Local Health Departments: The First and Last Line of Defense Against Preventable Disease
By Nar Ramkissoon
With vaccine costs constantly on the rise, fewer and fewer private practices are able to stock and provide them to their patients.
This is leading public health departments to become the only local providers of vaccines in many areas, making them the first and last line of defense against deadly, but preventable, diseases.
There are also challenges with vaccine storage and handling for private providers, from maintaining proper temperature levels to efficient inventory control. For private practices, it leads to profitability issues in continuing to offer all required and recommended vaccines to their community.
Also contributing to costs, the Advisory Committee for Immunization Practices(ACIP) has raised the number of vaccines it recommends in recent years. So not only are the costs of the vaccines rising, but the amount of vaccines are going up too.
Vaccines also need to be stored very precisely, leading to increased costs for private providers. It’s harder to maintain, making their entire vaccination program unprofitable, often leading to practices cutting it. When private practices do not have a vaccine due to demand, or just not stocking it, the first place they’ll refer a patient to is the local health department.
As with most federally-funded programs though, the funding is having trouble keeping up with demand, and tough calls are having to be made on which vaccines are worth it, and which are not.
To give you an idea of the costs being dealt with in this situation, here is a recent example. In the case of the meningococcal vaccine, the cost to vaccinate one person is nearly $200. It’s estimated that making this vaccination and a new booster shot that accompanies it mandatory for infants would cost more than $1 billion for the government to fund a year, while only saving a handful of people. In 2009, $387 million was spent for the vaccine, with an estimated 23 lives saved. Nobody wants to legislate the cost of saving a life, so it’s all up to the ACIP to decide which vaccines it should and should not recommend.
The CDC’s ‘Vaccines for Children’ program has also placed more emphasis on public health departments providing vaccines. Under the program, qualified facilities are required to provide vaccines for uninsured and underinsured children.
A healthier country is a more productive country, so it’s vital that these local health departments continue to be able to provide vaccines to the public, keeping the public safe and preventing epidemics.