State Thimerosal Legislation: Status Update and Program Impact

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Presentation transcript:

State Thimerosal Legislation: Status Update and Program Impact Ian Van Dinther State Government Affairs Analyst American Academy of Pediatrics

Overview Since 2004, six states have enacted legislation restricting the use of thimerosal-containing vaccines.

California Iowa Delaware Illinois Missouri New York States California Iowa Delaware Illinois Missouri New York

Overview This legislation may impede the ability of states to implement immunization programs in accordance with current recommendations.

Key Provisions of Enacted Laws Iowa (2004) Children under eight Permits vaccines containing “trace amounts as defined by the US FDA” Exempts flu vaccine and instances of public health emergency Effective 1/1/2006

Key Provisions of Enacted Laws California (2004): Children under 3 / pregnant women; effective 7/1/2006 0.5µg per 0.5ml dose / 1 µg per .5ml Exemption in event of actual or potential public health emergency or shortage (if Sec. State dept. HHS so finds, and Gov. concurs)

Key Provisions of Enacted Laws Delaware (2005): Children under 8 / pregnant women; effective 1/1/2006 Exempts influenza vaccines, and vaccines containing “trace amounts as defined by the US FDA” until 1/1/2007

Key Provisions of Enacted Laws Delaware (2005 - continued): Exempts only vaccines containing “trace amounts as defined by the US FDA” until 1/1/2008 Exempts only declared states of emergency and epidemics beyond 1/1/2008

Key Provisions of Enacted Laws Illinois (2005): No age specification 1.25µg per dose, effective 1/1/2006 Prohibits vaccines containing trace thimerosal after 1/1/2008 Dept. Health may waive requirement in event of actual or potential emergency, epidemic or shortage

Key Provisions of Enacted Laws Missouri (2005): Children under 3 / pregnant women; effective 4/1/2007 1µg per 0.5ml dose Dir. Dept. Health may waive (if Gov. concurs) requirement in event of epidemic, emergency or shortage

Key Provisions of Enacted Laws New York (2005): Children under 3 / pregnant women 0.5 µg per 0.5ml dose (all vaccines except flu) Children under 3: 0.625 µg per .25ml dose - flu vaccine Pregnant women: 1.25 µg per 0.50 milliliter dose – flu vaccine

Key Provisions of Enacted Laws New York (2005 - continued): Limits on flu vaccine for pregnant women do not apply until and unless the Commissioner of Health makes a yearly determination that there is an adequate supply of flu vaccine

Key Provisions of Enacted Laws New York (2005 - continued): Commissioner may authorize waiver of all requirements listed above in the event of an outbreak of disease, and/or vaccines are not available for distribution, in which case vaccination is permitted with informed consent Effective 1/1/2008

2006 legislative activity in: MI NE NC OH NJ NM TN VA VT WA CO FL HI IA (expands current law) IN KS MD MA ME

Implications for State Immunization Programs When implemented, restricts use of most available supplies of flu vaccine Prohibits use of some current formulations of childhood combination vaccines in states restricting trace thimerosal Limits access to vaccine for Japanese Encephalitis

How did this happen? Childhood influenza recommendation added to schedule Increased media/public attention to vaccine safety issues/controversies Thimerosal replaced exemptions as the legislative vehicle for vaccine hesitant pressure groups

A Note on the 1999 AAP/PHS Recommendation Often misinterpreted and misquoted by supporters of thimerosal ban legislation Statement recommendations addressed children under 6 months; the now - recommended flu vaccine is approved for children older than 6 months

A Note on the 1999 AAP/PHS Recommendation (continued) Statement explicitly states that vaccine availability should not be interrupted because of shortage of preservative- free vaccine When examined more carefully, the statement does not support – but rejects – the terms of the legislation

Options for States Continue to reassure the public about the value and safety of immunizations Exercise exemption language in law Scrutinize terms during implementation Repeal – a daunting task

Progress Being Made in State Legislatures None of the 2006 bills have yet been enacted Some state lawmakers now have seen these bills 2 or 3 sessions in a row We may be turning a corner on thimerosal legislation at the state level

For More Information: Tomorrow – Tools and Strategies for Working with State Legislatures International Ballroom F Tuesday, March 7, 2006: 2:00 PM-3:00 PM Ian Van Dinther 800.433.9016, ext. 7092 ivandinther@aap.org http://www.aap.org