Issue Category: Public Health Preparedness

August is National Immunization Awareness Month

August is National Immunization Awareness Month. This annual observance is designed to remind everyone that staying up to date on vaccinations is an important way to protect not only their health but the health of everyone around them.

Vaccines are a public health success story. Today, we are fortunate to have a broad spectrum of safe and effective vaccines, which if received on schedule, protect patients of all ages against vaccine-preventable diseases. Current vaccines protect against childhood disease including chicken pox, measles, and whooping cough, while protecting adults from the flu, Tdap, and shingles. Vaccines have also eradicated or nearly eradicated life-threatening diseases, such as smallpox and polio.

Children as young as 1-2 months old should be vaccinated against childhood illnesses and school-age children may need vaccine updates before they can return to school this fall. Ensuring that every child sees their doctor for a well-child visit and to receive any needed vaccine or vaccine updates is one of the best ways a parent can protect their child’s health and that of the community. Because the immunity created by a vaccine can lessen overtime, it’s important that children receive their vaccines on the recommended schedule. Adults may also need vaccine updates or to receive recently approved vaccines such as the RSV vaccine for adults 60 years of age and older.

During the COVID-19 pandemic, routine childhood vaccination levels among school-age children in the U.S. decreased, likely due to missed well-child medical visits. Globally, a report by UNICEF and the World Health Organization found that childhood vaccination coverage worldwide increased with about 4 million more children receiving full immunizations in 2022 compared to 2021, but were still below pre-pandemic levels.

Vaccines meet strict safety and effectiveness measures
In the U.S., safety measures are strict and prioritized to ensure that vaccines are safe for patients. Before any vaccine is approved for use, it is tested for safety and effectiveness through clinical trials and then must be approved by the Food and Drug Administration (FDA) and recommended by the Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices. While some people experience mild side effects after receiving a vaccine, such as swelling at the shot area, mild fevers and chills, serious reactions are extremely rare. Overall, the safety of all vaccines is closely monitored to ensure their continued safe use. If patients have questions about a vaccine including any potential side effects, they should speak to their healthcare provider.

Visit the Centers for Disease Control and Prevention website for more information on vaccine safety and for child and adult immunization schedules.

 

 

TFAH President & CEO Dr. J. Nadine Gracia speaks to JHU’s Public Health on Call podcast about the steps necessary to improve state and national emergency response readiness.

J. Nadine Gracia, M.D., MSCE, President and CEO of the Trust for America’s Health (TFAH), joined the Johns Hopkins Bloomberg School of Public Health podcast, Public Health on Call to discuss the nation’s and states’ readiness to respond to public health emergencies and the findings of TFAH’s Ready or Not 2023: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report.

“As we transition out of the emergency phase of the pandemic, now is not the time to turn our focus away from public health,” Dr. Gracia told podcast host Dr. Joshua Sharfstein.  In addition, Dr. Gracia highlights the importance of sustained public health funding, as well as a  focus on health equity. Listen to the full interview.

TFAH hosted the  Congressional Briefing and National Webinar, Ready or Not 2023 on May 3, where a panel of experts discussed national emergency preparedness and areas for additional focus.

TFAH President & CEO Dr. J. Nadine Gracia discusses the 2023 Ready or Not report

Dr. J. Nadine Gracia, President and CEO of the Trust for America’s Health (TFAH), discussed the results of TFAH’s  Ready or Not 2023: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report with the Public Health Review Morning Edition.

Dr. Gracia highlights the report’s findings that “the public health system has been chronically underfunded” and notes that “Congress and lawmakers should provide increased and sustained funding in support of the public health infrastructure.” Listen to the full interview.

On May 3 at 2PM ET, TFAH will host the  Congressional Briefing and National Webinar, Ready or Not 2023. Register today to learn more about the nation’s emergency preparedness.

Ready or Not 2023: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism

This briefing explores the findings from TFAH’s recent report, Ready or Not 2023: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism.

The past year alone saw the U.S. surpassing 1 million deaths due to COVID-19, decreasing rates of routine vaccinations, and increasing prevalence of health misinformation. In addition, last year the U.S. experienced 10 or more billion-dollar weather-related disasters for the eighth consecutive year. The webinar will review TFAH’s 2023 Ready or Not report which measures states’ degree of preparedness to respond to a wide spectrum of health emergencies and to provide ongoing public health services.

Subject matter experts discussed the nation’s readiness for public health emergencies, examine the findings of the report, and discuss key recommendations for policymakers.

Resources:

Trust for America’s Health

Children’s National Hospital

Unseen Guardians: Measles Outbreak Highlights Public Health’s Crucial Role and Evolving Challenges

Local health officials and CDC work together to stamp out Ohio measles outbreak

In 1912, the United States formally recognized measles—a highly contagious viral infection causing fever, cough, runny nose, red eyes, and a characteristic rash in milder cases, while leading to pneumonia, encephalitis, and death in more severe instances—as a nationally notifiable disease. For centuries, this ubiquitous childhood ailment afflicted millions. In the first decade of reporting, an annual average of 6,000 measles-related fatalities were recorded in the U.S.

The introduction of the first measles vaccine in 1963, with its near-perfect efficacy, marked a turning point. The vaccine was later combined with those for mumps and rubella (MMR) in 1971, and varicella (MMRV) in 2005, providing children protection against several diseases in a single shot. Bolstered by this potent new preventive tool, the Centers for Disease Control and Prevention (CDC) set a goal in 1978 to eliminate measles from the country. This objective was realized in 2000, thanks to robust vaccination campaigns, the introduction of a second dose in 1989 to increase efficacy, and rigorous disease surveillance systems.

In the new millennium, measles appeared a relic of the past, but the specter of outbreaks returned—first in the 2014-15 Disneyland episode, and then in the largest outbreak in decades in 2019. Declining vaccination rates, fueled by skepticism and misinformation, left vulnerable communities exposed. The 2019 outbreak primarily affected unvaccinated children in communities with low vaccination rates across 31 states, such as ultra-Orthodox Jewish communities in New York and vaccine hesitant regions in Washington. Travelers imported the virus, sparking infections among the unvaccinated.

One such measles outbreak erupted in Ohio in 2022. Between November 2022 and February 2023, when the outbreak was declared over, 85 cases were reported, primarily affecting children under five, with 36 hospitalizations. Among the 85 cases, 80 were unvaccinated, including 25 infants too young to receive their first dose.

To quell the outbreak, a team of epidemiologists from the CDC worked in concert with Columbus Public Health to track cases, identify and notify exposed residents, and understand the spread of the virus. Dr. Mysheika Roberts, Columbus’s health commissioner, led the outbreak response, raising awareness of the disease through public information and education, and promoting and easing access to vaccination.

In addition to the on-the-ground work of state and local health departments, the CDC plays a vital, often behind-the-scenes role in supporting those departments and safeguarding public health. It provides robust disease surveillance systems, expert guidance, technical assistance, and financial support, enabling locally targeted interventions and infrastructure improvements.

Though the latest outbreak was successfully contained, the Ohio measles episode may portend further challenges. Vaccine hesitancy, a complex and deeply ingrained phenomenon, threatens to erode hard-won public health gains and could precipitate resurgent outbreaks. The issue has multifaceted roots including mistrust in science and institutions, and misinformation amplified on digital platforms. In communities of color, vaccine hesitancy is compounded by longstanding health disparities and medical mistreatment.

The COVID-19 pandemic exacerbated the problem, with routine vaccination rates falling due to school closures and disrupted well-child doctor visits. A recent Kaiser Family Foundation poll revealed that, amid the politicization of COVID-19 vaccines and school mandates, over a third of parents with children under 18 believe they should have the choice to not vaccinate their children against measles, mumps, and rubella, even at the risk of others’ health. This represents a 52% increase compared to 2019. During the 2021-22 school year, kindergarten vaccination coverage fell to roughly 93%, leaving about 250,000 kindergartners potentially unprotected against measles.

Tackling vaccine hesitancy and strengthening our public health systems requires a multifaceted national approach. Federal, state, and local governments should invest in accessible, science-based education campaigns that dispel myths and foster trust. Working with local partners, public health agencies are developing tailored, culturally sensitive vaccine education and access programs that bridge gaps in understanding and acceptance.

The Ohio measles outbreak serves as a stark reminder that the fight against vaccine-preventable diseases remains ongoing, the indispensable role of the public health workforce, and the critical need for a robust public health system. Increased, sustained, and flexible public health funding is key to having such a system. As is growing a diverse workforce to ensure that those shaping policy and delivering services reflect the communities they serve. By taking these steps, among others, we can reduce vaccine hesitancy, create a more robust public health system, and foster an environment of trust in science. Doing so can protect the hard-won progress made against measles and other diseases, safeguard the health and well-being of generations to come, and pave the way for a more equitable future.

New Report Measures States’ Emergency Preparedness and Makes Recommendations About How to Strengthen the Nation’s Public Health System

Sustained Investment in Public Health Infrastructure and Preparedness is Needed to Protect Lives During Disease Outbreaks and Natural Disasters

(Washington, DC – March 23, 2023) – As infectious disease outbreaks and extreme weather events threaten the health of more Americans, a new report shows the need for strengthened national and state public health emergency preparedness.

Ready or Not 2023: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism, released today by Trust for America’s Health, measures states’ readiness to respond to a spectrum of health emergencies and to provide ongoing public health services. The report gives federal and state health officials and policymakers actionable data and recommends policies to improve the nation’s emergency preparedness at a time when health emergencies are increasing. During 2022, the U.S. surpassed 1 million deaths due to COVID-19 and saw decreasing rates of routine vaccinations and increasing prevalence of health misinformation.  In addition, the past year was the eighth consecutive year the U.S. experienced 10 or more billion-dollar weather-related disasters.

The report tiers states and the District of Columbia into three performance levels for health emergency preparedness: high, middle, and low. This year’s report placed 19 states and DC in the high-performance tier, 16 states in the middle performance tier, and 15 states in the low performance tier.

High Tier – 19 states & DC

CO, CT, DC, DE, FL, GA, KS, ME, MD, MA, MS, NJ, NC, OH, PA, UT, VT, VA, WA, WI

Middle Tier – 16 states

AK, AL, AR, CA, IA, ID, IL, IN, MO, ND, NE, NH, NY, RI, SC, TX

Low Tier – 15 states

AZ, HI, KY, LA, MI, MN, MT, NM, NV, OK, OR, SD, TN, WV, WY

“Increased and sustained investment in public health infrastructure, emergency preparedness, and health equity will save lives,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “Federal, state, and local officials as well as leaders in the healthcare and business sectors should use our findings to identify and address gaps in public health preparedness. Neglecting to do so will mean that the country will not be as prepared as it needs to be for the next public health emergency.”

The report’s findings showed both areas of strength within the nation’s public health system and areas that need attention.

Areas of strong performance include:

  • A majority of states have made preparations to expand healthcare and public health laboratory capacity in an emergency.
  • Most states are accredited in the areas of public health or emergency management. Some states are accredited in both.
  • Most U.S. residents who received their household water through a community water system had access to safe water. However recent water system failures in Jackson, Mississippi and Newark, New Jersey demonstrate the importance of continued attention to the integrity of municipal water systems.

Areas that need attention include:

  • Too few people were vaccinated against seasonal flu last year despite significant improvement in flu vaccination rates in recent years. During the 2021-2022 flu season, 51 percent of Americans ages 6 months or older received a flu vaccine, well short of the 70 percent goal established by Healthy People 2030.
  • Only half the U.S. population is served by a comprehensive public health system. Comprehensive public health systems ensure that necessary health services are available to all residents.
  • Only 26 percent of hospitals in states, on average, earned a top-quality patient safety grade in 2022. Hospital safety scores measure performance on such issues as healthcare-associated infection rates, intensive-care capacity, and an overall culture of error prevention.

The report contains recommendations for policy actions that would create a stronger public health system at all levels, including:

  • The Administration, Congress, and state lawmakers should modernize public health infrastructure, including by investing $4.5 billion annually to support foundational public health capabilities. In addition, Congress should continue to increase funding for the Public Health Emergency Preparedness cooperative agreement and public health data modernization to allow for earlier and more accurate detection of emerging health threats.
  • Policymakers at all levels should act to protect and strengthen public health authorities and should prioritize rebuilding trust in public health agencies and leaders.
  • Congress and state legislatures should invest in effective public health communications, including countering misinformation.
  • Congress and states should ensure first-dollar coverage for all recommended vaccines under commercial insurance and for uninsured people. States should minimize vaccine exemptions for school children, and healthcare facilities should increase rates of vaccination for healthcare workers.
  • Congress and states should provide job-protected paid leave for employees due to illness or family caregiving demands.
  • Congress and states should invest in policies and capacity to address the social determinants of health such as secure housing, access to transportation, and access to healthy food.
  • Congress should fund the entire medical countermeasures (MCM) enterprise, including the distribution and dispensing of MCMs. Congress should also create incentives for new products to prevent and fight antibiotic-resistant infections.
  • Congress and states should strengthen readiness for climate change, extreme weather, and environmental health threats.

Read the full report

Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.