Wednesday, April 16, 2014
Syd Sewall, M.D.
Families concerned about health care costs now have one less thing to worry about: As of Jan. 1, children 18 and younger get their vaccinations without having to pay the cost of the vaccine.
Maine's Universal Childhood Immunization Program (www.mevaccine.org) was initiated by the past Legislature and pools funds from the Maine Immunization Program and from private insurers to buy vaccines, which are then supplied to doctors' offices for free.
Representatives from many diverse organizations, including health providers and insurers, the pharmaceutical industry, the Maine Chamber of Commerce and the Maine Center for Disease Control, all understood the health benefits of vaccinations and thought that the financial barriers to vaccinating children should be eliminated. Everyone, especially the children of Maine, wins with the new program.
The legislation established a Vaccine Board that purchases all recommended childhood vaccines at reduced rates -- on average, about a 20 percent discount from what private doctors now pay. Insurance companies, therefore, have a reduced bottom-line cost for immunizing their covered families.
Financial barriers to getting vaccines are greatly reduced, so more preventive care can be delivered, thereby lowering the disease burden in our communities and lowering overall health spending. Practitioners are relieved of the financial burden of carrying thousands of dollars of vaccine inventory and of having to bill families hundreds of dollars when insurance claims are unexpectedly rejected.
The Vaccine Board is a true public-private partnership success. It solicits input from all the groups originally involved with setting up the program, and works with the Maine Immunization Program in setting policy, purchasing and distributing vaccine, and billing insurance companies for their share of the expenses (based on number of covered children). This is a complicated task, and board members are charged with making sure all these activities are accomplished efficiently.
As pediatricians, we are incredibly grateful to all who have helped make this program a success. We believe that immunizing our young patients is the most important preventive activity we do in our professional lives.
Those of us old enough to remember polio, measles, Haemophilus flu meningitis, birth defects from rubella -- all now virtually eliminated -- appreciate how protected we are from these former threats.
It is painful for us to see well-meaning but misinformed parents refuse or defer shots, thinking that their children are not at risk. These diseases are only an airplane flight away. What keeps our preventable disease rates low in Maine is the fact that the majority of parents act responsibly and keep their children's immunization status up-to-date.
When we vaccinate our kids, we not only lower their risk of disease, but also protect the children around them. Some children may not respond as effectively to the same vaccine, some may not be able to get certain shots because they are too young or they have a disease or condition that doesn't allow them to get vaccinated (such as some cancers).
Also, parents, grandparents and great-grandparents are less likely to get sick when kids get their shots.
What keeps the unprotected part of the population healthy is "herd immunity," which means that if enough people are resistant to diseases, they can't spread. Thus, parents who keep their children up-to-date not only help themselves, but help keep the whole community healthy.
As pediatricians, we believe that vaccines are the best form of prevention. We are delighted that this new law greatly diminish the barriers to getting vaccines.
Syd Sewall, M.D., practices at Kennebec Pediatrics, Augusta, part of MaineGeneral Health System. Larry Losey, M.D., practices at Brunswick Pediatrics, part of Central Maine Healthcare. Jonathan Fanburg, M.D., practices at Maine Medical Partners Pediatrics, Falmouth.