Final Observations

Immunization programs, like so many preventive health services, face the dilemma of being least noticeable when they are most successful: children and adults are not ill and do not require treatment because they have received appropriate immunizations. Achieving and sustaining that success requires a continuing investment of resources. Not making that investment and allowing immunization rates to decline creates the potential for serious disease outbreaks. But support for a continuing immunization effort can weaken if the need does not seem urgent and competing health care priorities claim more attention. Calling the Shots provides analysis and recommendations that can be used to inform legislators and other public officials about the key roles of the nation’s immunization system and the level of public funding that must be maintained to ensure that the system operates effectively.

The workshop highlighted several challenges facing immunization efforts. The recent introduction of a new and substantially more costly pediatric vaccine has altered some elements of the economic analysis in Calling the Shots. Growing concerns are emerging over the burden of vaccine costs among families, health care providers and health plans, and state and local health departments. Vaccine safety issues are receiving more attention and require greater effort to dispel rumors and to calibrate potential risks. Children and adults in low-income families continue to have lower immunization rates than the more affluent and often face an unstable health care services environment because of turnover among providers and health plans. Immunization registries promise access to



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Setting the Course: A Strategic Vision for Immunization Finance - Part 1 Summary of the Chicago Workshop Final Observations Immunization programs, like so many preventive health services, face the dilemma of being least noticeable when they are most successful: children and adults are not ill and do not require treatment because they have received appropriate immunizations. Achieving and sustaining that success requires a continuing investment of resources. Not making that investment and allowing immunization rates to decline creates the potential for serious disease outbreaks. But support for a continuing immunization effort can weaken if the need does not seem urgent and competing health care priorities claim more attention. Calling the Shots provides analysis and recommendations that can be used to inform legislators and other public officials about the key roles of the nation’s immunization system and the level of public funding that must be maintained to ensure that the system operates effectively. The workshop highlighted several challenges facing immunization efforts. The recent introduction of a new and substantially more costly pediatric vaccine has altered some elements of the economic analysis in Calling the Shots. Growing concerns are emerging over the burden of vaccine costs among families, health care providers and health plans, and state and local health departments. Vaccine safety issues are receiving more attention and require greater effort to dispel rumors and to calibrate potential risks. Children and adults in low-income families continue to have lower immunization rates than the more affluent and often face an unstable health care services environment because of turnover among providers and health plans. Immunization registries promise access to

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Setting the Course: A Strategic Vision for Immunization Finance - Part 1 Summary of the Chicago Workshop detailed data needed to stimulate and guide improvement efforts, but they are proving costly to operate and are not yet complete enough for many planned applications. Increasing public health resources in the wake of health care reform remains a challenging task. There were also encouraging signs. With appropriate data and information tools, health care plans and individual providers are able to improve immunization rates among their pediatric and adult patients. The health care system is finding that new partners, such as pharmacists, can help meet adult immunization needs. Communities and health departments are ready to respond when pockets of need are identified. New strategies and partnerships are emerging to combine resources within the public and private sectors in ways that are flexible enough to address each community’s needs. Workshop participants were optimistic that even if society’s continuing and significant problems such as poverty, inequity, and instability in the health care system could not be resolved, opportunities could be found to act on immunization needs. They noted that while federal assistance needs to be reliable and adequate to support local efforts, states and metropolitan areas also have important roles to play in strengthening the national immunization partnership. Creative approaches will be necessary to address persistent needs, to assure access to services while reducing reliance upon public resources, and to design new approaches that can use information resources efficiently. Strategies that persuade private health plans and providers to assume responsibility for achieving high coverage rates within the communities that they serve will be especially important in reaching national immunization goals for both children and adults.