FA16 Immunization Module’s Updates
Social/public policy hurdles for generating and administering vaccines
Brief Historical Background of Vaccines
Jenner’s smallpox vaccine led to the development and research of vaccines for other widespread and epidemic diseases. The twentieth century saw the development of vaccines for such diseases such as polio, tetanus, measles, and others. Similarly, as with the smallpox vaccine, many of these vaccines soon found their way into vaccination programs mandated by the government.
Mandatory smallpox vaccination programs typically arose through state police power legislation authorizing municipalities to deal with outbreaks. If a local municipality decided that the threat of outbreak was sufficient, they would execute their authority to mandate vaccination of everyone in the community, with the exception of those that were medically not recommended to do so. Those that chose not to be vaccinated tended to be quarantined and isolated from the rest of the community.
After observing that diseases became preventable by vaccination, the idea of waiting for an outbreak to trigger for mandatory vaccination slowly became replaced by vaccination programs that focused on the prevention of this diseases.
Despite vaccination being widely considered one of the greatest medical achievements of modern civilization, there are still children that are not being vaccinated throughout the world.
Let’s take a look at the percent of children 19-35 months old receiving vaccinations in the U.S.
According to the CDC, The percent of children 19-35 months old receiving vaccinations for:
Diphtheria, Tetanus, Pertussis (4+ doses DTP, DT, or DTaP): 84.2%
Polio (3+ doses): 93.3%
Measles, Mumps, Rubella (MMR) (1+ doses): 91.5%
Haemophilus influenzae type b (Hib) (primary series + booster dose): 82.0%
Hepatitis B (Hep B) (3+ doses): 91.6%
Chickenpox (Varicella) (1+ doses): 91.0%
Pneumococcal conjugate vaccine (PCV) (4+ doses): 82.9%
Combined 7-vaccine series: 71.6%
Although the percentages are relatively high, they show that there are children that are not being vaccinated.
The Affordable Care Act (ACA) has attempted to care of the financial gap by making vaccinations available across socio-economic backgrounds. ACA mandates provision of ACIP-recommended vaccines at no cost-sharing. Health insurance are mandated by law to cover ACIP-recommended vaccines, as well preventive check-ups. However, The Affordable Care Act it’s not extended to undocumented immigrants. Very few states cover children under medicaid look alike programs, such as All-Kids in illinois. However, the majority of the country does not extend their programs to undocumented immigrants, including children.
Similarly, many states have different exceptions to the immunizations requirements. This exceptions include: medical, religious and philosophical reasons.
For more information on the vaccines that are being covered :
http://www.hhs.gov/healthcare/facts-and-features/fact-sheets/aca-and-immunization/index.html
Resources:
http://www.slate.com/articles/health_and_science/medical_examiner/2015/02/map_of_vaccination_laws_by_state_personal_belief_exemptions_measles_and.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216445/
https://dash.harvard.edu/bitstream/handle/1/8852146/Balding06.html?sequence=2
@Luis, this was a very interesting read. Vaccines is an interesting topic with regards to the safety of the community as a whole and the beliefs that individuals hold. It is also unfortunate that insurances that cover vaccinations are not extended to everyone, including non-US citizens because if the health of the entire community was truly valued then vaccinations should be made available to everyone at affordable costs.
Really interesting update, Luis. It's a very interesting perspective on the balance between the security of a society and the rights of an individual. It also raises the compelling argument that making funds available to ensure that the maximum number of children in the US, regardless of citizenship or SES, receive vaccinations is not only ethically indicated, but pragmatically as well.