Improving Vaccination Efforts Requires Renewed Commitment

A Health Affairs blog post on Tuesday made the argument to invest in vaccine infrastructure and education to “turn the tide” on vaccine-preventable diseases, breaking it down by problem area. 

The authors, Amy Pisani, executive director at Vaccinate Your Family and J. Nadine Gracia, executive vice president and CEO at the Trust for America’s Health, argue that “the public’s health has suffered due to a lack of adequate resources to promote vaccinations.” The stigma around vaccination had fueled a spike of vaccine-preventable disease cases on a global scale.

Efforts are already underway to combat the rise of vaccine-preventable diseases. Still, there is a lot of work ahead as public health agencies, developers, and the like continue falling short. Like other public health threats (e.g., antimicrobial resistance) spread, it becomes increasingly urgent.

The World Health Organization recently explained how important vaccination is to address AMR. Vaccination is the second most important public health intervention only to water, it says. 

Pisani and Gracia outline a 3-part strategy that specifically applies to the US. "Solutions will require a renewed commitment to disease elimination, adequate funding, and enhanced bipartisan cooperation," they write. "Fortunately, Congress is currently considering strong bipartisan, bicameral legislation that would take important steps forward, including dealing with real-world impacts of vaccine hesitancy." Whether this legislation will advance remains unclear.

Solutions concern public health infrastructure, renewed vaccine confidence, and greater access.

State-of-the-art case monitoring technologies and systems for laboratory, communications, and vaccine distribution are seen as examples of infrastructure necessary for public health agencies, including the Centers for Disease Control and Prevention, to guard against disease outbreaks.

Legislation proposed in 2019, including the Lower Health Care Costs Act and the Leading Infrastructure for Tomorrow’s America Act, recognizes the need for infrastructure investment.

Pisan and Gracia cite another legislative proposal in support of the argument for addressing the hesitancy that has continued to plague vaccination rates. The VACCINES Act of 2019 would grant CDC new authority to promote confidence about the safety and effectiveness of vaccines’.

The authors point to a piece of proposed legislation in their call for access, as well, though this one is targets seniors. The Protecting Seniors Through Immunization Act would address the current situation whereby Medicare fully covers only certain vaccines, such as the flu vaccine.

"Special action is needed to overcome the obstacles facing certain populations with less access to core health services such as people with low incomes or those living in rural areas," the authors argue. Increased funding for the CDC's immunization program is a crucial starting point.

The CDC's immunization line item has failed to keep pace with how infection risks have risen. "It has been funded at roughly the same level ($610 million) for nearly a decade," the authors note. It is reportedly estimated $1 billion annually is needed to implement the CDC'sprogram fully.

The blog post follows on the heels of the CDC’s latest estimates on US influenza, reporting at least 13 million flu illnesses, 120,000 hospitalizations, and 6600 deaths from the flu this season. 

“Flu vaccine effectiveness estimates are not available yet this season, but vaccination is always the best way to prevent flu and its potentially serious complications,” the January 17 report says. 

A survey released by the American Academy of Family Physicians earlier this month, meanwhile, sheds light on just how common misconceptions about the flu and vaccines are.

Myths about vaccines are wide-ranging, from causing autism to natural immunity being more effective. Parents have been vaccine-hesitant and misinformed as a result. And a 2-year girl in Iowa reportedly became blind because of the flu earlier this month. Experts say an empathetic approach to talking about vaccines and patient-provider relationships can help move the needle.