March 18, 2015

Senate Medicaid, Health and Human Services

Immunization Hearing

Chairwoman Jones … and, members of the committee … thank you for your time and this opportunity to share Columbus Public Health’s insight on immunizations and support for certain policies that support vaccination rates.

I am Kelli Arthur Hykes, Director of Public Health Policy and I am joined by Phillip Tanjong,Vaccine Preventable DiseaseProgram Director; we are honored to be hererepresenting Columbus Public Health.

At Columbus Public Health, our number one priority is the health and safety of the community, especially our youngest – and most vulnerable -- residents. One of the best ways we can protect their health and improve their lives is through childhood immunizations.

Vaccine-preventable diseases still circulate in the United States, around the world … and, right here in our own community. Last spring and summer, Columbus Public Health and Franklin County Public Health (FCPH), Delaware and Madison County managed and investigated our largest community-wide outbreak of mumps in 35 years. In fact, there wasmore mumps cases right here in the state capital than in the entire country last year.This outbreak happens at a time when Ohio ranks last in the nation, tied with West Virginia, for the worst immunization rates.

Additionally, last summer’s multi-state measles outbreakis yet another example of how quickly infectious diseases can move from Disneyland to middle America where they sicken and cause serious complications in our youngest residents.

Consider that in 2014, there were more than645 confirmed cases of measles in the U.S.-- the highest number since 1994. And, 2015 is already off to a very early – and dangerous – start with at least 170 cases in 17 states.

Most alarming is that more cases don't have a source that is easy to find … which could mean that the endemic spread of measles has returned to our country … a notion that once seemed unthinkable with the eradication of measles. So instead of having to travel out of the country or be exposed to someone who got measles from a link to international travel, you could get measles just by going to a ball game … a movie theater … or even Disneyland, which created a lot of buzz this winter in part because of the number of children who were medically-fragile or too young to be vaccinated.

This potential reality is a wake-up call…

Clearly,outbreaks can cause serious complications and lasting consequences for children and their families. And there is a greater health and economic impact on our community, as well.

Last year in Ohio,outbreaks diverted scarce resources from local health departments and caused communities to spend significant time and money on vaccine preventable diseases. For example, Columbus Public Healthinvested more than $350,000 in resources to address the mumps outbreak alone. And, this figure does not include Delaware, Franklin County, Madison County, CDC or ODH resources.

Outbreaks also negatively impacted students’ education and parents’ employment if and when the Health Commissioner needed to exclude unvaccinated children for their own protection.

Immunization is a shared responsibility. And, families, health care providers, public health professionals, and elected officials must work together to help protect the entire community.

Columbus Public Health was proud to see this committee and the Ohio General Assembly pass a bill last session that protects children in daycare settings by extending the same responsibility to parents of young children, who comingle with children too young to be immunized, as to those of children enrolled in primary and secondary schools. We were also very pleased to help influence passage of a bill that now allows pharmacists to administer immunizations with a valid prescription for children over 7, all adults, and flu shots without an Rx for both groups.

Additionally, we are supportive of new opportunities that support public health, safety and heard immunity, including:

  • Requiring documentation of a meningitis vaccine for students in secondary schools;
  • And requiring that all postsecondary students provide up to date immunization records prior to enrolling for classes, as modeled by The Ohio State University. While our state’s public and private institutions have a myriad of rules and policies, adopting a standard helps position Ohio as a safe and healthy place for both in and out of state students to attend school.

It’s also important to note that while we are respectful of those who have a religious objection to immunizations and wouldn’t want that exemption to go away, only the Amish Community and Scientologists have an explicit religious opposition to immunizations. However, we are seeing many people choose a personal exemptionwithout a religious basis. We would be interested in tightening the acceptable exemptions forreligious or medical reasons, which can be documented. We are only as safe as our weakest link, because when we have a segment that is not fully vaccinated, our entire community is at risk.

Finally, we would also like to see funding restored for immunizations in the proposed budget. The changes could leave undocumented and uninsured families without a resource to vaccinate.

The bottom line is vaccines have prevented 6 million deaths yearly worldwide and saved more lives than any surgical technique or medication, including antibiotics. Together, we must do more to raise vaccination rates in order to protect the health and safety of our entire community.

Thank you for your time and your interest in public health. Phillip or I will be happy to answer any questions you may have.

(If you have additional questions, please feel free to contact Kelli Arthur Hykes at 614-645-2097 or and she will respond promptly on behalf of Columbus Public Health.)

Thank you!