Healthy People 2020 and The Decade of Vaccines

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FA Note:  Dr. Ten­pen­ney’s arti­cle below details what may be the most impor­tant prop­er­ty rights bat­tle we face. If we lose our nat­ur­al right to con­trol what hap­pens to our bod­ies, all oth­er “prop­er­ty” own­er­ship is illu­so­ry. The miss­ing ele­ment in this arti­cle is the vac­cine con­nec­tion to the Unit­ed Nations’ Glob­al Health ini­tia­tives, as tar­get­ed through Mil­le­ni­um Devel­op­ment Goals of the WHO and UNICEF.

Dr. Sherri TenpenneyWhile it appears that the recent measles hys­te­ria pushed a but­ton that rock­et­ed near­ly all 50 states to intro­duce vac­cine bills simul­ta­ne­ous­ly, call­ing to restrict and/or remove vac­cine exemp­tions for chil­dren, the plan has actu­al­ly been evolv­ing for a long time. The flur­ry of leg­isla­tive actions are root­ed in the Healthy Peo­ple guide­lines which began 35 years ago.

In 1976, Con­gress cre­at­ed The Office of Dis­ease Pre­ven­tion and Health Pro­mo­tion (ODPHP) to coor­di­nate dis­ease pre­ven­tion and health pro­mo­tion efforts across the Unit­ed States. Three years lat­er, Sur­geon Gen­er­al Julius B Rich­mond chron­i­cled the state of health in Amer­i­ca, then defined five quan­ti­ta­tive goals for pub­lic health. The doc­u­ment came to be referred to as Healthy Peo­ple. With the help of Assis­tant Sur­geon Gen­er­al Michael McGin­nis, the for­mal pub­li­ca­tion was released in 1979. In 1980, a com­pan­ion piece writ­ten by the Insti­tutes of Med­i­cine – Pro­mot­ing Health/Preventing Dis­ease: Objec­tives for the Nation — set forth 226 spe­cif­ic, mea­sur­able health objec­tives. This was the action plan for the Healthy Peo­ple goals. These two doc­u­ments, con­sid­ered to be “land­marks” in the his­to­ry of pub­lic health, became Healthy Peo­ple 1990.

Lofty goals were put forth for many areas of health, but some of the first direc­tives for mass vac­ci­na­tion were estab­lished in Healthy Peo­ple 1990. For exam­ple, one goal was to achieve at least a 60% influen­za vac­ci­na­tion rate among high-risk pop­u­la­tions. Anoth­er was to ful­ly vac­ci­nate all chil­dren with MMR, polio and DTP by two years of age.

The goals were meant to be nation­al in scope. But 1980s was long before the age of instant inter­net com­mu­ni­ca­tion and few of the objec­tives were met in the era between 1980 and 1990. There­fore, plan­ning the objec­tives for the new decade began in 1987, engag­ing broad based input from across the country.

By the time Healthy Peo­ple 2000 was released in 1990, more than 7,000 per­sons and pub­lic health orga­ni­za­tions at the local, state, and nation­al lev­els had par­tic­i­pat­ed in the devel­op­ment of 22 top­ics with 312 objec­tives. Includ­ed in Healthy Peo­ple 2000 were goals to ensure all chil­dren were ful­ly vac­ci­nat­ed and all old­er adults were vac­ci­nat­ed with both the influen­za and pneu­mo­nia vaccines.

In 2010, the cur­rent guide­lines were released, framed as Healthy Peo­ple 2020. The lat­est rec­om­men­da­tions are vast in scope and include gov­ern­ment intru­sion into near­ly ever con­ceiv­able area of per­son­al life and health. What start­ed out as 15 top­ics and 226 objec­tives in 1990 has grown to 42 top­ics and more than 1,200 objec­tives for 2020.

Rep­re­sen­ta­tives from more than 50 Fed­er­al Agen­cies helped devel­op the Healthy Peo­ple 2020 top­ic areas. Rep­re­sen­ta­tives from each agency also worked with the Fed­er­al Inter­a­gency Work­group (FIW), a task force that includes, among oth­ers, the Depart­ments of Agri­cul­ture, Edu­ca­tion, and Trans­porta­tion. The mas­sive efforts were coor­di­nat­ed by The Office of Dis­ease Pre­ven­tion and Health Pro­mo­tion (ODPHP), in con­junc­tion with the Depart­ment of HHS. All agen­cies drew on the exper­tise of the Assis­tant Secretary’s exten­sive Advi­so­ry Com­mit­tee on Nation­al Health Pro­mo­tion and Dis­ease Pre­ven­tion. The Assis­tant Sec­re­tary of Health, who reports direct­ly to the Sec­re­tary of Health and Human Ser­vices (HSS), has direct over­sight of ODPHP activ­i­ties. HSS has more than 77,000 employ­ees. Thou­sands of peo­ple par­tic­i­pat­ed in the devel­op­ment of Healthy Peo­ple 2020 and have a stake in its implementation.

U.S. National Vaccine Plan

In 2010, part­ners from all over the world came togeth­er with a glob­al com­mit­ment to immu­niza­tion, declar­ing 2010 to 2020 as the Decade of Vac­cines.  Amer­i­can chil­dren today receive 49 dos­es of 16 dif­fer­ent vac­cines before 5 years of age. There is no end in sight with at least 300 vac­cines in the cur­rent devel­op­men­tal pipeline.

The Nation­al Vac­cine Plan, devel­oped by the U.S. Depart­ment of Human Ser­vices (HSS) is the roadmap for a “21st cen­tu­ry vac­cine and immu­niza­tion enter­prise.” It lays bare the inces­tu­ous pub­lic-pri­vate rela­tion­ship between the phar­ma­ceu­ti­cal vac­cine man­u­fac­tur­ers, the U.S. gov­ern­ment and the World Health Com­mu­ni­ty. The plan includes spe­cif­ic out­lines and strate­gies for advanc­ing vac­cine R&D in con­junc­tion with the NIH and FDA; calls for gov­ern­ment guar­an­teed financ­ing, sup­ply, and dis­tri­b­u­tion of vac­cines; and requests fund­ing for new pro-vac­cine infor­ma­tion pieces to be dis­trib­uted con­sumers and health care providers.

The Nation­al Vac­cine Imple­men­ta­tion Plan was designed to coor­di­nate with Healthy Peo­ple 2020. This plan out­lines the goals and objec­tives to achieve increase vac­ci­na­tion over a 10-year peri­od, with action steps, process­es and mea­sur­able out­comes to be achieved between 2012 and 2015. The imple­men­ta­tion plan has five broad objectives:

  1. Devel­op new and improved vaccines
  2. Enhance the vac­cine safe­ty system
  3. Sup­port com­mu­ni­ca­tions to enhance informed vac­cine decision-making
  4. Ensure a sta­ble sup­ply of, access to and bet­ter use of rec­om­mend­ed vaccines
  5. Increase glob­al pre­ven­tion through vaccination

In Decem­ber, 2014, the Robert Wood John­son Foun­da­tion released a spe­cial report called Out­breaks: Pro­tect­ing Amer­i­cans from Infec­tious Dis­eases. The first 10 pages dis­cuss Ebo­la, super­bugs, tuber­cu­lo­sis, pan­dem­ic flu and mos­qui­to-borne dis­eases, the major infec­tious dis­ease threats seen today. The doc­u­ment then tran­si­tions to a lengthy dis­cus­sion about vac­cines and the major risk of infec­tion for unvac­ci­nat­ed children.

Elimination of Exemptions: The Playbook

On page 75 of this doc­u­ment, the play­book for the cur­rent flur­ry of vac­ci­na­tion laws is suc­cinct­ly and shock­ing­ly laid out.

Increas­ing Vac­ci­na­tion Rates: Improv­ing the nation’s vac­ci­na­tion rates would help pre­vent dis­ease, mit­i­gate suf­fer­ing, and reduce health­care costs. The Trust for America’s Health and the Robert Wood John­son Foun­da­tion rec­om­mend a num­ber of actions that can be tak­en to increase vac­ci­na­tion rates for chil­dren, teens and adults around the coun­try, including: 

  • Min­i­mize vac­cine exemp­tions: States should enact and enable uni­ver­sal child­hood vac­ci­na­tions except where immu­niza­tion is med­ical­ly con­traindi­cat­ed. Non-med­ical vac­cine exemp­tions, includ­ing per­son­al belief exemp­tions, enable high­er rates of exemp­tions in those states that allow them [imply­ing reli­gious and philo­soph­i­cal exemp­tions should not be allowed.]
  • Increas­ing pub­lic edu­ca­tion cam­paigns about the safe­ty and effec­tive­ness of vac­cines: Fed­er­al, state and local health offi­cials, in part­ner­ship with med­ical providers and com­mu­ni­ty orga­ni­za­tions, should con­duct assertive cam­paigns about the impor­tance of vac­cines [hence, the measles media blitz] par­tic­u­lar­ly stress­ing and demon­strat­ing the safe­ty and effi­ca­cy of immu­niza­tions. Tar­get­ed out­reach should be made to high-risk groups and to racial and eth­nic minor­i­ty pop­u­la­tions where the mis­per­cep­tions about vac­cines are par­tic­u­lar­ly high.
  • Expand alter­nate deliv­ery sites: The Nation­al Vac­cine Advi­so­ry Com­mit­tee (NVAC) has rec­om­mend­ed includ­ing expan­sion of vac­ci­na­tion ser­vices offered by phar­ma­cists and oth­er com­mu­ni­ty immu­niza­tion providers, vac­ci­na­tion at the work­place, and increased vac­ci­na­tion by providers who care for preg­nant women. [schools have vac­ci­nat­ed chil­dren with­out parental con­sent.]
  • Bol­ster­ing immu­niza­tion reg­istries and track­ing: States should take steps to inte­grate immu­niza­tion reg­istries and EHRs to help track when patients receive vac­cines, improve infor­ma­tion shar­ing across providers, remind providers to rou­tine­ly pro­vide rec­om­mend­ed vac­ci­na­tions, remind patients of vac­ci­na­tions and address gaps.
  • Requir­ing uni­ver­sal immu­niza­tion of health­care per­son­nel for all ACIP rec­om­mend­ed vac­ci­na­tions:  Accord­ing to a joint pol­i­cy state­ment by the Asso­ci­a­tion of Pro­fes­sion­al in Infec­tion con­trol and Epi­demi­ol­o­gy (APIC) and Soci­ety for Health­care Epi­demi­ol­o­gy of Amer­i­ca (SHEA), manda­to­ry immu­niza­tion pro­grams are the most effec­tive way to increase health­care per­son­nel vac­ci­na­tion rates. As such, the Soci­eties sup­port health­care employ­ee poli­cies that require health­care work­ers to demon­strate immu­ni­ty or doc­u­ment receipt of ACIP-rec­om­mend­ed vac­ci­na­tions as a con­di­tion of employ­ment, unpaid ser­vice [vol­un­teers will be vac­ci­nat­ed], or receipt of pro­fes­sion­al priv­i­leges [doc­tors vac­ci­nat­ed to work].

This infor­ma­tion is sober­ing – but should be infu­ri­at­ing. The objec­tives in Healthy Peo­ple 2020 rep­re­sent the mas­sive expan­sion of a nan­ny-state gov­ern­ment, intent on tak­ing over every area of a person’s life and elim­i­nat­ing health choic­es. The leg­isla­tive moves we are fight­ing were set in motion many years ago.

What can you do? Get involved.

Join the por­tal. Work to stop the bills that are on deck to take away our rights. Tell those involved that mass vac­ci­na­tion and Healthy Peo­ple 2020 is not about mak­ing peo­ple healthy. It is about control.