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>Testimony by Jerri Johnson >Health and Human Services Policy Committee >January 27, 2003 > >Costs to the State of Adding Vaccine Requirements > >Immunization requirements are enforced by child care >providers, state licensers of child care providers, >and the public schools. This enforcement costs money >for staff to do record-keeping and follow-up. Much of >this cost is borne by the state. A study in 1998 >estimated that enforcing the immunization requirements >cost the state at that time around $5 million per >year. Will adding new vaccines to the list increase >costs to schools? It will, because many more follow-up >contacts will be needed for these particular vaccines. > >Currently, 35% of parents are not vaccinating their >children for chickenpox. Minneapolis Public Schools >estimated that each parent follow-up contact cost $18 >in staff time. > >Minneapolis Public Schools wrote to the Department of >Health asking that no immunization requirements be >added until funding is in place to enforce them. In >addition to the state costs of enforcing vaccine >requirements, these vaccines cost money in health care >dollars. > >I have included a handout in your package with medical >cost analyses of pneumococcal and chickenpox vaccines. >Chickenpox and pneumococcal vaccine programs actually >cost more money than they save from preventing >disease. The pneumococcal vaccine, for example costs >around $60 per dose, or $240 per child for the >four-dose series. The chickenpox vaccine also does not >recover costs when looking at the cost of the vaccine >compared to the cost of the disease. Only by factoring >in indirect costs, such as lost wages for a parent to >stay home with a child sick with chickenpox, is this >vaccine deemed to be cost-effective. > >But these assessments of indirect costs did not >include the cost of caring for vaccine-injured >children. Hospitalization and medical costs for these >children are extremely high. During school years, they >require special education services, costs borne by the >state. These children may later be cared for in group >homes the rest of their lives, incurring huge costs to >the state. Twelve per cent of our children now have >chronic disease of some sort, and many medical experts >believe that the rapid increase in diseases such as >autism, ADD, juvenile diabetes, and asthma is >partially attributable to the increase in required >vaccines. > >A parent who stays home for 5 days when her child has >chickenpox may use vacation days or may lose some >income. But parents of children disabled by vaccines >often must quit work permanently to stay home with >their child, losing years of income, and the >vaccine-injured child may never grow up to earn a >productive income. > >But ultimately, the question before us is not about >dollars and cents. When we are preventing communicable >disease, and when we are preventing vaccine injuries, >the real issue is the value in human life that can't >be quantified. You can't put a price on the joy of >having a healthy baby, and you can't quantify the >grief of a parent who loses a baby, no matter what the >cause. > >And so the Minnesota Natural Health Coalition is >calling for the following: > >1. Safer vaccines. Pharmaceutical companies need to be >held accountable to produce vaccines that have fewer >serious side effects. > >2. The State of Minnesota should not require new >vaccines if we do not know whether they are safe for >our children. In the case of the pneumococcal vaccine, >during the pre-licensure study, where 17,000 healthy >infants with no acute or underlying chronic disease >were given Prevnar, 162 infants required emergency >room care and 24 were hospitalized within 72 hours of >receiving the vaccine, 8 infants who had never had >seizures before had seizures within 72 hours. 40 >infants who had never had asthma before required >doctor's care for asthma, wheezing, shortness of >breath or breath-holding within 72 hours of the >vaccine. One previously healthy child developed >congestive heart failure within 72 hours of the >vaccine. Three children developed >hypotonic/hyporesponsive episodes. Were these serious >situations caused by the vaccine? There is no way to >determine this without following the time-honored >scientific process of comparing the test group with a >control group that did not receive a vaccine. This was >not done. One variable, the test vaccine, was compared >with another variable, another experimental vaccine. > >Yet the physicians who conducted the study concluded >at the end, this test "did not reveal any severe >adverse events related to vaccination that resulted in >hospitalization, emergency room visits, or clinic >visits." This is the Vaccine Information Sheet on >Prevnar given to parents at their clinics. It says, >"So far, no serious reactions have been associated >with this vaccine." Given the structure of the >clinical study, it is not scientifically possible to >say that these reactions were caused by the vaccine, >nor is it possible to say that they were not. > >3. If it is inherently impossible to produce a vaccine >without a significant risk of serious adverse effects >or death, then we need to be clear about that. If the >pneumococcal vaccine effectively reduces pneumococcal >disease, but at the price of death or disability to a >few babies, we need to know those numbers. Our >research needs to be science-based, with control >groups, and parents need to know the risks so they can >make an informed decision. > >We are having a good debate in this country on the >smallpox vaccine. This could be a great model for our >infant vaccination programs. Public health officials >are doing a good job of articulating the risks of >smallpox and the risks of the vaccine. 1 or 2 deaths >per million from the vaccine is being taken very >seriously. Adults are weighing the risks and benefits. > > >We should afford the same courtesy to infants and >their parents in the routine vaccine program. > >4. Parents should be educated that if their child is >ill, vaccination should be postponed. They should be >told that if their child suffered a seizure or bad >reaction to a previous vaccine, she is at risk for an >even greater reaction to the next one. .If parents >have a family history of a severe vaccine reaction, >they should know that their child may be at risk. The >CDC already has guidelines on this, and they are >printed on the sheets given to parents when the child >receives a vaccine. If parents knew this before making >their appointments with the doctor, perhaps many >vaccine injuries could be avoided. Again, the smallpox >discussion is a good model on this - people are being >informed that if you have eczema, you are at risk from >the vaccine. . If you are on corticosteroids, you are >at risk. Similarly, parents of infants could be >advised on this at an early date. > >5. If new vaccines being produced can not be safer, >then perhaps we need to rethink the model which >vaccinates the entire population for a disease. This >model was developed in response to overwhelming >epidemics like polio. However, in the case of invasive >pneumococcal disease, which affects only 0.2% of >Minnesota children, this may not be an appropriate >model. > >6. Finally, parents who believe that their child was >harmed or killed by a vaccine need to be heard and >taken seriously. They should not be brushed off by >being told it was not related to the vaccine. Their >experience should be studied for clues to how we can >have safer vaccine programs.
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