if you
look at the four studies that were published, what they found was that
there
was no evidence that Thimerosal at the level contained in vaccines
increased
one’s risk of autism. And these studies
were big, I mean big enough to pick up events that were occurring, you
know, as
rare as one per 100,000 vaccine recipients. I
mean, this is – and that’s a very sensitive study.
If you look sort of back at the swine flu
epidemic in the late ‘70s, the sort of swine flu vaccine given in the
late ‘70s
also caused – or caused a severe event, the so-called Guillain-Barre, at one per 100,000 people
easily picked up in a retrospective study. If
Thimerosal was even responsible for a very, very small
number of
cases of autism it should be easily picked up by these studies, and it
wasn’t. And so I think it wasn’t because
it’s not there to be picked up. In terms of
the question
about whether or not those in CDC or me or people who try and educate
the
public about the science of vaccines or the – or the benefits of
vaccines, I
think the notion that we are unduly influenced by pharmaceutical
companies can
only be made by people who don't know us. You
know, people, you know, like me or Amy Pisani: Maggie, this
is Amy as
well. I – first of all, I really – I
very much respect your journalism. And
I'm sure you must know many of the folks from CDC, and I'm – Mrs.
Carter and Mrs.
Bumpers actually presented at the final – the final presentation at the
National Immunization Conference last week. And
their message to the folks in the room was really to
thank them,
because these are incredibly intelligent people and they could have
chosen a
much more lucrative field, their professions, they could have made so
much more
money in their lives. But these are people that chose to go into public
health. And because – if you've ever met
them, they are so passionate about children and adults, and truly –
they really
truly want to help people. And they're
also, if you remember, many of them have children of their own, and
they're
immunizing their children. I can’t
imagine that they would take part in anything that would harm either
the public
or particularly their own children. And
so I just think it’s – it’s not helpful to society when people who have
these
allegations – and of course they have terrible things happen to their
children,
they need an answer. But it doesn't help
to make allegations, false allegations about the folks who really truly
are out
there every day trying to make a difference in the lives of people,
people like Operator: We will now
go to T. J.
Greaney, with Southwest – Southeast Missourian. Please
go ahead. T. J. Greaney: Hi, Dr. Offit. I
was wondering if you could speak
specifically to the research done by David and Mark Geier.
And within that study – have you read it,
first of all?
Well, there’s
a few studies
that they’ve published. Are you talking about ((inaudible)) ... T. J. Greaney: The
most recent one ...
T. J. Greaney: ... in the “Journal of American Physicians.”
Right, I did, yes. T. J. Greaney: OK. And within
the study what you think about the
vaccine adverse events reporting system that they've used for a lot of
their
data and how you explain the large rise in autism cases.
In a place, my home state of
So, again,
two
questions. So I did read the study in
the Journal, I think, of American Physicians and Surgeons by the Geiers. That one, the one I'm talking about, was the
one that showed actually a decrease in the incidence of autism in
children who
had – in California I think who had – over the last year or so, the
notion
being that since Thimerosal is largely out of vaccines that now autism
is
decreasing. First of all, you can’t –
you really can’t use VAERS data to answer that answer.
I mean, the VAERS so-called vaccine adverse
events reporting system is a – is a passive reporting system that is
co-directed by the CDC and the Food and Drug Administration. And
anybody can
report. I mean, I think the advantage of
that system is that should there be, you know, millions of children
immunized,
say, with a new vaccine, it’s a hypothesis generating mechanism. And that’s – it worked I think with the
RotaShield
vaccine where it was – there suddenly was an increase in reports of intussusception and that – the
so-called intestinal blockage. Then a
study was done comparing groups that did or didn't receive, you know,
the
vaccine to look at whether or not there was an increase in the relative
risk of intussusception. And
clearly there was. But that can only be
done by doing a
case-control study where you look at children and tie it to the medical
records
that did or didn't receive the vaccine. You
can never do that with VAERS data. And
because it’s a passive reporting system it’s just –
it’s impossible
to draw those kinds of conclusions. So I
think that’s why they published in something like the “Journal of
American
Physicians and Surgeons,” not a more reputable epidemiological journal
or
medical journal, because the data were just not able to support their
hypothesis. I'm sorry,
there was a second
question you had in there and I don't think I answered it. T. J. Greaney: Well, yes,
just the second
part of that is in a lot of states, including
Right. I mean,
also – and the same thing happened in Amy Pisani: T. J., this is
Amy. I just wanted to clarify as well. T. J. Greaney: Well, aren’t
there Thimerosal
alternatives, alternatives that are, you know, equally cost effective
or – Amy Pisani: Thimerosal-free
vaccines? T. J. Greaney: Yes. Amy Pisani: Flu vaccine? There
isn’t enough to go throughout the
country, though. The manufacturers are trying to speed up production,
but they
can’t do it any quicker than they are. And so there simply isn’t enough. Banning Thimerosal in a state doesn't help at
all because these children may in fact end up getting influenza and
then being
hospitalized and, God forbid, dying.
It’s a
classic example of
what we’re – we’re about to launch into where state by state sort of
passes
these restrictive laws is moving to – you know, moving away from any
multi-dose
vials, which will obviously make this much more expensive.
I mean, multi-dose vials make vaccines much
less expensive. But when you have a
multi-dose vial you need a preservative because you continue to violate
the –
you know, the rubber stopper with the syringe periodically or -- and
the needle
periodically. And so we’ll move to
single-dose
vials, which will be much more expensive and therefore make this less
affordable. And all for the notion, this
sort of – this – for political correctness. I
mean, Thimerosal, mercury, just is never going to sound
good. But the fact of the matter is the
mercury
contained in vaccines is much less – much, much less than you're
exposed to
during your normal day. But it’s just
politically a very easy weight to lift. And
it’s a shame because we’re going to spend a lot of
money on
something that has absolutely nothing to do with vaccine safety and is
only
going to make vaccines more expensive. Amy Pisani: And preclude
our ability to
create vaccines for a pandemic, because we need – we need multi-dose
vials in
order to get vaccines out to the entire country in the event of a
pandemic.
Well, I can
tell you this for
certain, that the government when they make pandemic flu vaccine will
make it
with Thimerosal, because there’s not a chance in hell that they would
be able
to make that many single-dose vials. So… Amy Pisani: Paul, if the
manufacturers
switch over to making single-dose vials, will they then be able to – it
takes a
long time to switch over to making multi-dose in the production
facility,
doesn't it?
Yes. Amy Pisani: (So maybe we
can take a
question). Operator: As a final
reminder, press
star one if you would like to ask a question or make a comment. We’ll pause for just one moment. There appears
to be no
further questions at this time. I would
like to turn the conference back over to Ms. Amy Pisani for any
additional or
closing remarks. Please go ahead, ma'am. Amy Pisani: I just want
to thank everyone
for taking the time to come to the call today. And
if you have any further questions you're more than –
we would love
to take your call – or e-mails at info@ecbt.org. Any
questions that you have for Dr. Offit as
well we can send over to him to answer for you. Again,
that’s info@ecbt.org. We
also have a very extensive website with all the information on vaccine
safety
available. And our website address is
www.ecbt.org. Dr. Offit also has a
wonderful website, and, Paul, I’ll let you give that website address.
Sure. It’s
www.vaccine.chop.edu. Amy Pisani: Thanks for
joining us, Dr.
Offit, and thank you very much, everyone, for coming today.
Thank you. Operator: That does
conclude today’s
teleconference. Thank you for your
participation and have a wonderful day. END Carter/Bumpers Celebrate Public Health Advocates During
National Immunization Conference by Amy Pisani (amyp@ecbt.org)
Rosalynn
Carter and Following
Carter’s speech, Bumpers led the
attendees in a
standing ovation to celebrate one another’s achievements stating that
“many of
you could have chosen a path that would have provided you with a much
more
lucrative income in the field of medicine. But instead, you followed
your heart
and dedicated yourself to serving the public, and serve them well you
have. The greater public may never know
the sacrifices you make every day and the hard work you conduct to
ensure their
safety. And that is why you must
remember to give one another, and yourself, the credit that you so
greatly
deserve. Rosalynn and I thank you… and
now I want all of you to stand up and take a moment to congratulate
those
around you for a job well done.” Carter and Bumpers also received a special recognition award given to Every Child By Two by the CDC National Immunization Program "In recognition and appreciation of 15 years of outstanding service in protecting children from vaccine-preventable diseases. Every Child By Two provided critically important leadership that helped the nation achieve the highest immunization ever for two year old children. (A Photo of Carter and Bumpers holding award with Dr. Anne Schuchat can be found at http://www.ecbt.org/images/AwardWeb.jpg) To
hear the presentations by both Mrs.
Carter and Mrs.
Bumpers recorded live at the 2006 National Immunization Conference
please go to http://cdc.confex.com/cdc/nic2006/techprogram/MEETING.HTM
scroll to the
bottom
of the page and click on “Closing Plenary Session” then click on the
blue and
green globe icon next to either Mrs. Carter’s or Mrs. Bumper’s listed
session. PLEASE
NOTE, you will not
be
able to listen to these recordings if you are using Mozilla Firefox web
browser, they only work with Internet Explorer or Netscape browser
versions. ******************************* Rosalynn
Carter Talking
Points National
Immunization Conference Betty
and I want to start by telling you we
have come here, 15
years after the inception of our Every Child By Two program, not to
celebrate
our own successes, but to celebrate a truly successful partnership
between
public health advocates, private foundations, physicians and the
Centers for
Disease Control and Prevention. We
are constantly reminded by the media
about the heroic
efforts of a fireman, or police officer who saved the life of a family
or
individual. Our society highly values
rescue heroes, and rightly so. But, our
society may never be aware that every year nearly 33,000 people owe
their lives
to those of you in this room, and to our counterparts in private
healthcare. You
helped to prevent over 14 million cases
of
vaccine-preventable diseases and you save our society nearly 42 billion
dollars
each and every year. That
is why Betty and I are so pleased to be
here today to celebrate
the many successes that have brought our nation record high coverage
levels,
even though there are more vaccines and a more complicated immunization
schedule than ever before. In
fact, since ECBT’s inception in 1991
children are
protected against six more diseases. These
include chicken pox, pneumococcal disease, influenza, meningitis,
hepatitis A
and soon rotavirus. In
addition, a new booster against whooping
cough can now be
given to adolescents and adults who have become a reservoir for
infecting young
children. In
2003 measles was declared no longer
endemic in our
country, followed two years later by rubella. Last year we celebrated the 50th anniversary of the Salk polio vaccine, which forever changed the lives of every human being on this planet. It
was the development of so many critical
vaccines that
necessitated a national strategic plan that would insure access to
immunizations to every child in this nation. One
excellent example is the Vaccines for
Children Program
(VFC), which was established in 1994. The
VFC program demonstrates the incredible success we can
celebrate
when both public and private providers work together to ensure the
health of
our nation’s most vulnerable children. More
than 40% of our children are currently
being vaccinated
in their own medical home, by nearly 1,000 participating physicians. VFC
is critical because it is an entitlement
program,
therefore as soon as the ACIP recommends a new vaccine, it can be
purchased and
distributed to participating providers – there is no lag time waiting
for
increased funding from Congress. On
the contrary, children who are currently
underinsured,
meaning that their working families have insurance but which doesn’t
cover vaccines
or charges high deductibles or co-payments are becoming increasingly
vulnerable. The 2007 Congressional budget
is not adequate
to pay for their vaccines. These
children are not eligible to receive
VFC vaccines
unless they travel to a Federally Qualified Health Center.
Relying on these centers limits access to
many underserved children due to location or accessibility. The Children’s Vaccine Access Act has been
introduced in Congress to remedy this gap in the system but receives
little
support each year. There
is certainly agreement among advocates
that a remedy
must be sought to resolve the vaccine funding crisis.
Options must be formulated and then carefully
considered in order to mend what may quickly become a large tear in our
immunization coverage net. We
have celebrated the discovery of several
new vaccines in
recent years, yet Congress has not allocated sufficient funds to
purchase these
life-saving drugs. 2.1
million children continue to be
under-immunized in our
affluent nation. Adolescents
need access to current and
future vaccines that
can save their lives, and health departments have little or no funds to
purchase and deliver vaccines to susceptible adults.
There
are also immunization disparities
among African-American children. All of us
have been
working hard to resolve the access issues that were felt to be much of
the
cause of under-immunization in hard to reach populations particularly
in
inner-cities. And yet disparities still
exist resulting in lower rates in African-American children. Research
shows that these children are in
fact being seen by
physicians enough times to be up-to-date, but for reasons which we
can’t
determine, they are not being vaccinated on time. Through
a Wyeth-funded project we will work
with several
cities to determine the causes and attempt to resolve these disparities. We hope to use already proven strategies
while personalizing approaches for each city and to share with you
results that
can be replicated throughout the country. This
is one example of why high overall
coverage rates can
not be the one and only indicator of victory over diseases. There are low rates being recorded in several
places throughout the country. And,
we have seen time and again in history
that if we don’t
make changes to the system of delivery before a crisis occurs, we will
see outbreaks of deadly diseases again. I
provide you these examples, not to
discourage you. Instead I hope to
encourage each and every
one of you to celebrate your successes and then improve upon them. We
must strive to better the system at every
chance. We face unprecedented
opportunities to fight
diseases, while at the same time; we have many challenges to overcome. We
need to ramp up our efforts to develop a
new and better
system that will provide incentives to manufacturers to develop new and
better
vaccines, and ensure the availability of those vaccines to everyone. History
has shown that we can always improve
on the core systems. It
wasn’t until the polio vaccine was
licensed in 1955 that
we saw any involvement of the federal government in
immunization
activities. After
polio vaccine was licensed, Congress
created the Polio
Vaccination Assistance Act and provided funds in 1955 and 1956 to help
states
and communities buy and administer polio vaccines.
Later,
in 1962 Congress enacted President
Kennedy’s proposal
– the Vaccine Assistance Act, which was legislation that allowed the
CDC to
support mass immunization campaigns and to initiate maintenance
programs. This
was the first time vaccines were
furnished directly to
state and local health departments instead of cash.
CDC’s
public health advisors and
epidemiologists were also
provided to the states for the first time to work on
vaccine-preventable
diseases. The
next year, the very first grants were
made to grantees
under section 317 of the Public Health Service Act.
As you know, funding levels for the 317
program has varied greatly, but never more so than in the 60’s and 70’s. It
was during this time that the measles
eradication effort
met such great success. By 1968 measles
incidence had declined by more than 90%. Unfortunately,
when the rubella vaccine was
licensed in 1969
to combat a terrible epidemic, all federal funding shifted from measles
activities
to rubella. The result was a resurgence of
measles. Fortunately,
in 1971 the first measles, mumps, rubella
vaccine was licensed and in 1972 Congress appropriated additional funds
for the
purchase of vaccines other than rubella. But,
funding decreased dramatically by the
mid 1970’s. In 1970 federal funding
reached $17
million. But by 1976, prior to Jimmy’s
election, funding had decreased to only $5 million.
Another epidemic of measles followed. Well,
measles had no idea what it was up
against, because
Betty Bumpers was hard at work in Arkansas in the 70’s and she was
about to go
national with her campaign to stomp out children’s diseases. In 1977 a national childhood immunization initiative was announced. We had two goals
Joseph
Califano, Secretary of the Department
of Health,
Education and Welfare (now HHS) developed a plan that would require
increased
federal funding, increased volunteerism, increased public awareness
education,
and increased cooperation between federal agencies. By
1977 immunization grant funds rose from
$5 million to $17
million and by 1979 we received $35 million. We
also worked hard to pass laws in every
state mandating
vaccination for school entry. 28 million
records were reviewed in two years and by 1981 95% of children entering
school
were immunized! This meant that we
reached our goal of 90% rates for all children, although the infant
levels were
still much lower. By
1989 immunization grant funding reached
127 million. Unfortunately, most of the
increases were for
the purchase of new vaccines. There were
very minimal increases for the delivery systems needed to distribute
vaccines. As
you know, there was a terrible outbreak
of measles from
1989-1991 which resulted in 55,000 cases. That
is when I called on Betty and we decided to start our
Every Child
By Two Campaign. In
our early years we focused almost solely
on raising
awareness of the need for timely infant immunizations by traveling to
every
state in the country to publicize the crisis. We
encouraged the establishment of
coalitions in every state
and urged our friends and colleagues to play a visible role in
promoting
immunizations to their constituents and to serve on the coalitions. A
very important change also occurred at the
national level
in 1991. Federal funds to pay for
immunization
services including nurse salaries, clinic costs and supplies were
allocated for
the first time as part of President Bush’s immunization initiative to
raise
childhood rates to 90%. State
and city grantees were required to
create Immunization
Action Plans, most of which focused on the need to increase the
availability of
immunization services. Developing
community
partnership became a key component to the state plans. Later
in 1993 President Bill Clinton formed
the Childhood
Immunization Initiative. The objectives
of this initiative included:
And,
thanks to the collaboration between
private sector
organizations like the The
National Association of Health Plans
also promotes
consistent coverage for routine immunizations by health insurers. In
1993, the Centers for Disease Control
placed an even higher
priority on immunization activities and created the National
Immunization
Program (NIP). NIP and state and local
health departments worked together with partners and coalitions to
conduct mass
campaigns, raise awareness and share successful strategies. Today we enjoy a rich culture of partnerships
and we are celebrating one another’s success. Immunization
registries have been developed
and are being
used by providers throughout the country. This
was once a goal that seemed unattainable, and yet now
we are
working to insure that they are integrated with even more inconceivable
technology of electronic health records. Another
partnership that we are grateful for
is the Women
Infants and Children Program (WIC), which has been instrumental in
assessing
immunizations of their clients. These
are largely the same children that are eligible for the VFC program and
so it
is so helpful to have WIC screen these children and refer them to
providers
when they are not up to date. Funding
support rose significantly by 1995. But in
the following years programs received
drastic funding cuts. This
year the President’s budget requests
507.3 million for vaccine
purchase and delivery. But advocates agree that we require at least an
additional 250 million dollars to meet immunization program needs. History
illustrates that disease levels seem
to be
correlated to national and state-level priorities.
When our nation makes public health a high
priority and provides funding to support outreach and delivery,
diseases
retreat. Conversely,
when public support and funding
declines, we
have repeatedly witnessed outbreaks of disease. In
the past 15 years we have developed
six new vaccines
to combat deadly illnesses in children. Congress
has responded by providing insignificant
increases in funding. This
shortage in funding has resulted in a
two-tiered
delivery system, where some children receive all vaccines, while others
are
denied. This year alone a vaccine for rotavirus was approved and later this year we hope to see approval of a vaccine for cervical cancer. Influenza vaccine recommendations were also expanded to protect even more children from this deadly disease and to hopefully protect child |
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