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The Need for Continued and Strengthened Support for Immunization Programs

Policy Date: 1/1/2000
Policy Number: 200023

THE AMERICAN PUBLIC HEALTH ASSOCIATION,
Knowing that through past resolutions and policy statements, it has affirmed the importance of immunizations, both in the United States and globally; and
Wishing to update and amplify these policy statements (Resolutions 7805, 7806, 7906, 8706, 9103); and
Recognizing that great progress has been made in improving immunization coverage among infants and young children as a result of the Childhood Immunization Initiative;1 and
Recognizing that continued success in controlling vaccine-preventable diseases requires assuring that the 11,000 infants born each day receive needed immunizations on schedule; and
Noting that the National Vaccine Advisory Committee (NVAC) has recently published a report describing the strategies needed to sustain success in childhood immunizations;2 and
Noting that the Surgeon General on April 27, 1999,3 supported the establishment of a nationwide network of state/community population-based immunization registries to facilitate this immunization as called for in an NVAC report,4 and
Noting that the NVAC report called for a five-year federal grant program to fund development and implementation of registries while a long-term financing mechanism was being developed; and
Noting that recent issues raised regarding vaccine safety5 make it imperative that vaccine safety monitoring activities be enhanced6 (immunization registries being an important component); and
Noting further that immunization of adolescents and adults, particularly the frail elderly, lags significantly behind progress with young children; and
Noting that recent cuts in federal funding for immunizations9 threaten the continuation of existing activities and preclude the further development of registries and vaccine safety monitoring or the extension of programs to immunize adolescents and adults; and
And further noting that the Institute of Medicine has recently released a report10 describing the U.S. immunization system as "a national treasure that is too often taken for granted" and calling for substantial increases in federal and state allocation of funds to support immunization infrastructure; therefore
1. Reaffirms its support for immunization as one of the most cost-effective means of preventing infectious diseases;
2. Urges the Congress and state legislatures to fully fund, and CDC and state health departments to implement, the recommendations called for by the Institute of Medicine in its recent report "Calling the Shots."
3. Urges CDC and the US Department of Health and Human Services (DHHS) to develop, and the Congress to approve, a legislative proposal for a five-year grant program to support development and implementation of immunization registries, as called for by NVAC;
4. Urges the Congress to fund fully the Vaccine Safety Action Plan developed by the DHHS Vaccine Safety Working Group;
5. Urges CDC and DHHS to develop, and the Congress to approve, a legislative proposal to provide federal support for immunization of adolescents and adults;
6. Urges CDC and DHHS to develop and fund additional programs for outreach to those populations that remain hard to reach and are underimmunized; and
7. Urges CDC and DHHS to promote public awareness of the importance of immunizations.

References
1. The Childhood Immunization Initiative. HHS Fact Sheet, April 20, 1999. http://waisgate.hhs.gov/cgibin/waisgate?WAISdocID= 8133121002+1+0+0&WAISaction=retrieve
2. National Vaccine Advisory Committee. Strategies to sustain success in childhood immunizations. JAMA. 1999;282:363-370.
3. Statement of David Satcher addressing the All Kids Count national conference, St. Paul MN, April 27, 1999 (same statement presented to National Immunization Conference, Dallas TX, June 23, 1999).
4. National Vaccine Advisory Committee. Development of Community- and State- Based Immunization Registries. Approved January 12, 1999. www.cdc.gov/nip/registry/I_recs.htm
5. Committee on Government Reform, US House of Representatives, hearing on “Vaccines: Finding the Balance Between Public Health and Personal Choice.” August 3, 1999.
6. National Vaccine Advisory Committee. Resolution: Vaccine Safety Action Plan, January 12, 1999. www.cdc.gov/od/nvpo/nvr11299.htm
7. Centers for Disease Control and Prevention. National Vaccination Coverage Levels Among Children Aged 19-35 Months——United States, 1998. MMWR. September 24, 1999; 48(37):829-830.
8. Centes for Disease Control and Prevention. Influenza and pneumococcal vaccination levels among adults aged greater than or equal to 65 years——United States. MMWR. October 2, 1998; 47(38):797-802.
9. A bill making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2000, and for other purposes. HR3037; pp. 50-51.
10. Institute of Medicine Committee on Immunization, Finance Policies, and Practices. Calling the Shots: Immunization finance policies and practices. Washington, DC: National Academy Press. 2000.