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With School Vaccine Exemptions on the Rise, What Can Be Done to Protect Our Students?

June 12, 2018 1 comment

Today, PloS Medicine published a study that examined the increase we are seeing across the country in philosophical exemptions to school vaccine requirements, also known as personal belief exemptions.

According to the authors, 12 of the 18 states that allow philosophical exemptions have seen an increase in parents choosing to exempt their children from one or more vaccines. As a result, several metropolitan areas are at risk of an outbreak of disease, such as measles, similar to the one we saw originate at Disneyland in Anaheim, California three years ago.

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The Washington Post notes that the study “characterized many rural counties, as well as urban areas, as ‘hotspots’ because their high exemption rates put them at risk for epidemics of measles, whooping cough and other pediatric infectious diseases.

Amy Pisani, Executive Director of Every Child By Two/Vaccinate Your Family, expressed concern about what is known as the “community protection threshold” by stating, 

“It’s alarming to see the rise in exemption rates across this country, putting communities at greater risk. Parents need to understand that timely vaccines are critical to protecting children’s health and should be at the top of the family’s to-do list.”

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While the study reveals some interesting data points, there’s little information as to why it appears that parents are increasingly claiming exemptions for their children.

In most states, the school vaccine exemptions tend to be elevated in a handful of communities, as opposed to a general rise in exemptions throughout the state.  It appears that more research needs to be done to better inform public health policymakers regarding the underlying reasons parents are exempting their children from school required vaccines.

In the meantime, some of the states with the highest levels of exemptions have passed legislation to make nonmedical exemptions more difficult to obtain. For example:

  • In Washington state, a law was passed that required parents to have their exemption form signed by a health care provider.
  • In Oregon, parents have the option of watching an online module on the dangers of not vaccinating or getting a form signed by a health care provider.

While both states saw an immediate and encouraging reduction in the number of exemptions claimed, it appears that these policies have not been effective over time and exemptions are once again on the rise.

Tightening laws and policies clearly does not keep those parents who are intent on seeking exemptions from obtaining them. But how about eliminating nonmedical exemptions?

After the 2014-2015 measles outbreak in California, the state legislature decided to eliminate all nonmedical exemptions. Again, one year after the law was passed exemption rates fell dramatically and, most importantly, vaccination rates rose well above community immunity thresholds, thus better protecting communities against disease outbreaks.

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But what will the future hold?  Will parents who have philosophical reasons to avoid vaccines for their children find ways to obtain medical exemptions?

Initial data suggests that may be the case. According to an article in JAMA, the California medical exemption rate reflected a three-fold increase following the introduction of the law, from 0.17% to 0.51%. According to the article’s authors,

“Some vaccine-hesitant parents may have successfully located physicians willing to exercise the broader discretion provided by SB 277 for granting [medical exemptions]…If true, this practice would be inconsistent with the recommendation from the American Academy of Pediatrics to reserve [medical exemptions] for children having contraindications.”

In the coming years, public health partners may have a better sense of whether eliminating nonmedical exemptions can sustainably increase vaccination rates and protect our communities against dangerous vaccine-preventable diseases. We will also be looking to additional studies to learn how many parents are choosing exemptions because they have true personal objections to vaccinations, or because they don’t view vaccination as a priority among their long back-to-school lists.

In the meantime, it’s important to help state legislators and the public understand what has been tried to-date and what are the most promising policy paths forward. 

Here are some ways that you can be informed and help to inform others:

  • Consider sharing Vaccinate Your Family’s fact sheet on the impacts of exemption legislation with your local lawmakers to remind them of their role in strengthening our defenses against vaccine-preventable disease.
  • Check out Vaccinate Your Family’s 2018 State of the ImmUnion report to learn more about federal policies that aim to protect our families and communities from dangerous diseases.
  • Help ensure children are better informed about how diseases develop and how vaccines work with the immune system by sharing specially designed science curricula from The Vaccine Maker’s Project with school nurses and science teachers at your local elementary, middle or high schools.
  • Find out more about the vaccination rates in your state and community by contacting your local schools, public health department or reviewing the latest CDC vaccination coverage reports.
  • Stay informed about the latest immunization news and research by following Vaccinate Your Family’s Facebook, Twitter and Instagram accounts, subscribing to this Shot of Prevention blog and sharing the information we discuss on these channels with your social contacts.

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Together we can work to ensure that students get the protections they deserve in their schools and communities.

Immunization Funding is an Investment in Public Health that Saves Lives and Dollars

February 26, 2018 Leave a comment

ba3f8b28-e868-42b5-b217-1d8da24ffbd8For 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)

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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.   

Congress Proposes Big Cuts to Prevention and Public Health Fund

February 6, 2018 1 comment
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!



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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.

The State of the ImmUnion: A Report on Vaccine-Preventable Diseases in the U.S.

February 1, 2018 Leave a comment

As we continue to reflect on the State of the Union this week, Every Child By Two’s Vaccinate Your Family program has prepared a special report that examines the State of the ImmUnion.

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At a time when legislators are examining ways to make our country stronger and more resilient, this report emphasizes the need to improve our defenses against emerging health threats by detailing ways in which we can protect our citizens from the dangers of vaccine-preventable diseases.

The statistics are staggering.  Vaccine preventable diseases are currently costing our economy billions of dollars, all while threatening the health of our citizens.  As an example, each year flu causes anywhere from 3,000-49,000 deaths in the U.S. and over $87 billion in direct and indirect costs to our economy.  And this is just the toll of one particular disease over the course of one year.  There are plenty of other vaccine preventable diseases that we can, and should, turn our attention to.  There are also many actions we can take as a nation to raise immunization rates and lower disease incidence, all while saving both lives and money.

So what is it that public health advocates and legislators can do?

In the second annual State of the ImmUnion report, Vaccinate Your Family details the challenges that lie ahead and offers specific ways in which legislators can support strong vaccine policies.

Immunization supporters across the country are encouraged to share this resource with legislators and call upon them to strengthen the State of the ImmUnion.

Simply send them an email or tag them in a tweet with a link to the report (http://vaccinateyourfamily.org/soti).

Here are some suggested messages you can use:

Preventable diseases cost the U.S. economy billions each year! Legislators (tag key state/federal legislators) can help reduce these costs by ensuring all citizens have access to life-saving and cost-saving #vaccines. Get the facts from Vaccinate Your Family in their 2018 #StateoftheImmUnion report. http://vaccinateyourfamily.org/soti #SOTI2018

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What should legislators be doing to make the #SOTU more resilient in the face of emerging health threats? Strengthen the #StateoftheImmUnion with suggestions found in Vaccinate Your Family’s #SOTI2018 report. http://vaccinateyourfamily.org/soti

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Disease outbreaks like seasonal flu cost money and lives. Find out how policymakers can help ensure a strong #StateoftheImmUnion in Vaccinate Your Family’s #SOTI2018 report. http://vaccinateyourfamily.org/soti

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Thank you for your continued support and stay tuned for updates on how Vaccinate Your Family’s State of the ImmUnion report can be used to advocate for strong immunization policies throughout the year. 

Impact of Latest Congressional Actions on Immunization Programs

December 12, 2017 Leave a comment
By Erica DeWald, Director of Advocacy, Every Child By Two/Vaccinate Your Family

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As we near the end of 2017, we want to extend a big thanks to each of you! Without your support for immunizations, our voice would not be heard in Washington. Only through regular outreach to our lawmakers have we been able to demonstrate the impact federal policies would have on vaccination rates and thus our country’s health.

Unfortunately, our work for the year isn’t over yet. We are still closely monitoring the appropriations process as well as the reauthorization of the Children’s Health Program (CHIP), which provides health coverage for 8.9 million children who are uninsured.

Congress has twice extended the deadline for an FY18 spending bill. The next Continuing Resolution (CR) expires December 22. A new proposal from House Appropriations Chairman Frelinghuysen would extend funding for all non-defense spending through January 19 and reauthorize the CHIP funding for five-years. Unfortunately, the proposal also includes $6.35 billion in cuts to the Prevention and Public Health Fund (PPHF). As a reminder, PPHF accounts for 53% of the Immunization Program’s funding.

The Immunization Program’s non-PPHF funding also remains in jeopardy. The Senate has proposed level funding from FY17 for the Centers for Disease Control and Prevention’s Immunization Program (which received a 4 million dollar cut last year), while the House has proposed a 50 million dollar cut. That large of a cut would devastate immunization infrastructure. 

Both CHIP and the Immunization Program enjoy bipartisan support but Congress has had difficulty understanding how their funding choices affect our nation’s health. If fewer children are able to access health care through CHIP – either because Congress is delaying reauthorization or because they have instituted new demands that states match funds – then less children will end up receiving life-saving vaccines. Second, if Congress uses Prevention & Public Health Fund (PPHF) dollars to help pay for CHIP as proposed in the House bill, they are in fact cutting essential funds from the very public health clinics and immunization programs that accept CHIP and provide care to children.

Please consider calling your Representative and Senators to urge them to support ALL public health funding. Ask them to reauthorize CHIP without using the PPHF as a budgetary offset. You can find contact information for your legislators at whoismyrepresentative.com.

Every Child By Two/Vaccinate Your Family will continue to watch these legislative issues and do our best to keep you informed.   

Thank you again for your interest and support!

Educating Legislators About Preventative Health and Vaccination

October 30, 2017 Leave a comment

Every Child By Two will be making a special presentation on Capitol Hill on Tuesday, October 31st, alongside experts from the American Public Health Association, the American Diabetes Association and the National Council on Aging.

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The panel, which will be moderated by the National Coalition on Health Care, will discuss the vital role of Health and Human Services initiatives to drive down health costs and improve health outcomes at each stage of life.

Every Child By Two’s Executive Director, Amy Pisani, will explain the ability of vaccines to save both lives and money – and the impact federal funding cuts will have on our efforts to combat vaccine-preventable diseases in the U.S.

Please contact your legislators and suggest they attend this special presentation on Prevention Across the Lifespan.  

It will be held at the U.S. Capitol Visitor Center from 10-11:30 am on October 31st in room SVC-203.  If you are unable to attend, we encourage you to watch Every Child By Two’s portion of the presentation via Facebook Live on the Vaccinate Your Family Facebook page.

You may also want to review and share our 2017 State of the ImmUnion report with your legislators.

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This report examines what we can do, as public health advocates and legislators, to make our ImmUnion stronger and more resilient in the face of emerging health threats. The report highlights the successes of vaccines, the economic and societal savings incurred from vaccines, challenges facing the public health system and key areas of focus to achieve optimal protection against vaccine-preventable diseases.  There are even resources within the report that help individuals learn more about the vaccination rates in their state and what can be done to ensure the health of families throughout the nation.  To access the report, click here.

Help Stop Devastating Cuts to Immunization Infrastructure

July 20, 2017 18 comments

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The House is moving forward on budget proposals for Fiscal Year 2018 (FY18) and has suggested a $50 million cut to immunization funding to the Centers for Disease Control and Prevention (CDC).

This 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; and
  • Conduct surveillance, laboratory testing and epidemiology in response to disease outbreaks.
With the U.S. currently facing costly outbreaks of vaccine-preventable diseases such as 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 not asking for a funding increase, we are simply asking that Congress not reduce current levels of immunization funding.
States have already had to make tough decisions because of a $4 million cut in funds in the 2017 budget.

Please call your Representative today and tell him or her:

“Please reject the proposed $50 million cut to the CDC Immunization Program and maintain level funding for FY18. A funding reduction would have serious consequences for communities across the country at a time when outbreaks of vaccine-preventable diseases such as measles are on the rise.”

SOTI-Report_Cover.pngYou can also reference Every Child By Two’s 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 ImmUnion stronger and more resilient in the face of emerging health threats. You may even want to share this report with your Representative since it highlights the successes of vaccines, the economic and societal savings incurred from vaccines, challenges facing the public health system and key areas that we need to focus on to achieve optimal protection against vaccine-preventable diseases.

Please use Who Is My Representative? to quickly find your Member of Congress in the House.

Thank you for your continued support of immunizations and their critical role in protecting our health!