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Highlights From February 2006 ACIP Meeting Paul Offit Briefs Media On Vaccine
Safety Concerns Carter/Bumpers
Celebrate Public Health Advocates During National Immunization
Conference Resources Available
To Education State Leaders About Vaccine Safety And Other Health Issues National Infant
Immunization Week 2006 Deputy National
Coordinator For Health Information Technology Sought CDC Sends Letter Regarding Revised
Hepatitis B Virus (HBV) Recommendations |
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.”
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 ensure 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 ensure 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 children in the event of a pandemic. Now
we must ask: Will
there be enough influenza vaccines to
meet our needs?
Both seasonal and avian. Are
manufacturers willing to continue to
develop new
vaccines, and in particular, vaccines for diseases seen mainly in
economically
deprived nations? Are
there proper liability protections in
place and
incentives for manufacturers to continue to research new vaccines? And
when new vaccines are discovered, but
not funded, which
children should we choose to vaccinate, and which ones should go
without protection? These
are questions you must take the time
to ask your
representatives at the state and national level. Members
of Congress will not respond to an
issue that does not concern their constituents. So let them hear your
concerns! And
in the meantime, we must work together
to develop
innovative ideas to shore up our immunization delivery system. Today,
there is so much for us to celebrate. But
we must strive for more, because we can't
stop until every child and adolescent is protected from
vaccine-preventable
diseases. Remember, there are four
million new ones born every year! |
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