380: Immunization Exemption Strategies, Island Area Funding Pitch

Heather Tomlinson, ASTHO Senior Analyst for Immunizations, reminds us in an ASTHO blog article that there are strategies to reduce the impact of non-medical immunization exemptions; the CDC has added COVID-19 vaccinations to its immunization schedule...

Heather Tomlinson, ASTHO Senior Analyst for Immunizations, reminds us in an ASTHO blog article that there are strategies to reduce the impact of non-medical immunization exemptions; the CDC has added COVID-19 vaccinations to its immunization schedule in its latest update; and Gaafar Uherbelau, Minister of Health for the Palau Ministry of Health and Human Services, provides the latest updates on talks between Congress and the U.S. island areas looking to improve funding for health care in their jurisdictions.

ASTHO Blog Article: The Impact of Non-Medical Vaccine Exemptions on Childhood Vaccination Rates

The Hill News Article: CDC adds COVID vaccine to routine immunization schedule for kids, adults

ASTHO News Release: Island Health Officials Advocate to Strengthen Healthcare Infrastructure During ASTHO’s Spring Leadership Meeting

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This is Public Health Review Morning Edition for Monday, March 20th, 2023. I'm Robert Johnson. Now, today's news from the Association of State and Territorial Health Officials.



The U.S. has seen a resurgence of vaccine preventable diseases as non-medical exemptions have grown in popularity.



ASTHO's Heather Tomlinson, reminding us that non-medical immunization exemptions can lead to lower herd immunity and more illness, especially among school aged children.



So as of May 2022, 44 states grant religious exemptions, 15 allowed personal belief exemptions, and six states offer medical exemptions as their sole vaccine exemption type. This legislative session, we've seen at least 13 states introducing bills related to non-medical exemptions and childcare or school immunization requirements, so we want to make sure that state health agencies are prepared to address these types of bills.



Tomlinson says there are ways to reduce the impact of non-medical exemptions.



We've seen states adopt a wide range of strategies. One effective method implemented in Georgia was to require yearly exemption renewal submissions. Other states like Oregon, included parental education as part of the exemption application process to ensure that parents understand the benefits of immunizations and the risk of not having their child vaccinated. Massachusetts recently introduced legislation that would create standardized exemption forms for religious and medical exemptions and would require signatures from both a guardian and a physician.



You can read Tomlinson's blog article on non-medical immunization exemptions using the link in the show notes.

Also today, the CDC has updated the nation's vaccination schedule. O'Keyla Cooper has more.



To formalize current recommendations for health care providers and schools, the CDC has added COVID-19 vaccinations to its immunization schedule. Doctors can use the vaccine schedule as a resource to determine the best time to administer vaccines. However, the decision to require vaccinations is made by state and local governments. Read more by using the link found in the show notes.



Talks continue between Congress and the U.S. Island areas looking to improve funding for health care in their jurisdictions. Earlier this month, health officials from several territories and freely associated states came to Washington D.C. to make the case. We had the chance to ask Palau Health Minister Gaafar Uherbelau about the latest on the negotiations. In Washington D.C. talking about the Compact of Free Association (COFA). Tell us a little bit about the conversations that have occurred around COFA. Here in Washington, D.C., how's it going?



Pretty good, so far. I think the most health specific topics around the COFA renegotiations for Palau and the other two freely associated states, really looking at how we can retain what we have existing in that compact agreement in terms of health services, and really to try to expand on those to see if we have more eligibility for federal programs as well as more funding for healthcare infrastructure around that space.



And the idea is to have the funding available to allow people to stay home to get their health care, right?



Absolutely. So, the main idea, as you say, is really developing our capacity and our capabilities in the islands so that our people don't have to seek quality health care services abroad, which you know, leads to other issues such as brain drain and out migration. So really, that is the goal is to make sure that we have equitable access to quality health care, and health, public health and human services in the islands, so that we can take care of our people in the islands, instead of looking for the services abroad.



How do you feel the process is going? There seems to be support on Capitol Hill for this idea from both parties from what we've heard.



So, in addition to existing federal programs, you want to look at expanding Veteran Affairs (VA) benefits and services to our veterans who are out there in the islands. And I think that is a good starting point for the discussion on how we can expand on these health-related topics in and around the Compact with not just the Congress, but also with the White House and other federal agencies that are tasked to assist us with administering these federal grants and programs.



What message seems to resonate the most? What do people respond to most positively about what you're saying to them regarding these issues?



Well, the freely associated states, I think we have a very large number of recruits compared to other U.S. states and jurisdictions. So, the per capita, the number of recruits that are being enlisted to the U.S. armed forces are quite high. And so, the argument is that if that's the case, we should also be able to look after our veterans, I, myself included, when they're done with their service, and that's really where we're trying to ensure that the point is coming across that we need to take care of our veterans in the islands.



You can read more about the COFA agreements using the link in the show notes.

That'll do it for today's newscast. We're back tomorrow morning with more ASTHO news and information. I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.

Heather Tomlinson

Senior Analyst, Immunization, ASTHO

Gaafar Uherbelau

Minister, Ministry of Health and Human Services, Republic of Palau