Arizona health official seeks to get vaccines to all who need them

By Dennis Thompson
HealthDay Reporter

(HealthDay News) -- For more than a decade and a half, Kathy Fredrickson has served as one of a handful of public health officials working to improve immunization rates among the poorest Americans.

Fredrickson currently serves as chief of the immunization office of Arizona 's Department of Health Services, a post she's held for 10-plus years. For more than five years before that, she held a similar job with the North Dakota health department.

"Vaccination has been touted as one of the best public health interventions in the last 100 years," Fredrickson said. "There are people who can remember when they couldn't go to pools or schools when there was a polio outbreak. Those days are over, but only because we stay on top of prevention."

The primary goal of her Arizona program is to procure vaccines and distribute them to health providers, Fredrickson said. This year, she expects to manage the distribution of $90 million worth of vaccinations throughout the state.

Federal funding pays for vaccinations for the poorest people, those receiving health care through Medicaid, Fredrickson said. Privately insured people receive their immunizations through their health plan.

But there's a growing slice of people who have health insurance that doesn't cover immunization or only covers a percentage of the cost. "We call that group the under-insured," she said.

In Arizona , making sure the children of the "under-insured" receive their vaccinations is important enough that the state uses tax dollars to cover the cost, Fredrickson said.

"There should be no parent who has to pay out-of-pocket for the cost of vaccine for ages 0 through 18," she said. "We're trying to remove any barriers for parents to take their children in for vaccination, and cost can become a barrier."

There are specific problems in providing state-level immunization care, particularly for under-insured people, Frederickson said.

For instance, any new vaccines added to the immunization schedule usually are picked up quickly by the federal government. But the timing of the schedule change could come in the middle of the state's fiscal year, meaning a delay of months before the money is approved to start passing out the new vaccine, she explained.

Frederickson also has to work to overcome misperceptions about new vaccines. For example, the new HPV vaccine prevents a sexually transmitted disease that causes most cases of cervical cancer. But many parents can't get past the way the disease is spread to see the broader health advantages, she said.

"They link it to the sexual act, and figure their daughter doesn't need the vaccine, because she's not sexually active," she said.

Fredrickson sees that type of thinking as part of an overall wave of public apathy related to vaccination.

"Providers find they are spending more time talking with parents and answering their questions than ever before," she said. "We've done such a good job of reducing and almost eliminating these diseases, they question why we want to vaccinate against them."

But Fredrickson and her fellow public health professionals know why -- any flaw in the job they perform could cause a resurgence in deadly diseases like mumps, rubella, measles and the like.

"We keep those statistics in our minds to remember why we do what we do -- the deaths caused by these diseases before immunization put a stop to them," she said. "At every national convention, they put those stats up on a big screen to remind us of the progress we have made."

Copyright © 2008 ScoutNews, LLC. All rights reserved.