Bill boosts childhood vaccination

Posted May 03, 2010, at 5:56 p.m.

One of the red flags in recent Maine Kids Count reports has been the declining number of children age 3 and under who have received all the recommended immunizations against childhood diseases.

For years, Maine has been a universal vaccination state — meaning that the state was able to provide, through its own resources and the federal Vaccines for Children program — vaccines for all parents who want to immunize their children.

More recently, due to rising costs, new vaccines, and decreasing state resources, Maine has gone to a two-tier system where many parents now have to purchase vaccines for their children, and providers have to create a separate record-keeping system that caused some of them to stop providing shots.

Not surprisingly, the number of fully immunized children has dropped — to 73 percent. At one time, Maine vaccinated more of its children than any other state, but it now has fallen well below the national average of 76 percent.

Why are these numbers important? Because the benefits from vaccination go well beyond those to individual children and families, important as those are. When at least 80 percent of a population is vaccinated, most communicable diseases are unlikely to spread. When the proportion falls below that, outbreaks are much more likely.

And that’s exactly what has happened in Maine. Since 2007, the state has recorded outbreaks of hepatitis A, mumps, whooping cough and chicken pox — all preventable diseases that most of us assumed, incorrectly, had disappeared.

Concerned about these alarming trends, a coalition of doctors, public health organizations, and children’s advocates sought legislation to turn things around. Against the odds, they succeeded.

As everyone knows, this was a year when it was nearly impossible to find any new state money for programs. Recognizing that reality, LD 1408, sponsored by Rep. Gary Connor of Kennebunk, took a different approach.

Through Rep. Connor’s persistent efforts and the help of many partners, the Health and Human Services Committee eventually gave its unanimous endorsement to the bill, which was enacted and signed into law by Gov. John Baldacci on April 2. While its smooth passage through the Legislature, including unanimous votes in both houses, did not draw attention to the bill, this is a major achievement nonetheless.

It was accomplished in no small part by the creative cooperation of providers, insurers and public health officials. Without committing any new state dollars, LD 1408 puts Maine back on the road toward universal vaccination.

The legislation commits insurers to covering all of their policyholders for the cost of vaccines; most other children are covered through the MaineCare program that includes the Children’s Health Insurance Program. In return, vaccines for privately insured children will be provided at the discounted Vaccines for Children rates. By working through an established program, Maine was able to gain new benefits for children without increasing costs.

This is the kind of public-private partnership that makes sense in so many areas, but health care above all.

The benefits from increased immunization are widespread. This is one of the most cost-effective health care investments we can make. For instance, older people are less likely to contract certain serious and even fatal infections if children are vaccinated and cannot spread the disease. We also avoid chronic disabling conditions to the heart and lungs that can result from serious childhood illnesses.

High costs are not the only reason some children are not vaccinated in Maine, but it may be the most important one. It’s certainly one factor that has changed substantially over the past decade, with costs steadily rising and immunization rates steadily falling.

Maine’s ability to increase access to childhood vaccinations bodes well for implementation of the new federal health reform legislation here. And before too many years have passed, we hope to report plenty of good news in Maine KIDS COUNT about how children are healthier, families are better off, and our investments in the future are paying off.

Dean Crocker is president of the Maine Children’s Alliance.

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