What is the Public Health Preparedness of our Nation?
Jan 18, 2017
The Trust For America’s Health (TFAH) recently examined the nation’s ability to respond to public health emergencies. They tracked progress and vulnerabilities, and included a review of state and federal public health preparedness policies. In their report titled Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism, they found that 26 states and Washington, D.C. scored a six or lower on 10 key indicators of public health preparedness.
As Every Child By Two continues to report on the State of the ImmUnion, we’ve asked Trust for America’s Health to elaborate on the vaccine section of their report in the following guest post co-authored by Dara Alpert Lieberman, MPP, Senior Government Relations Manager and Albert Lang, Senior Communications Manager.
The Importance of Vaccines Can Never be Overstated
In the most recent report on public health preparedness from the Trust For America’s Health (TFAH), there is a line about vaccines that bears repeating:
“Some of the greatest public health successes of the past century — including the worldwide eradication of smallpox and the elimination of polio, measles and rubella in the United States — are the result of successful vaccination programs.”
Yet, somewhere along the way we lost our wonder in the awe-inspiring results vaccines produce.
A recent model estimated that, from 1994-2013, the Vaccines for Children program prevented as many as 322 million illnesses, 21 million hospitalizations and 732,000 deaths at a net savings of $1.38 trillion in societal costs. And, each year, we know that three million lives are saved because vaccines exist and are administered. According to the CDC:
- Nearly everyone in the U.S. got measles before there was a vaccine, and hundreds died from it each year. Today, most doctors have never seen a case of measles.
- More than 15,000 Americans died from diphtheria in 1921, before there was a vaccine. Only one case of diphtheria has been reported to CDC since 2004.
- An epidemic of rubella (German measles) in 1964-65 infected 12.5 million Americans, killed 2,000 babies, and caused 11,000 miscarriages. In 2012, 9 cases of rubella were reported to CDC.
If you think this is hyperbole, remember that we effectively eliminated measles in the United States in 2000, yet, since 2014, we have experienced a resurgent number of measles cases, largely among people who were unvaccinated.
In our recent report, Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism, we found that just 10 states vaccinated at least half of their population against the seasonal flu.
We like to use this as a bit of a proxy indicator. Basically, if we can’t vaccine a large portion of the population for something that is more or less the norm, what are the odds we could quickly vaccinate a majority of the population during a pandemic. For example, if there was a vaccine for Zika, would the nation been able to dispense it?
Another lesson we can draw from vaccination rates: when we become complacent, our preparedness suffers. We can’t let vaccine complacency continue. To improve vaccination rates, TFAH’s report included policy recommendations such as:
- Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of foundational capabilities alongside a complementary Public Health Emergency Fund which would provide immediate surge funding during an emergency;
- Minimizing vaccine exemptions. Health and education sectors should work together to ensure children receive required vaccinations;
- Boosting demand for vaccines. Federal, state and local health officials, in partnership with medical providers and community organizations, should continue to expand assertive campaigns about the importance of vaccines, particularly stressing and demonstrating the safety and efficacy of immunizations;
- Making adult vaccinations routine — including regular recommendations and referrals. Private providers and health systems should have standing orders for vaccinations so every provider of care for adults can assess the need, recommend and either provide directly or refer to another provider for vaccination;
- Reducing barriers to alternative delivery sites. Vaccination services, particularly for adults, should be offered by pharmacists and other community immunization providers;
- Increasing provider education. Professional medical societies and medical and nursing schools should support ongoing education and expanded curricula on vaccines and vaccine-preventable diseases;
- Ensuring first dollar coverage and access to all recommended vaccines under Medicaid, Medicare and private insurance;
- Continuing support for vaccine programs. The Vaccines for Children and Section 317 immunization programs provide a safety net for individuals who are uninsured or remain outside of the traditional healthcare system, such as children who are eligible but not enrolled in Medicaid/State Children’s Health Insurance Program (CHIP);
- Requiring universal immunization of healthcare personnel for all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP);
- Bolstering immunization registries and tracking. Federal and state policymakers should take steps to facilitate reporting of immunization;
- Requiring on-time immunizations — based on the medically-recommended vaccines for a person’s age and health status — as a quality measure for all health plans;
- Supporting expanded research and use of alternatives to syringe administration of vaccination; and
- Supporting the development and use of maternal immunizations.
During outbreaks and pandemics, we need to quickly vaccinate the effected population, yet we continually fail under routine and typical scenarios. Vaccines prevent diseases we know, illnesses that have already caused significant harm and damage.
We need to get vaccinations right because, every year, the world meets a new enemy. This villain might be microscopic – a new virus, resistant Superbug, or reemerging disease. Or it can be a visible menace, like a natural disaster or terrorist attack.
The nation would be a step ahead when a catastrophe occurs if we did better on vaccines.
Every Child By Two will continue to inform the public about the “State of the ImmUnion” in upcoming blog posts here on Shot of Prevention. Be sure to subscribe to this blog, like our Vaccinate Your Family Facebook page, or follow us on Twitter @ShotofPrev to receive critical updates on vaccine policy in the U.S.
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