SETTING THE COURSE
A STRATEGIC VISION FOR IMMUNIZATION
PART 2 SUMMARY OF THE AUSTIN WORKSHOP
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
Support for this project was provided by the Centers for Disease Control and Prevention. The views presented in this report are those of the Institute of Medicine Committee on Immunization Finance Dissemination Workshops and are not necessarily those of the funding agencies.
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COMMITTEE ON THE IMMUNIZATION FINANCE DISSEMINATION WORKSHOPS
DAVID R. SMITH, M.D. (Chair), President,
Texas Tech University Health Sciences Center, Lubbock, TX
BRIAN BILES, M.D., Professor and Chair,
Department of Health Services Management and Policy, The George Washington University
STEVE BLACK, M.D., Co-Director,
Vaccine Study Center, Kaiser Permanente, Oakland, CA
GORDON H. DeFRIESE, Ph.D., President and Chief Executive Officer,
North Carolina Institute of Medicine, Durham
DIANNE WHITE DELISI, M.A., State Representative,
Texas House of Representatives
R. GORDON DOUGLAS, JR., M.D., Former President,
Merck Vaccines (retired), Princeton, NJ
JONATHAN FIELDING, M.D., M.P.H., Director of Public Health and Health Officer,
Los Angeles County Department of Health Services
MAXINE HAYES, M.D., M.P.H., State Health Officer,
Washington State Department of Health, Olympia
ROBERT L. JOHNSON, M.D., Professor and Chair,
Division of Adolescent and Young Adult Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School
SAMUEL L. KATZ, M.D., Wilburt C. Davison Professor Emeritus,
Department of Pediatrics, Duke University Medical Center
WILLIAM KISSICK, M.D., M.P.H., Dr.P.H., George Seckel Pepper Professor of Public Health,
The Leonard Davis Institute, The Wharton School, Philadelphia
RONALD J. SALDARINI, Ph.D., President,
Wyeth Lederle Vaccines and Pediatrics (retired), New Jersey
WILLIAM SCHAFFNER, M.D., Professor and Chairman,
Department of Preventive Medicine, Vanderbilt University School of Medicine
GARTH SPLINTER, M.D., M.B.A., Associate Professor, Chief Medical Officer,
University Hospital Trust, Oklahoma City, OK
Committee Staff
ROSEMARY CHALK, Senior Program Officer
JANE DURCH, Consultant
RYAN PALUGOD, Project Assistant
REVIEWERS
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Gerry Fairbrother, Ph.D., The New York Academy of Medicine
Bernard Guyer, M.D., M.P.H., The Johns Hopkins University
Sara Rosenbaum, J.D., The George Washington University
Sharilyn Stanley, M.D., Texas Department of Health
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Neal A. Vanselow, M.D., Rio Verde, Arizona. Appointed by the National Research Council and Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
ACKNOWLEDGMENTS
The Institute of Medicine workshop on immunization finance was organized with the generous assistance of many individuals and organizations in Austin and throughout the state of Texas. We acknowledge in particular the gracious hospitality provided by the staff and officers of the Texas Medical Association, particularly Gayle Harris, Brent Annear, Ken Ortolon, Steven Levine, and their colleagues. David Smith and Richard Butler from the Texas Tech University Health Sciences Center and Eduardo Sanchez, Charles Bell, Sharilyn Stanley, Lynn Denton, Linda Linville, Lucina Suarez, Brad Prescott, and their associates in the Texas Department of Health also provided invaluable assistance in identifying key experts, resource materials, and technical support for the meeting. Jane Durch, consultant to the Institute of Medicine, provided an excellent summary of the workshop that served as the basis for the final report.
Additional guidance was provided by the Texas Pediatric Society, the Texas Association of Local Health Officials, the Texas Association of Health Plans, and the Dallas-Fort Worth Business Group on Health in identifying appropriate speakers and participants. The legislative office of Texas Representative Dianne White Delisi assisted with promoting the workshop among members and staff from the Texas legislature. Jane Siegel, Janet Squires, and Mary Droge from the Texas Pediatric Society prepared editorial materials to help publicize the meeting and immunization issues within the state. County health department officials, especially representatives from the Austin/Travis County Health and Human Services Department and the El Paso City-County Health and Environment District, were also most helpful.
Staff from the National Immunization Program of the Centers of Disease Control and Prevention in Atlanta helped to identify immunization program directors and public health advisers in Texas and also prepared data analyses to inform the workshop discussions.
The Center for the Advancement of Distance Education (CADE) at the University of Illinois provided on-site technical support for an audiocast of the October 12th workshop to a national audience. An archival copy of the speakers’ remarks and slides can be found at the IOM website: www.iom.edu/iom/iomhome.nsf/pages/hcs+immunization+finance+dissemination.
Tables and Figures
TABLES
1 |
Change in annual morbidity from vaccine-preventable diseases: prevaccine baseline and 2000, |
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2 |
Estimated vaccination coverage for the 4:3:1:3 series among children ages 19 to 35 months, 1996–2000, |
FIGURES
1 |
Six roles of the national immunization system, |
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2 |
Amount and source of funds for the Texas Immunization Program, 2001, |
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3 |
Amount and source of funding for vaccines, Texas Department of Health, 1993–2001, |
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4 |
Amount and source of funding for immunization infrastructure, Texas Department of Health, 1993–2001, |
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5 |
Provider participation in Texas VFC, by county, October 2000– September 2001, |