What Your Dentist Should Be Telling You About Oral Cancer and HPV
I had my teeth cleaned yesterday, and while I was at the dentist I remembered that April is Oral Cancer Awareness Month.
The dentist never mentioned it, but I knew just what she was doing when she put her gloves on and started rolling her fingers around the inside of my checks, under my tongue and on the outside of my neck and jaw. She was doing what all oral health professionals should do – a thorough examination that could help with early detection of oropharyngeal cancers (also known as cancers of the throat and tongue) which are commonly caused by the human papillomavirus (HPV).
As someone who has been diagnosed with two different cancers in the past, I no longer think “not me”. Quite honestly, knowing how prevalent HPV is (it’s estimated that 80% of sexually active people will contract HPV at some point in their life) it’s probably more likely that I would be diagnosed with an HPV related cancer than many other types of cancer. Although most cases of HPV resolve without incident, the fact remains that approximately 14 million new cases of HPV occur in the U.S. each year, with at least 79 million people estimated to be currently infected and about 31,500 cases of HPV related cancers diagnosed in men and women each year in the U.S.. This includes cancers in the oropharynx, cervix, vagina, vulva, penis, and anus.
While HPV can cause up to six different types of cancer, oral cancers are on the rise. It’s estimated that HPV-associated oropharyngeal cancer affects about 16,400 people each year, and that by year 2020, it will become the most common HPV-related cancer in the US, surpassing cervical cancer.
Here are a few other details to consider:
- 70% of all oropharyngeal cancers in the U.S. are caused by HPV
- cancers of the oropharynx are about 4 times more common in men than women
- 1 in 9 American men have oral HPV
- And get this…oral HPV has been detected in newborns when the mother has an HPV cervical infection
While I’m pleased that my dentist took the time to closely examine my neck, throat, mouth and tongue for any abnormalities, I’m disappointed that she didn’t take the opportunity to discuss the importance of HPV vaccination with me.
Education of the public regarding the risk factors which lead to oral cancer, recognition of the early signs and symptoms, and the development of patient awareness, are primary responsibilities of the dental community.
In 2017, the American Academy of Pediatric Dentistry (AAPD) issued a policy statement on HPV vaccination that encourages oral health care providers to educate patients and parents on the relationship of HPV to oral and oropharyngeal cancer and to counsel them regarding the HPV vaccination, in accordance with CDC recommendations. Currently, the CDC recommends two doses of HPV vaccination for girls and boys beginning at ages 11 or 12, but vaccination can be started at age 9 and can be administered through age 26 for females and age 21 for males.
While oral health professionals should be recommending HPV vaccination to all age-eligible patients, it would be prudent to also provide that information to patients who are parents. Although my dentist is not a pediatric dentist, my five children are also patients and we all get our regularly scheduled dental cleanings twice each year.
At no point has anyone at this particular dental practice ever discussed oral cancer or HPV with me or any of my children, despite the fact that all five of my children are considered “age-eligible”. (I know this because after my appointment yesterday, I asked my kids.)
Yesterday, my dentist failed to discuss HPV vaccination as a potential way to prevent oral and oropharyngeal cancers, which I consider to be a missed opportunity. However, during our collective twelve appointments each year for the past five years, it’s actually more like 60 enormous missed opportunities!
I get it. Dentists may not be comfortable discussing vaccines. Or HPV. But how comfortable can it be for them to have to tell their patients they may have oral cancer? How comfortable can it be for those patients who will end up having to suffer through an oral cancer that may have been preventable?
Fortunately, there are tests that can help detect HPV in women before they develop cervical cancer. However, the same is not true for HPV-related head and neck cancers. These cancers typically develop in the throat at the base of the tongue, in the folds of the tonsils or the back of the throat, making them very difficult to detect. That is why regular dental exams can be vital. But prevention is always preferred to treatment, and HPV vaccination represents our best chance at prevention.
Since my dentist didn’t provide the information I feel all parents and patients deserve to know, I plan to bring them this action guide for Dental Health Providers, created by the National HPV Vaccination Roundtable when I return next week for my daughter’s visit.
According to the Oral Cancer Foundation, there are over 100,000 dentists in the U.S., each one seeing between 8 and 15 patients per day. If you include those patients who come to a practice and see someone other than the dentist, such as the hygienist, the number of patient visits is significantly higher. If they each did their part to educate their patients, imagine what a huge difference they could make in boosting HPV vaccination rates and reducing oral cancers.
Until we start seeing more dentist taking these types of actions, please help spread the word about the association between HPV and oral cancers, during Oral Cancer Awareness Month and all throughout the year.
Below you will find additional resources regarding HPV vaccination and HPV-related head and neck cancers. Here’s hoping that you never have to deal with an oral cancer diagnosis, like Jason Mendelsohn, Scott Vetter, Frank Summers and others.
Other Resources:
National HPV Vaccination Roundtable
Vaccinate Your Family Website: HPV Information
How Flu Strains are Selected for the Seasonal Flu Vaccine Each Year
by Serese Marotta, Chief Operating Officer of Families Fighting Flu
The Centers for Disease Control and Prevention (CDC) recommends that everyone ages 6 months and older, with rare exception, get an annual flu vaccine. But did you ever wonder how the flu strains are selected for the seasonal vaccine every year?
A lot more goes into the decision than you might think!
Seasonal flu vaccines contain three (trivalent) or four (quadrivalent) flu strains. Because flu is a complex, dynamic virus that is constantly changing, there are more than 100 monitoring centers in over 100 countries located across the globe that monitor flu activity on a year-round basis to identify which flu strains are circulating.
These centers receive and test thousands of influenza virus samples from patients. They then send representative virus samples to five World Health Organization (WHO) Collaborating Centers for Reference and Research on Influenza, located in Atlanta, GA (i.e., the CDC); London, United Kingdom; Melbourne, Australia; Tokyo, Japan; and Beijing, China. The surveillance data gathered from these samples, along with other information, are used to make a recommendation on which flu strains should be included in the upcoming year’s seasonal flu vaccine.
Contrary to popular belief, the flu vaccine is not just based on last year’s flu viruses. Three general sources of information are considered in the selection of flu strains for the seasonal flu vaccine:
- Surveillance data represents information gathered from the influenza monitoring centers that collect virus samples from patients. Experts use this information to determine which flu strains are circulating and where.
- Laboratory data refers to antigenic characterization of the flu viruses in a laboratory, which simply means the identification of specific molecular structures on the influenza virus that are recognized by our immune systems and elicit an immune response. The antigen is the “invader” (i.e., in this case, the flu virus) that causes our immune systems to launch an attack through the formation of specific antibodies. Antibodies are what our bodies produce following flu vaccination so that it’s properly “armed and ready” to recognize and fight that specific flu virus if and when we’re exposed.
- Genetic characterization of flu viruses may also be considered in the selection of vaccine strains. This refers to “mapping” of the genetic codes that make up each flu strain, which allows the experts to monitor changes in circulating flu viruses.
- Data from clinical studies on vaccine effectiveness are also considered.
With this robust amount of data in hand, the WHO then meets twice per year to make a recommendation for flu vaccine strains for the upcoming season: once in February to recommend flu strains for the Northern Hemisphere seasonal flu vaccine, and again in September to recommend flu strains for the Southern Hemisphere seasonal flu vaccine. But it doesn’t stop there! Each country then considers the WHO recommendation, reviews the available information, and makes their own decision on which flu strains to include in their country’s seasonal flu vaccine.
In the U.S., once the WHO makes their recommendation for flu strains for the upcoming year’s seasonal flu vaccine, an advisory committee from the U.S. Food and Drug Administration (FDA) meets in February or March to review the WHO’s recommendation and supporting information and vote on the final selection of flu strains. The role of the FDA is an important one, because once the flu strains are selected, the FDA produces materials in their laboratories that are critical for actually producing the flu vaccines. For instance, the FDA provides vaccine manufacturers with the seed viruses and the potency reagents needed to ensure that flu vaccines made by one manufacturer are similar to those made by another. The FDA also conducts quality control measures by ensuring that batches (referred to as “lots”) of flu vaccines released by the manufacturers meet appropriate standards and reflect the correct genetic composition.
Following the selection of flu strains for the seasonal vaccine and receipt of the appropriate materials and information from the FDA, private sector manufacturers begin the process of making the vaccines. All flu vaccines in the U.S. contain the same flu strains, i.e., the flu vaccine available in New York contains the same three or four flu strains as the vaccine that’s available in California. And it’s important to remember that all flu strains (influenza A or B) can be potentially dangerous, regardless of an individual’s health status, and are capable of causing serious illness, hospitalization, or even death.
Influenza is a vaccine-preventable disease that has the ability to affect all of us around the world, which is why it remains such a pressing global public health issue. Seasonal flu vaccines may not be perfect, but given the complexity of flu viruses and their ability to change and mutate frequently, the U.S. does have a solid, scientifically-based approach for flu vaccine development. While much research and development is being done for a universal flu vaccine, the possibility of this technological advancement is still many years off. In the meantime, let’s not forget all the hard work and research that goes into helping to protect us with the currently available seasonal flu vaccines. And if you’re wondering “why bother” with a flu vaccine that may be substantially less than 100% effective, let’s remember that something is better than nothing, especially when it comes to your life or the life of a loved one.
More in-depth information on how flu strains are selected for the seasonal flu vaccine every year are available from the CDC and FDA.
About Families Fighting Flu: Families Fighting Flu (FFF) is a national, nonprofit, 501(c)(3) volunteer-based advocacy organization dedicated to protecting the lives of children and families by helping to increase annual influenza vaccination rates, especially among children 6 months and older and their families. Our members include families whose children have suffered serious medical complications or died from influenza, as well as healthcare practitioners and advocates committed to flu prevention. In honor of our children, we work to increase awareness about the seriousness of influenza and to reduce the number of hospitalizations and deaths caused by the flu each year.
Updates from the Advisory Committee on Immunization Practices February Meeting
Photo Credit: James Gathany, Centers for Disease Control and Prevention
The Advisory Committee on Immunization Practices (ACIP) held its first meeting of 2018 on February 21st and 22nd. The Committee consists of a panel of immunization experts that advise the Centers for Disease Control and Prevention (CDC). Part of their charter is to continually evaluate new data and update or change vaccine recommendations as warranted.
The agenda for the February 2018 meeting included presentations pertaining to several different diseases and vaccines, to include hepatitis, influenza, anthrax, HPV, pneumococcal, meningococcal and Japanese encephalitis.
A overview of the meeting is provided below, with details on presentations in the order they occurred:
Hepatitis B
The committee voted unanimously to approve a non-preferential recommendation for a new Hepatitis B vaccine (Dynavax’s HEPISLAV-B™) to their list of recommended vaccines for adults 18 years and older against infections caused by all known subtypes of Hepatitis B.
This vote came following the presentation of data showing that the new two-dose vaccine generates a more rapid and higher antibody response than the standard 3 dose vaccine.
Hepatitis B is a viral disease of the liver that can become chronic and lead to cirrhosis, liver cancer and death. The hepatitis B virus is 50 to 100 times more infectious than HIV, and transmission is on the rise. In 2015, new cases of acute hepatitis B increased by more than 20 percent nationally and 850,000-2.2 million persons are estimated to be living with infection in the U.S.
Since there is no here is no cure for hepatitis B, vaccination is our best chance at preventing the disease. While about 90% of people are infected during infancy, in adults, hepatitis B is most often spread through contact with infected blood and through unprotected sex with an infected person. Some individuals who are especially susceptible include those who are immunosuppressed or living with diabetes. The CDC recommends vaccination for those at high risk for infection due to their jobs, lifestyle, living situations and travel to certain areas.
The Working Group summary suggested that this new vaccine option is likely to improve vaccine series completion and result in earlier protection, which is especially beneficial in persons with anticipated low adherence such as injection drug users. Additionally, the improved immunogenicity in populations with typically poor vaccine response such as the elderly, diabetics and those on dialysis, is promising. The ACIP will continue to review post-marketing surveillance studies and additional data to ensure safety and cost-effectiveness considerations.
Hepatitis A
The committee voted unanimously to pass three recommendations pertaining to Hepatitis A.
- Hepatitis A vaccines should be administered for post-exposure prophylaxis for all persons 12 months of age or older.
- Hepatitis A vaccine or immune globulin (IG) may be administered to persons 40 years of age or older, depending on the providers’ risk assessment.
- Hepatitis A vaccine should be administered to infants age 6-11 months of age traveling outside the US when protection against hepatitis A is recommended. This recommendation takes into consideration the fact that infants under 12 months who will be traveling internationally will typically also need an MMR vaccine. Since Hepatitis A immune globulin and MMR vaccine should not be administered simultaneously, these children should receive a single dose of HepA vaccine. It’s important to note that infants should then complete the full, 2 doses of MMR and HepA vaccines at 12 months of age as recommended.
Influenza
The Committee heard five presentations specific to influenza.
The first two were reports of current season data; one detailing flu surveillance, the other providing early influenza vaccine effectiveness data.
According to the update, the majority of circulating flu strains are similar to those contained in the 2017-2018 vaccine. The only virus clearly showing antigenic drift was the B/Victoria lineage viruses which represents less than 1% of circulating viruses. So far this season, influenza A (H3N2) has been dominant, with influenza B activity starting to increase more recently. Activity has been the highest we’ve seen since 2009, and while final severity can’t be determined until the end of the season, hospitalization rates and mortality could be similar to or exceed those send during the severe 2014-2015 season.
Based on data from 4,562 children and adults with acute respiratory illness enrolled during November 2, 2017–February 3, 2018, at five study sites, the overall estimated effectiveness of the 2017–18 seasonal influenza vaccine for preventing medically attended, laboratory-confirmed influenza virus infection was 36%. The percentage differs by age group and by virus. A detailed report can be found here.
The most notable news out of the Committee last week was the vote to restore the live attenuated influenza virus (LAIV) vaccine as an option for the 2018-19 season. LAIV is commonly known as the nasal spray flu vaccine or by its brand name, FluMist This renewed ACIP recommendation offers FluMist as one of several vaccine options for non-pregnant people who are 2-49 years of age during the 2018-2019 season, but does not indicate any preference for FluMist over injectable flu vaccines.
While FluMist has not been recommended for the past two flu seasons due to reduced effectiveness against the H1N1 flu strain in children, the Committee heard three presentations specific to LAIV vaccine efficacy in children prior to taking a vote on future recommendations for LAIV. The first reported on the efficacy of Fluarix Quadrivalent in children 6-35 month of age. Another presented the results of a randomized trial of a new H1N1 LAIV strain in U.S. children. The third was a review LAIV in children 2-17 years of age.
The possible root cause of the poor effectiveness of LAIV against H1N1 was discussed and poor replication of the H1N1 selected strain was thought to be the likely problem. A new strain selection process is now in place in cooperation with the Food & Drug Administration (FDA) and it suggested that the antibody responses of the latest reformulated version of the quadrivalent vaccine, which includes the new 2017-18 post-pandemic 2009 H1N1 LAIV strain (A/Slovenia), will perform significantly better than what was previously observed when the vaccine included the 2015-16 post-pandemic LAIV strain (A/Bolivia). Immunogenicity and viral shedding data in small trials supported this notion, but no efficacy data is available at this time.
The Committee was therefore forced to a vote using only the science available to date. There was a lively discussion among members who expressed various concerns. While flu vaccine effectiveness is a serious issue, some committee members expressed concern that they may be holding FluMist to a higher standard than other influenza vaccines, yet all have efficacy challenges from year to year. Other members were concerned with how the vaccine may perform in an H1N1 dominated season. Until the vaccine is used, further effectiveness assessments are performed, and a prominent H1N1 year occurs, a certain level of uncertainty will remain.
While members voted overwhelmingly (12-2) to reinstate LAIV on the immunization schedule, a second vote to give other flu vaccines a preferential recommendation over LAIV failed (11-3). So, while the ACIP will not indicate a preference for any one type of flu vaccine over another, the public will ultimately determine whether there will be high uptake of this particular vaccine next season. Read more…
How One Teen is Engaging Her Peers to Help Eliminate HPV Related Cancers
By Allyson Rosenblum
What if you could save a life or prevent someone from the devastation of cancer simply be providing them with information, would you do it? What if it was someone you knew or cared about, would you do it then?
My name is Allyson and I am a 17 year-old high school student living in Southern California. Earlier this year, I set out to do something that I hope will make a difference in the lives of others. I would like to encourage teenagers who care about their health and the health of future generations to join me.
What I’m asking is fairly simple. I am requesting high school and college students to pass along valuable information about HPV infection and prevention to those they know and care about.
I have personally seen HPV and cancer devastate the lives and dreams of people I love. Beginning in October of last year, I witnessed my mother’s difficult battle with cancer every day as she endured three surgeries and eight months of chemotherapy. Two months later, my cousin informed me that she was diagnosed with cervical cancer resulting from an HPV infection she acquired as a teenager. At just 35 years old, she has now had to accept the fact she will never be able to have biological children of her own. Seeing all this pain and needless suffering has moved me to take action.
I decided to start a social media campaign on Facebook and Instagram, which I called “Two Shots To Beat Cancer.”
My goal is to enlist high school and college students throughout the U.S. to help in passing along information about the importance of early HPV vaccination to other high school and college students using various social media platforms.
Let me emphasize that this campaign is not about teen sex. Rather, it’s about prevention of HPV prior to sexual activity. If people can avoid acquiring the strains of the HPV virus that are linked to cancer, they will be less likely to suffer with an HPV related cancer later in life or pass the virus on to others. This is why the CDC recommends the HPV vaccine to 11-12 year olds. However, if a child did not get vaccinated in their pre-teens, it’s not too late. The vaccine is recommended up to age 26 for women and age 21 for men.
Unfortunately, most people my age do not want to talk about health related issues. We’re often uncomfortable talking about such topics, especially with adults, and reticent to share private information about ourselves. As such, many of us remain unaware of the dangers and prevalence of HPV, and questions and concerns often go unaddressed. However, it is precisely the lack of education and informed knowledge that allows the HPV epidemic to persist. By sharing timely and credible information among peers, I hope to empower my generation to take responsibility for their health and to help encourage better health practices among our peers.
I started this campaign in January and through the power of social media have already been able to get 1807 high school and college students to join me in all 50 states. With an average of 600 followers per student, that gives us the potential of reaching 1,084,200 students and counting! However, I’m not content with that. I believe we can do far better! In fact, if high school and college students were aware that there are 14 million new people acquiring HPV in the U.S. each year and over 50% of them are teens and young adults who are just becoming sexually active, than I believe they may see their important role in this mission.
I would encourage any high school or college student who cares about their own health, or the health of future generations, to find out more by visiting my website at TwoShotsToBeatCancer.org and joining the Two Shots To Beat Cancer Facebook Page and following our Two Shots To Beat Cancer Instagram account.
By joining me in this worthwhile endeavor, we can be the generation that puts an end to HPV related cancers. By posting to social media and sending letters to politicians, newspapers and school board administrators, we can make a difference and help to stop the spread of HPV. It takes little time, costs no money and by encouraging students to engage in important and life-changing conversations, we can save lives and prevent needless suffering.
Immunization Funding is an Investment in Public Health that Saves Lives and Dollars
For the past two decades, every President has proposed a fiscal budget that has underfunded immunization programming. Fortunately, over the years, Congress has been steadfast in approving higher amounts. As we approach another crossroad in our fiscal planning, we must, once again, call upon Congress to properly fund critical prevention programs.
In the following Op Ed published in The Hill, Every Child By Two Executive Director, Amy Pisani, makes the case that Congress should support the CDC’s Immunization Program to the fullest extent possible. In order to truly effect change, the program requires $1.03 billion. While it may seem like a hefty sum, the argument in favor of full funding is that an investment in public health will save lives as well as future expense.
Undercutting the Immunization Program
Puts Both Lives and Dollars at Risk
By Amy Pisani, executive director of Every Child By Two, a nonprofit organization committed to reducing the burden of vaccine-preventable diseases in families and individuals.
Earlier this month, President Trump released his proposed Fiscal Year 2019 budget. It notes an impressive achievement: For every $1 the Centers for Medicare and Medicaid Services (CMS) spends on preventing fraud and abuse, the agency saves $5.
Whenever you can spend money to save money in government, it’s a no brainer for policymakers. Unfortunately, that rationale seems to have escaped the President on the issue of vaccination.
For every $1 we spend on childhood vaccines, we save $10.10, which is nearly double the savings of preventing fraud. The vaccines given to children born over the past two decades will result in a savings of $360 billion in direct and nearly $1.65 trillion in societal costs.
The benefits don’t end with children. The U.S. still spends nearly $26.5 billion annually treating adults over the age of 50 for just four diseases that could be prevented by vaccines: influenza, pertussis, pneumococcal disease and shingles.
The majority of these avoidable costs are borne by federal health insurance programs. Yet for the second year in a row, the President has proposed gutting the Centers for Disease Control and Prevention’s (CDC’s) Immunization Program.
This is not just a discussion of dollars saved. It’s also a matter of lives saved. Over the past 23 years the Vaccines for Children program has prevented 381 million illnesses, 855,000 early deaths and 25 million hospitalizations, but we have much more work to do.
(Click here to read the full article on The Hill)
For information pertaining to the preparedness of our nation, and for suggestions on what we can do as a nation to make our country stronger and more resilient in the face of emerging health threats, review Vaccinate Your Family’s second annual State of the ImmUnion report here.
Meningitis B and Your College Student: Preventing the Call
Emily was a 19-year-old college student when she called home complaining of a headache. Thirty-six hours later, she passed away due to serogroup B meningococcal disease. Emily was able to donate six of her organs, together with bones and tissue, to save the lives of five others.
Emily’s mother, Alicia Stillman, who graduated from Arizona State University, returned to Arizona after founding The Emily Stillman Foundation to honor her late daughter’s life. She shared the story of how Emily contracted Meningitis B and her family decision to donate Emily’s organs. She also explained the work she is doing to help educate others about the availability of Meningitis B vaccines in the United States and to encourage organ donation. She spoke with Debbie McCune Davis, Director of The Arizona Partnership for Immunization (TAPI), who is leading the effort to increase awareness of the approved vaccine and who is working with Arizona Universities to promote the Off to College education campaign.
Together these two women share a message of hope, as they work to save lives and prevent serogroup B meningococcal disease by educating parents, students, educators and medical professionals across Arizona and the nation.
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- Alicia Stillman, Co-Founder and Director of The Emily Stillman Foundation and Co-Founder of the Meningitis B Action Project
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- Debbie McCune Davis, Director for The Arizona Partnership for Immunization (TAPI)
Alicia: I always felt I was living a blessed life. I enjoyed motherhood. I had three beautiful children, a wonderful husband, and a successful career. I believed I was doing everything right to raise healthy, independent children, as I sent each one off to college.
Emily and the Stillman family after her high school graduation.
My middle daughter Emily had a fabulous first year away at a small liberal arts college in Kalamazoo, Michigan. In 2013, she was well into the second semester of her sophomore year when she called home one evening, complaining of a headache. Thinking it was from lack of sleep, I advised her to take some ibuprofen, and to touch base with me in the morning. Little did I know that was to be the last time I would ever hear my Emily’s voice.
The call the next morning wouldn’t come from my Emily, but rather from the Dean of the College. She told me my daughter had been admitted to the hospital during the night with Bacterial Meningitis, that she was very sick, and I needed to get there as soon as possible. I remember insisting that this was not possible because even at that time, I knew she had received “the meningitis shot”. In fact, I even remembered that before she left for college, she had received a meningitis booster. What I did not yet know at that time was that the vaccine she had received (MenACWY) only protected her against 4 of the 5 common serogroups of Meningococcal Disease. I had no idea that there was a strain she was not protected against because a vaccine for that strain was not even available in the United States at that time.
Less than 36 hours later I said goodbye to my baby. My beautiful girl that I had promised to always protect and take care of was gone. As I said goodbye to her on that cold February morning, I told her that I would be ok…and that I would figure this out. I would make sure this could not happen to other people.
Debbie: Stories like Alicia’s weren’t preventable in the U.S. when Emily Stillman contracted and lost her life to Meningitis B, but they are today. In October of 2014 and January of 2015, the FDA approved licensing for two different vaccinations for Meningitis B. Soon after that, the Advisory Committee on Immunization Practices (ACIP) of the Center for Disease Control and Prevention (CDC) acknowledged that college age students should talk with their doctors about Meningitis B.
In Arizona, our Board of Regents (the governing board of our state university system) took quick action to recommend all incoming freshmen get the vaccine. There had been outbreaks in the PAC 12 schools and Arizona wanted to promote healthy campuses. We, at TAPI, worked with the Universities, their Medical Directors and all of our professional medical organizations including Osteopaths, Pharmacists, Nurses, and Pediatricians to put forth a unified message and raise awareness.
Our Off to College flyer launched an awareness campaign for parents and college age students to make certain each has the benefit of protection from all strains of meningitis.
Alicia: I live my promise to my Emily every single day with my work at The Emily Stillman Foundation. Before the vaccine was approved in the U.S., I discovered the vaccine was available in Canada. We took busloads of families across the Detroit/Windsor border into Canada to get the MenB vaccine. We met with the FDA (Food and Drug Administration) and many members of Congress to urge the fast tracking of the licensing process. I testified at the CDC and encouraged ACIP to grant a firm recommendation to protect our adolescents and young adults. I set up vaccination clinics locally to provide the vaccine before medical practices were willing to hear about it. I speak nationally, working with colleges, medical practices, and parents to raise awareness to this hideous disease, its symptoms, and the vaccinations now available to prevent it.
I won’t stop until the MenB vaccine is on the required list, and is available to all people. Only then will my promise to my Emily be fulfilled.
Debbie: Today, we at TAPI are taking it a step further…we don’t want kids to wait until they’ve moved into their dorms to receive their vaccination.
We are working with high schools, parents groups, physicians, athletic departments and more to promote Vaccinate Before You Graduate here in Arizona. We want this to become part of the college prep routine—take your college entrance exams, turn in your transcripts, apply for scholarships, choose your school, order your cap and gown and vaccinate!
As mothers, and as experts – one from a heart-breaking loss, and one as a professional who works tirelessly to prevent disease – we urge you to enjoy these moments with your child. However, as you are giving them that final send off, smoothing the bedding on their dorm bunk, stocking snacks and toiletries, telling them to study hard and have fun (but not too much fun), asking them to be safe, be sure to also give them the tools to stay healthy.
Make sure they have their boosters, that they are up to date on all vaccination and be sure your health professional has given your child protection from all strains of meningitis, including Meningitis B. If your child has already started that journey and is off to college, check with the student health services at their school for information about vaccine availability on campus.
Do it for your child, do it for yourself and do it for Emily.
Alicia Stillman lives in West Bloomfield, Michigan with her husband of 29 years, Michael. In addition to her angel daughter Emily, she has two live children – Karly, 25, and Zachary, 21. Alicia holds an MBA in Management Accounting, and is the Accounting Director for a multi-state Law Firm. She is the Co-Founder and Director of The Emily Stillman Foundation, founded in 2014 in memory of her late daughter Emily. The Foundation has a trifold mission to raise awareness for and encourage organ and tissue donation, to educate about Meningococcal Disease as well as all vaccine preventable diseases, and to advocate globally for all health and wellness issues. Most recently, Alicia partnered with Patti Wukovits to co-found the Meningitis B Action Project. Alicia can be reached through the Foundation at emilystillmanfoundation@gmail.com.
Debbie McCune Davis has served as Director for The Arizona Partnership for Immunization, better known as TAPI, since February 1996. She was an elected member of the Arizona Legislature, serving from 1979 until 1994 and again from January 2003 until her retirement in January 2017, serving in both the House of Representatives and the Arizona State Senate. In her local community Debbie serves on numerous committees and task forces, working to improve the health status of women and children in Arizona. She has established a reputation for being a knowledgeable advocate for maternal and child health and childcare issues. In 2012 she was recognized for her advocacy by the Children’s Action Alliance in Phoenix and Every Child By Two in Washington, DC. Debbie also served on the Board of Directors of the American Immunization Registry Association and she volunteers her time as a member of the planning committee of the National Conference on Immunization and Health Coalitions. She is married to Glenn Davis and has a blended family of 5 children and 3 grandchildren. More information about TAPI may be found at www.whyimmunize.org.
Congress Proposes Big Cuts to Prevention and Public Health Fund
by Erica DeWald, Director of Advocacy, Every Child By Two
Congress is Proposing a $2.85B Cut to Prevention and Public Health Fund (PPHF) over 10 Years
Congress is once again developing a Continuing Resolution (CR) to keep the government from shutting down on Thursday, February 8. Every Child By Two (ECBT) is pleased to report that the proposed CR budget also includes critical funding for many public health programs including two years of funding for community health centers and the National Health Service Corps.
Unfortunately, it also includes a $2.85 billion cut over ten years to the nation’s Prevention and Public Health Fund (PPHF).
Here’s how it’s broken down (courtesy of Trust for America’s Health):
| Fiscal Year | Current Law | Latest CR | Net | Cumulative Net |
| FY2018 | $900M | $900M | 0 | 0 |
| FY2019 | $800M | $900M | +$100M | +$100M |
| FY2020 | $800M | $1.0B | +$200M | +$300M |
| FY2021 | $800M | $1.0B | +$200M | +$500M |
| FY2022 | $1.25B | $1.1B | -$150M | +$350M |
| FY2023 | $1.0B | $1.1B | +$100M | +$450M |
| FY2024 | $1.7B | $1.1B | -$600M | -$150M |
| FY2025 | $2.0B | $1.1B | -$900M | -$1.05B |
| FY2026 | $2.0B | $1.1B | -$900M | -$1.95B |
| FY2027 | $2.0B | $1.1B | -$900M | -$2.85B |
| FY2028 | $2.0B | $0B | -$2.0B | -$4.85B |
As we’ve shared in previous updates, the PPHF accounts for 53% of Centers for Disease Control and Prevention’s (CDC’s) Immunization Program budget. Any cut could mean serious reductions in our country’s and states’ abilities to:
- Support the science that informs our national immunization policy.
- Provide a safety net to uninsured, low-income adults by enabling vaccine purchases;
- Monitor the safety of vaccines.
- Educate healthcare providers.
- Perform community outreach.
- Conduct surveillance, laboratory testing and epidemiology in response to disease outbreaks.
With the U.S. continuously facing costly outbreaks of vaccine-preventable diseases such as influenza, measles and pertussis (also known as whooping cough), now is not the time to weaken the backbone of our nation’s public health infrastructure.
We are watching these budget developments closely.
While it’s somewhat reassuring that Congress is replacing the money they cut from the PPHF to reauthorize the Children’s Health Insurance Program (CHIP) in this CR, no cut is acceptable. On the positive side, this delay in finalizing the budget does give us time to shore up support among Congressional Members for the critical services funded by the PPHF.
We will continue to send you updates on immunization funding and will be sure to let you know if we need to begin reaching out to our Members of Congress.
Thank you as always for your support of immunizations!
Every Child By Two/Vaccinate Your Family has prepared our second annual State of the ImmUnion report to examine how strong our defenses truly are against vaccine-preventable diseases and what we can do as public health advocates and legislators to make our country stronger and more resilient in the face of emerging health threats.
We hope this report will offer you insights into areas of improvement to strengthen our protection against dangerous, and potentially deadly, vaccine-preventable diseases.
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