What Ronald Reagan Can Teach Us About Vaccine Policy

Many U.S. Presidents, even George Washington, worked to get people vaccinated and protected. Well, Washington got them variolated and protected against smallpox, but that still counts.

As can be expected, some Presidents did a better job than others.

“Government’s first duty is to protect the people, not run their lives.”

Ronald Reagan

Do you have to run someone’s life to prevent outbreaks and help make sure folks get protected against vaccine-preventable disease?

Ronald Reagan’s Vaccine Policy

A lot happened in regards to vaccines when Reagan was President. After all, he was the President who signed the National Childhood Vaccine Injury Act (NCVIA) of 1986, which created VAERS and the NVICP!

What else happened?

“…the Reagan Administration starved the Federal program for childhood immunization…”

The Shame of Measles

That’s right, Federal support for vaccine programs reached a low point during Reagan’s years in office, as rates of children living in poverty and without health insurance also increased.

That’s not a good mix!

“During the Reagan years, the price of vaccine went up and Federal funding for childhood immunization went down.”

The Measles Menace

Not only did the price of vaccines go up, but new vaccines were added to the immunization schedule in the mid-1980s.

So even if Federal funding for vaccines had stayed the same, it would essentially have been a big cut!

“Measles is a wholly preventable disease, and it was almost eradicated from the country in 1983, when only 1,497 cases were reported. But by 1990, after Federal budget cuts and the end of the Government’s monitoring of immunization programs, more than 30,000 cases of measles and more than 60 deaths were reported.”

Panel Ties Measles Epidemic to Breakdown in Health System

All of this followed President Jimmy Carter’s National Childhood Immunization Initiative in 1977, which reached its goal of immunizing over 90% of children!

Not surprisingly, this followed a growth in federal grants from $5 million to $35 million towards state immunization budgets. Yes, it costs money to get kids vaccinated and protected. But don’t forget that it costs even more money to control outbreaks once they start.

“Immunization policy during the Carter Administration demonstrated that when both an administration and key congressional actors viewed immunization as a priority and made sufficient funds available to support the public health delivery system and its infrastructure, coverage levels would continue to rise and disease levels continue to decline.”

Johnson et al on Federal immunization policy and funding: A history of responding to crises

Unfortunately, the coverage levels and growth during the Carter administration weren’t sustained for very long after Reagan took office in 1981.

As can be expected, neither were declines in rates of measles.

Instead, we eventually saw big outbreaks of measles across the United States. From 1989 to 1991, at least 123 people died among 55,000 cases, with another 11,000 hospitalized.

“The measles outbreak of 1989–1991 exposed many incorrect assumptions behind the belief that low levels of coverage were sufficient to control the transmission of infectious disease. The changing demographics of society, the mixing of young children in day care settings, new patterns of health care delivery, high rates of uninsured children, and the shrinking size and morale of health departments all fostered circumstances in which disease transmission occurred within major metropolitan areas even though disease reports were low, and state health officials believed statewide immunization coverage was at acceptable levels.”

Calling the Shots: Immunization Finance Policies and Practices

How did it get fixed?

President George HW Bush announced his own immunization action plan to raise vaccinated rates, and we once again put more Federal money into our immunization programs.

The result?

Immunization rates went up and the outbreaks stopped.

The President and the Children

Outbreaks that didn’t have to happen.

A 1987 op-ed in the New York Times warned about was coming and how to prevent it…

“Each dollar spent to immunize young children saves $10 in later medical costs. Yet in 1985, one of four children between ages 1 and 4 was not immunized for rubella, mumps, polio or measles and 13 percent lacked immunization for diphtheria, tetanus and pertussis. Congress would increase funding by about $20 million, enough to immunize 600,000 more youngsters.”

The Reagan administration didn’t listen.

The Children's Defense Budget analysis details how Reagan proposed cutting $2 to $3 million a year from the immunization program beginning with his 1982 budget.
The Children’s Defense Fund budget analysis details how Reagan proposed cutting $2 to $3 million a year from the immunization program beginning with his 1982 budget.

Are we headed for something similar in the years ahead?

Consider that:

  • the Children’s Health Insurance Program (CHIP) expired on September 30 and it has yet to be reauthorized
  • the short-term CHIP “fix” took $750 million cut from the Prevention and Public Health Fund, which provides 40% of the total funding for the CDC’s immunization program
  • the Section 317 Immunization Program was already slated for a big drop in President Trump’s FY 2018 Budget

So we may have fewer kids with insurance and less money for immunization programs.

When did we last see that scenario?

Take Action and remind Congress and our President of the “critical role” they play in protecting our children and that they should #PutKidsFirst.

“As Members of Congress, we have a critical role to play in supporting the availability and use of vaccines to protect Americans from deadly disease.”

Sens. Lamar Alexander et al Dear Colleague Letter

“Supporting the availability and use of vaccines” does not mean decreasing funding for vaccine programs!

And protecting “Americans from deadly disease” certainly does not mean having fewer people covered on insurance plans.

What to Know About Ronald Reagan’s Vaccine Policy

Ronald Reagan essentially starved the Federal program for childhood immunization, which led to lower vaccine rates and deadly outbreaks of measles. Let’s not allow history to repeat itself.

More on Ronald Reagan’s Vaccine Policy

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