Disease outbreaks feared as funds cut for free vaccines

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With federal funding gone, Maine will no longer be providing free immunizations for children – a move health officials fear could increase the chance of disease outbreaks in the state.

Previously, the state, with a combination of public and private funding, provided vaccines to doctors, free of charge. Now, doctors will have to buy those vaccines up front.

According to Maine Public Health Director Dora Mills, a full set of vaccinations for a child from birth to 5 years of age, which consists of measles, mumps, rubella, hepatitus, chickenpox and tetanus, runs at about $1,600.

“It’s a huge amount of overhead we’re not used to,” said Angela Wescott, office manager at Pine Point Pediatrics in Scarborough. “It’s going to be a hardship.”

Because doctors will have to acquire those vaccines on their own, insurance companies will be affected, too, according to Anthem spokesman Mark Ishkanian.

Ishkanian said, because doctors won’t be getting the vaccinations at a bulk rate, the cost per shot will be higher, and, in the end, insurance companies will be the ones covering that increase.

But more troublesome for the insurance companies, Ishkanian said, is the threat of vaccination rates dropping, which translates to a higher risk of outbreak, creating the potential of a much more expensive problem.

Mills said, over the past few years, the cost of vaccines has risen and federal funding has decreased, resulting in lower vaccination rates in the state.

Though insurance companies had been reimbursing the state for part of the cost, without the federal funding, the state will only be able to provide free vaccines for children who are on MaineCare, have absolutely no insurance or are Native Americans, who are covered by a separate state program.

For the rest, Mills said, she expects vaccination rates to continue to drop.

“The bottom line of what’s happening is there are a lot more barriers,” Mills said about children being able to get vaccinated, creating a real threat for outbreaks of diseases like mumps, measles and whooping cough.

“It’s very sad,” she said.

Just three years ago, she said, the state was providing 100 percent of vaccinations for children. Starting next year, that will go down to 45 percent.

As government funds have decreased over the past three years, the overall vaccination rates for children have dropped about 5 percent, and Ishkanian said the decrease this year “cannot help.”

According to Curtis Allen, spokesman for the National Centers for Disease Control, its budget for immunization programs, not including Vaccines for Children, throughout the country has dropped from $307 million to $273 million from last year to this year, and every state’s piece of that pie is getting cut proportionately.

For Maine, that means a reduction in funding from about $2.5 million to $2 million. Allen said that’s a number that has been flat or reducing for the state over the past several years, while at the same time more vaccines are being required and the price of the vaccines themselves are going up.

Because of those factors, he said, “even if it’s flat, it’s a reduction.”

“We’re going in the wrong direction in the state,” Ishkanian said.

According to Allen, Maine is not alone. He said Nevada has also had to stop providing vaccines for children with insurance, and, most states, he said, never provided vaccines for those children to begin with.

But both Allen and state officials said, the actual impact is yet to be determined.////

“We were caught by surprise,” said Katherine Pelletreau, executive director of the Maine Association of Health Plans, a nonprofit trade association that works to educate the public on health care. “We don’t understand the scope of the impact yet.”

Mills said the state hasn’t yet come up with hard numbers for how many children the change will affect. She said parents may start to delay vaccinating their children, only get the vaccinations required for school or even lie on school records saying they have a philosophical opposition to vaccines in order to avoid the cost – something she’s heard has happened before.

Pelletreau said the first order of business is to try to figure out a way to get back to universal coverage, before health insurance companies and doctors start thinking about changes they will need to make in order to continue providing vaccines for children.

“Everybody is still reeling about the news,” Pelletreau said.

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