PHOENIX - Recent outbreaks of diseases in schools and elsewhere illustrate Arizona's challenges when it comes to getting residents vaccinated, according to Maricopa County's top health official.
"It really matters to you whether your neighbor and your neighbor's kids have been vaccinated," said Dr. Bob England, director of the Maricopa County Department of Public Health. "So we have to keep that level of herd immunity up, and we're flirting around with losing it."
England and others testified Wednesday in favor of a bill that would establish a committee to study the cost and availability of vaccines in Arizona.
HB 2101, authored by Rep. Kate Brophy McGee, won a unanimous endorsement from the House Health Committee.
The bill would have lawmakers, state and local health officials, health professionals, representatives of insurers and pharmaceutical companies and others study the financing and availability of childhood and adolescent vaccines and the costs associated with those vaccines across Arizona.
The panel would have to submit its findings by Dec. 15, 2014.
England said it is through vaccines that once-common childhood diseases have become rare. He encouraged lawmakers to focus on herd immunity, or the level of immunization needed to keep a disease from spreading in a community.
"If you get enough people in a group vaccinated, even with an imperfect vaccine, the odds of one's persons germs finding somebody that it can jump to goes way down," he said.
An outbreak of measles in Pima County several years ago is a good example of how costly an outbreak can be, England said.
"That little outbreak that impacted 20 people cost that community about $1 million to contain," he said. "If there's an outbreak in a school, yours truly has to exclude unimmunized kids from that school, not to protect them necessarily but to keep that level of herd immunity up in the schools so that outbreak doesn't keep going and bouncing around from child to child."
Arizona students are exempted from immunizations if parents or guardians submit a signed statement to school officials acknowledging they have reviewed information about immunization from the Arizona Department of Health Services. Arizona is among the few states that allow exemptions for philosophical and personal reasons.
Mike Perlstein, representing the Arizona chapter of the American Academy of Pediatrics, said the high cost of vaccines has created a strain for private medical practices.
"An average office shows that 42 percent of overhead is gone to just purchase the vaccine," he said. "My office, a five-man practice, in the last three years we've averaged over $600,000 of vaccines purchased throughout the year. There's a lot of issues when the cost of the vaccine is increased. Our payment doesn't change for a while."
He added that many rural physicians have stopped offering vaccines, shifting responsibility to the public sector.
Jennifer Tinney, program director for The Arizona Partnership for Immunization (TAPI), said she hoped a study committee would address the costs that parents face when it comes to vaccines, including out-of-pocket payments and insurance premiums.
"There's a lot of different solutions out there, but I think this is a very complicated subject that really requires some further study and looking at," she said.