Wednesday, April 15, 2009

Vaccine Policy

Advisory Committee on Immunization Practices (ACIP)
  • Composed of 15 members—mostly doctors and/or people with public health degrees.
  • Provide advice and guidance to Secretary for Health and Human Services and to the CDC about vaccine selection.
  • Meets 3 times a year.
  • Makes vaccine recommendations for the number of doses, age for vaccination, dosing intervals and vaccine precautions.
Vaccines for Children (VFC)
  • Federally funded to provide vaccines for children who would not otherwise be able to pay for them.
  • Started in 1994.
  • Eligible children qualify for all vaccines recommended by the ACIP.
  • Costs around $3 billion to operate.
  • Vaccine administrators are allowed to charge an administration fee, but there is a cap on how much they can charge. In Michigan the maximum fee is $16.75.
Eligibility for VFC
  • Must be under 18 years old and one of the following:
  1. Medicaid eligible—children whose health insurance is covered by the state
  2. Uninsured
  3. American Indian or Native Alaskan
  4. Underinsured—if private health insurance coverage does not cover vaccination, covers only selected vaccines, or places a cap on vaccine coverage.
Which vaccines are recommended by the ACIP?
http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm#printable

Diseases these vaccines prevent

  • Hepatitis B- Can cause infection of the liver which can lead to cirrhosis (hardening of the liver which leads it to stop functioning). Children and infants are much more likely to develop chronic hepatitis than adults.
  • Rotavirus- Easily transmitted GI disease that is the leading cause of diarrhea in children. Responsible for thousands of doctor visits, ER visits, hospitalizations and 527,000 deaths of children under 5 yearly.
  • Tetanus- Caused by a common soil bacterial toxin in deep wounds. Infection causes severe muscle spasms throughout the body which can result in death.
  • Pertussis- Highly contagious, chronic cough that may become serious in young children. Cases of the disease rose from 8,296 in 2002 to 25,827 in 2004 (perhaps because of decreasing vaccinations???)
  • Haemophilus influenzae type b- Before the vaccine, was one of the leading causes of meningitis among children under 5. Can result in brain damage and deafness.
  • Pneumococcal- Is the leading cause of meningitis in the United States. Difficult to treat after infection and spread from person to person through close contact.
  • Diphtheria- Sore throat, swollen glands, difficulty breathing. Before vaccination was a leading cause of death in children. It currently is very rare in the U.S.
  • Inactivated Poliovirus- Can cause paralysis which can lead to lifelong disability or death. Has not been in the U.S. for 20 years, but it still has not been eradicated from the world yet, which means we still need to be vaccinated.
  • Influenza- Respiratory disease that kills about 36,000 people a year, elderly people and children are at high risk for complications.
  • Measles- Running nose, cough, sore throat, sneezing, generally not very serious.
  • Mumps- Painful swelling of glands and flu-like symptoms.
  • Rubella- rash, swollen glands, fever—not a very serious illness.
  • Varicella (chickenpox)- Causes a rash and is not a serious illness in children. However, it is potentially dangerous in pregnant women, newborns and adults.
  • Hepatitis A- Transmitted by eating contaminated or undercooked food. Causes a variety of not very serious symptoms, usually goes away on its own but can last up 2 months.
  • Meningococcal- Causes meningitis, this is the type that is recommended for college students.
Sources: http://www.cdc.gov/vaccines/, http://www.webmd.com/, http://www.mayoclinic.com/

Michigan Vaccine Requirements:
http://www.immunizationinfo.org/vaccineInfo/disease_stateinfo.cfv
This is a list of all vaccinations required at the different school levels.

Michigan Exemption Law:

(1) A child is exempt from the requirements of this part as to a specific immunization for any period of time as to which a physician certifies that a specific immunization is or may be detrimental to the child's health or is not appropriate.

(2) A child is exempt from this part if a parent, guardian, or person in loco parentis of the child presents a written statement to the administrator of the child's school or operator of the group program to the effect that the requirements of this part cannot be met because of religious convictions or other objection to immunization.

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