On The Hill

ECBT Attends 2004 National Influenza Vaccine Summit

Institute Of Medicine Releases Definitive Final Report Rejecting Relationship Between Vaccines And Autism

California's Health Plans And Coalitions Spearhead Activities During Immunization Week

Upcoming Events

Congress is currently at an impasse in its fiscal year 2005 budget negotiations (budget resolution).  The Senate is stalemated on the issue of whether to require offsets—lower spending in some areas and/or revenue increases--in order to accommodate any new tax cuts or spending increase.  The budget resolution sets spending limits for the appropriations committees.  Whether or not Congress can reach agreement on a final budget resolution, appropriators may send spending bills to the floor beginning on May 15. 

We are finding that Members of Congress understand the importance of immunization and the need to increase spending.  Their ability to do so is severely challenged this year, however.  Readers must make the case at every opportunity by citing the reduced illnesses and deaths achieved every day.  Your state wishes to immunize low-income adults against flu, pneumonia, tetanus and hepatitis in local health departments but cannot; pneumococcal conjugate vaccine is very expensive but also very effective.  Finally, efforts are underway to lift price caps on the relatively inexpensive vaccines, and soon even more vaccines will be recommended.  These arguments are all clear to us, and we need to make them clear to legislators.

Senators Jeff Bingaman’s  (D-NM) and Gordon Smith’s (R-OR) Children’s Vaccine Access Act (S. 2272) has had a positive reception with Congressional staffers.  The bill would allow state and local health departments to administer vaccines allocated to the Vaccines for Children (VFC) program to privately-insured children who lack coverage for immunization services.  VFC is an entitlement program, and as such, is a guarantee to those who qualify.  Currently those “under-insured” children can only receive vaccines through this program at federally-qualified and rural health centers, which can be inaccessible to many families.  By expanding the sites where VFC vaccine is offered, states would save on the vaccines they can purchase with 317 discretionary federal funding, which is limited.  States would be able to purchase vaccines for other low-income populations with their federal (317) grant dollars.  This bill is unlikely to move unless Members of Congress hear from their constituents.

There is some discussion about recommending the use of Hepatitis A vaccine to everyone.  On April 21, the Congressional Biomedical Research Caucus (a group of Members of Congress who share this interest) sponsored a briefing on Hepatitis A.  Dr. David P. Greenberg, director of a vaccine research center connected to the University of Pittsburgh School of Medicine and Children’s Hospital of Pittsburgh, explained the disease and its impact.  The Hep A virus causes liver inflammation in about 100,000 per year in the U.S.  The vaccine is nearly 100 percent effective with two doses.  In states where the disease burden is highest, Hep A immunization is required for school entry.  Greenberg recommends universal coverage at age two.  However, CDC and other experts who make the decisions about vaccine recommendations believe that the population is adequately protected from Hep A based on current recommendations.

Facilitating the use of electronic rather than paper medical records has been high on the list of federal priorities in the last month.  As the Alliance for Health Reform, the group that is co-chaired by Senators Rockefeller (D-WV) and Frist (R-TN) to inform members of Congress on health care policy, reports “the health care sector has languished behind almost all other industries in adopting information technology, which has the potential of vastly improving quality.  For example, a variety of studies have found that prescribing drugs through a system known as computer physician order entry, compared with a handwritten prescription, greatly reduces the incidence of the wrong medication being prescribed or the wrong dose dispensed.”  At an Alliance briefing on May 7, Dr. Thomas E. Sullivan, president of the Massachusetts Medical Society which publishes The New England Journal of Medicine, suggested that Congress commit funding to support the effort.

President Bush mentioned the need to use electronic systems for medical records in this year’s State of the Union address, connecting their use to reductions in medical errors and medical costs.  On April 27 the president announced his intention of establishing a nationwide electronic medical records system within 10 years.  For that purpose he’s created the Office of National Health Information Technology at the Department of Health and Human Services (HHS), and appointed David J. Brailer, MD, Ph.D director.  Dr. Brailer is a senior fellow at the Health Technology Center in San Francisco, has designed and advised electronic health information exchange projects.  He was CEO of a health care management company that provides on-line services.  An advisory committee to the President is dedicated to information technology, and one of its subcommittees deals with health care.

HHS Secretary Thompson held a summit earlier this month with health care industry and technology company leaders, physicians and others to discuss medical information technology.  The National Health Information Technology office is to coordinate and evaluate current and future HHS Department information technology efforts and establish technical standards to allow physicians and hospitals to share electronic records.  For those familiar with immunization registries, please note that HL 7 standards will be used in the expanded set of standards.  (The Health Level 7 is a voluntary international health standards setting organization that has been adopted by many immunization registries.)