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tv   Senate Health Committee Hearing on Vaccines and Outbreaks  CSPAN  March 9, 2019 11:42am-1:34pm EST

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tally earlier when it passed the house -- we don't think there is enough votes to get to it to a two thirds majority to override the veto. so then we are unfortunately to the courts, into the next round of feuding over appropriations. remember, there have been so many disasters of the national disaster -- natural disaster variety, not the questionable disaster declarations, the border variety, that congress will he to do and which is a supplemental bill to deal with tornado damage, hurricane damage and the like. that is probably the next place where this becomes an issue. there we have emergencies that everyone will agree are emergencies. so there will be money spent there that is not being spent on the wall either. >> we appreciate the information. we will keep following on twitter.
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thank you. >> the senate committee on this hearing is an hour and 15 minutes. health education, labor, and pension will please come to order. senator murray and i will each have an opening statement and we will introduce the witnesses and after their testimony, senators will have five minutes each of questions. it wasn't long ago when i was a boy that i remember the terror in the hearts of parents that their children might contract polio.
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i had classmates who lived in iron lungs. the majority leader of the united states senate, mitch mcconnell, contracted polio when he was very young. it is a poignant story about his mother who didn't know what to do but she took him to warm springs because that's where president roosevelt went. and for a long period of time, she massaged his legs several hours per day which is hard to imagine if you remember toddlers. that's why he is able to walk today. thousands of others are not so lucky. following the introduction of a vaccine in 1955, polio was eliminated in the united states in 1979 and in every country in the world except three, polio is just one of the diseases we have a radical the united states thanks to vaccines. before the vaccine for measles was developed, up to 4 million americans each year contracted
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the highly contagious airborne virus. in 2000, the centers for disease control and prevention declared measles eliminated from the united states. in the 1980's, smallpox was declared eradicated from the world i the cdc and the world health organization. these stories of polio and measles and smallpox are a remarkable demonstration of what modern medicine can accomplish in the lives of millions of people in our country and the world. four years ago, this committee held a hearing on vaccines. that was following the 2014 outbreak of measles. it was the worst outbreak since the disease was declared eliminated in 2000. even though 91% of americans had been vaccinated for measles in 2017, according to the cdc, we continue to see outbreaks of this preventable disease because there are pockets in the united
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states that have low vaccination rates. last year, there were 300 73 cases of measles, the second highest number since 2000 and so for this year, 159 cases reported. the outbreaks are confirmed in washington state, new york, texas, and illinois. we know some americans are hesitant about vaccines. today, i want to stress the importance of vaccines. not only has the fda found them to be safe but vaccines save lives. vaccines have been so successful that until recently, americans have lived without fear of getting measles, polio, or rubella. we have made significant strides in improving vaccination rates. in 2009, about 44% of americans had received vaccines for seven preventable diseases, all of which i will try to pronounce. diphtheria, tetanus, pertussis,
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polio, measles, rum -- mumps and rubella, influenza, hepatitis b, chickenpox. over 70% of americans are vaccinated against all seven of these diseases. next scenes protect not only those who have been backside but the larger community. this is called herd immunity. some young people cannot be vaccinated because they are too young or have a weak immune system because of a genetic disorder or they are taking medicine that compromises their immune system like cancer treatment. vaccines protect those who cannot be vaccinated by preventing the spread of disease. low immunization rates can destroy a communitiesherd immunity. while the overall vaccination rate nationwide is high enough h to create thiserd immunity, certain areas, the pockets of the country where vaccination rates are low, are vulnerable to outbreaks.
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there is a lot of misleading and incorrect information about vaccines that circulates online throughout social media. here is what i'd like for parents in tennessee to know, parents in washington, parents in texas, everywhere in the country. vaccines are approved by the fda. the meet the fda's gold standard of safety and the advisory committee on immunization practices makes recommendations on the use of vaccines in our country and annual child and adult vaccine schedules. this advisory committee is made up of medical doctors and public health professionals for medical schools, hospitals, professional medical organizations around the country. they are among the best or country has to offer and they have dedicated their lives to helping others. these recommendations are reviewed and approved by the cdc director and are available on the cdc website. there's nothing secret about any of this science.
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have shown that vaccines are safe. internet fraud claims vaccines are not safe and are preying on the unfounded fears and struggles of parents and they are creating a public health hazard that's entirely preventable. is it important for those who have questions for those who have to speak with a rep. -- reputable health care provider. just because you find it on the internet doesn't mean it's true. vaccines save lives of those who received vaccines in the lives of those too young or vulnerable to be immunized. before i turn this over to senator murray, want to add that the national child vaccine injury act of 1986 required the department of health and human services to submit a report to congress within two years after the legislation was signed into law. the health committee has received two reports from the department submitted to congress in 1988 and july, 1989. i ask consent that the reports
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be submitted to the committee records of a can be more accessible to the public. >> thank you very much. as states grapple with measles outbreaks, this issue cannot be more timely. i remember in 2001 measles was officially eliminated from the united states and what welcome news that was for families across this country. i remember the efforts, years of efforts that actually led to that victory. he for the vaccine was available, measles outbreaks used to spread through communities like wildfire. if you were old enough to drive, odds are you already had measles. today, vaccines that protect against measles have been in use for over 50 years. like other vaccines, we know the vaccine is safe, effective and save lives. that is why today, generation of students are starting college almost none of whom had to worry about a measles outbreak at school.
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it also means a generation of new parents may not appreciate just of dangerous measles is. before the introduction of the measles vaccine and widespread vaccination, millions of people caught measles annually, meaning thousands were hospitalized, hundreds of people died, mostly children under five years old. measles is not just deadly, it's also one of the worlds most contagious diseases. it is easily transmitted through coughing and sneezing. it can linger in the air and on infected surfaces for two hours. it is already contagious four days before an infected person develops a rash and another four days after. nine out of 10 unvaccinated people exposed to measles catch it. that's why the measles vaccine is so important in providing protection. experts say in order to establish herd immunity against measles, to prevent an outbreak from occurring within a community, at least 95% of
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people should be vaccination. meeting that threshold is crucial to protect people who are unable to get vaccinated, infants, those with medical conditions. unfortunately, while the national vaccination rate remains high, and communities across the country, we are falling behind. vaccine coverage rates are declining in certain areas contributing to the rise in preventable outbreaks. like in clark county, washington were public health officials continue to respond to a measles outbreak. the immunization rate among children in that community is less than 70%, far below what is needed to keep families safe. the result is a true public health emergency. over 70 confirmed cases and counting. the majority of cases have affected children under 10 years old who are unvaccinated. each case is not a consent for family members were worried about their will of the ones who are seriously sick, it is a
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threat to neighbors and communities mod struggling to get an incredibly contagious disease under control. it's a terror for parents with newborns who cannot yet get vaccinated and a strain on our public health system as hundreds of staff in washington state are pulled from critical public health roles to respond to this crisis. the centers for disease control and prevention stretches to support the response to outbreaks in washington and several other states. measles is not the only disease that deserves our attention amidst slipping vaccination rates. diseases like the chairman mentioned, mumps, pertussis, or whooping cough are cause for concern. these out rights are a clear sign we have had to do more to address vaccine hesitancy and make sure parents have the fact they need to understand the science. vaccines are safe and effective and life-saving. parents across the country want to do what is best for their families to keep them safe which
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is why they need to be armed with the knowledge about the importance of vaccination and why we need research and vaccination communication to help us better educate people to address vaccine hesitancy and build vaccine confidence. also need to understand the role social media and online misinformation play in spreading dangerous rumors and falsehoods. we need to better prepare the full spectrum of health care providers who are often the professionals people trust most to counter vaccine hesitancy and promote vaccination. important not only for parents but also expectant parents who may already be deciding whether or not they plan to vaccinate and for promoting adult vaccines and encouraging people to protect themselves and others throughout their lives. i look forward today to hearing from dr. weisma about hown washington state is working to get parents reliable information about the importance of vaccination and all of our witnesses here today about how the federal government and
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partners can promote vaccines and prevent the spread of misinformation. while we are now fighting multiple measles outbreaks, it's important we also educate people on the hpv vaccine role in preventing sexually transmitted diseases and lowering cancer risk, the flu vaccine on the heels of one of the most deadly flu seasons in years, the whooping cough vaccine especially for those around infants who are particularly susceptible to the disease and the value of other recommended vaccines. we also need to make sure we are approaching the public health challenges like this from a global perspective. we know diseases are not stopped at borders or walls or bans. they are stopped by doctors and nurses and vaccines and public health awareness. they are stopped by strong investments in public health systems here at home and abroad. they say amounts of prevention is worth a pound of cure. that's certainly the case here. a dose of mmr vaccine is about $20.
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meanwhile, washington state has spent over $1 million already addressing the current measles outbreak. investing in prevention is not just more effective at keeping our families and communities healthy, it is more affordable as well. the vaccines for children program is another great example of this. over 25 years and it's helped low income families get shots at no cost and has saved $1.6 trillion, prevented 380 million illnesses, and saved 860,000 lives. that's more people that live in seattle. i hope we can work together in a bipartisan way to build on programs like this with strong steps to help address public health crises and that are yet, to prevent them from happening the first place. i'm glad to have this opportunity to learn more about how we can do that and consider how to make sure people across the country understand that user safe and effective to keep their families and community healthy.
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>> chairman, i would ask a letter from the national association of county and city health officials be submitted for the record. it speaks of the important role of our local health departments across the country in responding to vaccine preventable disease outbreaks and other emergency health crises. >> so ordered, thank you, senator murray. i will now introduce our witnesses. each one of you will have up to five minutes for questions and answers. i will ask the senators to keep the questions and answers within the five minutes so everyone can have a chance to participate. senator murray will introduce the first witness. >> from my home state of washington, i am pleased to introduce dr. john huisman, who was appointed the secretary of health in 2013. he has a 22 year career working to keep our families and communities healthy. throughout his career, he has worked at four different health departments including clark county public health in vancouver which is the current
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frontline of our measles outbreak in our state and i know some of my colleagues on the committee will appreciate learning that before you came to my state to work in our public health system, you got your education in there is receiving your bachelors degree in wisconsin, your masters in connecticut, and your phd in north carolina. i'm glad we have you now in washington state working to help keep our families safe and healthy and respond to public health threats as we currently are and i appreciate you coming out. >> thank you, senator murray. senator isakson, will you introduce the second witness? >> i am pleased to introduce to the committee and everyone here today dr. zod omar. close enough. we are delighted to have you here today as an expert on the subject we are discussing. he is a professor of global health and professor of epidemiology and pediatrics at emory university, school of public out the medicine. the uni.
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they may qualify a witness for today's hearing. the research include studies in the united states and internationally including a trials to estimate the efficacy of influenza, polio, measles and other vaccinations. doctor omer published approximately 250 papers of the peer review and served on several advisory committees and panels including u.s. national vaccine advisory committee. he's also mentor over 100 junior faculty members and graduate students entering the pipeline.
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chair of the department of pediatrics at the university of tennessee health science center serves as the pediatrician. he received his medical degree and completed his internship and residency at alabama birmingham and 9 99 named 99 named it seemh scholar in the development program aand the developmentprot jude faculty for the department of infectious diseases where he spent 13 years managing a translational research lab studying viruses and bacteria pneumonia. fourth, john boyle is president and ceo of the immune deficiency foundation in maryland he
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received a bachelor of science from boston university and a master in the nonprofit management from notre dame of maryland university. finally, we welcome mr. lindenberge currently a stun norwalk ohio and he's here to share his experience seeking information about vaccines and making decisions about whether or not to become vaccinated. doctor wiesman, let's begin with you. >> chat chairman alexander, ranking member murray and members of the committee thank you for the opportunity to discuss public health work at protecting people from vaccine preventable diseases. vaccines are safe, effective and the best protection we have against serious preventable
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diseases. vaccinating children in the united states could save millions of lives can increase expectancy and saved our society truly into dollars. washington secretary of health is to protect and promote the health of all its people and ensure the public policy is based on the best available science. i want to speak directly to the parents who have children with health issues and are attending the hearings in washington state and now watching this hearing today. i see your pain and desire for answers to your children's health issues. your mission to protect them from the health of your children is one we shared. while the science is clear of vaccines do not cause autism, we do need to better understand its causes. we need to develop together affected families, scientists and public-health officials, research agendas to get the answers we need. state territorial intertribal local public health agencies are on the frontline and washington
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state we provide all of our recommended vaccines without charge to children under the age of 19. we provide an electronic immunization information system for healthcare providers to track the vaccine schedules. we help parent parents be confid suspicions by sending them the information they need to keep children healthy and publish the talk about childhood immunization and assists school nurses by giving access to the electronic immunization records. as of yesterday washington state's measles outbreak of 71 cases plus those associated with the outbreak in oregon and one in georgia led by the governmental public health. the moment of the suspected cases reported to the investigators interviewed the person to determine when they were infectious, who they were in close contact with and what's public spaces they visited.
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it's still infectious to health officer orders them to isolate themselves so they don't infect others and notify the public about the community about the public places they were in when they were infectious and stand up to the call center to handle questions. we also reach out to individuals that were in close contact with the patient if they are unvaccinated without symptoms we ask them to quarantine themselves that is how long it can take to develop symptoms and we monitor them so that we quickly know if they develop measles. if they show symptoms we get them to into a healthcare provid obtained samples and if they have measles, we start the investigation process all over again. this is a time intensive activity responding to this preventable outbreak has caused over $1 million required the work of more than 200 individuals first we need sustained predictable increase federal funding congress must prioritized public health and
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support the prevention of public health funds. we are constantly reacting to the crisis rather than working to prevent them. the association of state and territorial officials over 80 organizations are asking you to raise the cdc budget by 22% buy fy 22. this will immediately bolster prevention services, save lives and reduce health care costs. second, the response to the outbreak has been benefited greatly from the pandemic and all hazards prepared in fact so thank you. the publi public-health emergeny cooperative agreement and the preparedness programs authorized by the law are funded $400 million below the funding levels in the 2000. more robust funding is needed and i strongly urge you to quickly reauthorize because many of the authorizations expired last year. third, the 317 immunization program has been fun for ten years. without increased funding we cannot afford to develop new ways to reach parents with immunization information or
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maintain or electronic immunization systems. fourth, we need federal leadership for a national vaccine campaign spearheaded by the cdc in partnership with states that counter the message is similar to the successful true campaign we have lost much ground, urgent action is necessary. everyone has the right to live in a community free of the vaccine preventable diseases to make this a reality we must continue to invest in th in and strengthen our public health system. thank you. >> thank you for the opportunity for me to talk about vaccines. the elimination from the u.s. is a significant public-health success. since then, most of the cases have occurred through u.s. travelers going outside and bringing it back.
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the frequency and size of the outbreaks have been alarming for those of us that follow the trends. the rest of the testimony will be focused on answering some of the salient questions have been coming up so the first question is why haven't we seen a national outbreak in the us u.s. and we cannot take this for granted with a status like germany, france and italy specifically or more recently have had national outbreaks and is not a coincidence that we haven't seen some other outbreaks and there are several reasons for it. first of all, the school level mandates work they were by changing the vaccination compared to the non- vaccination by having the appearance go through the video.
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it is important because it is based on the fact that the physicians are the most trusted source of the vaccine information. ie will just give a few numbers for example more than half of the cases there is a contribution of vaccine refusal in our epidemiology of measles. it's changing the balance of convenience i was talking about but that is an issue i will focus on some of the things the
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federal government is doing in the testimony provided a few more details on that specific issue and i would be happy to answer questions. there are a lot of local factors that are specific but there's one constant that specifically physicians are the most trusted source of the vaccine information they do not have the time to properly counse counsele patient is using evidence-based approaches and part of the reason if not all of the reason is the fact that this isn't
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reimbursable so they lose money on the important public health education. to invest in the acceptance of the communications research by often say if you do not accept the vaccine development of science, and we don't, they go through the evaluation of the science from trials and basic science etc. we shouldn't be accepting the behavioral science and in this country for example, the council prevention initiatives are a gold standard in these kinds of interventions and evidence-based communication strategies and the institute for the immunology and infection and allergy they have had very effective development in the area of hiv aids behavior so we
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have that in this country and need to invest in the actual research. before we develop evidence and while we develop evidence, there is an existing blueprint for interventions that the advisory committee put together and not all of it and its recommendations have been implemented so that i it's ready to be implemented. the important role in fighting these fires for the local health departments is so unique in the world. that shows that there is broad societal support for the vaccines and those of us that worked to protect children from his infectious diseases really appreciate that. >> thank you, doctor omer. doctor mccullers, welcome.
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good morning chairman and other members of the committee my name is john mccullers at the university of tennessee as someone that devoted his career i believe there is no more precious resource and our children and they should be protected by all means available to us. they are the future of this nation. the childhood vaccination program in the united states has proven to be one of the most powerful achievements in our history and the first half of the 20th century there were more than 1 million infections and more than 10,000 deaths every year in this country from diseases which are now preventable by childhood vaccines. measles alone cost within half a million. measles is a highly contagious disease characterized by fever, cough, sore throat and is a very dangerous disease about one in a thousand infected persons developed encephalitis and an infection of the brain gives no
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specifics treatment in the vaccination is the only means of preventing these outcomes. from the missiles in 1963 it improved public health efforts to see that nearly every child received it new cases were arising in the states that were israeli eliminated and 2000 and the issues of the vaccine opposition and vaccine hesitancy are now impairing our ability to effectively ensure coverage aided by the state laws that make it easy to avoid vaccination. the last decade has numerous outbreaks to the states including several that are ongoing and present. these are strongly linked to the vaccine refusal and in particular to cluster vaccinated individuals as a specific community or region. this doesn't limited to the united states however countries worldwide are dealing with
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similar outbreaks and a single example for the committee there were zero cases of measles in brazil in 2017 but more than 10,000 cases occur on the countrywide level in 2018 when travelers brought measles into the country. the vaccine is safe and effective. one dose provides complete protection and up 93% of individuals while the second raises the level to 97% kerry ad a very few side effects occur. about one in ten children experience fever for one to two days after vaccination and one in 3,000 to one in 4,000 have a simple seizure associated with no lasting effects allergic reactions are very rare and typically mild when compared to the outcomes of the disease itself they recommend on time and complete vaccination. unfortunately it's getting worse in many states and it is complicated by the variety of state policies regarding exemption for vaccination and
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methods of counseling about vaccines. vaccines. the rate of the parents claiming a nonmedical exemptions is about 2.5 times higher than the states that allow both religious and philosophical objections and seeing that multiple pathways really worsens the problem. social media is driving a new phenomenon somewhat distinct from the vaccine opposition turned hesitancy. when parents get much of their information about healthcare issues such as vaccines from the internet or social media platforms such as twitter and facebook, reading uninformed opinions about the absence of accurate information can lead to really understandable concern and confusion. they may be hesitant about being provided with more information. about half of the time when the council appropriately printed
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vaccine hesitancy would agree to have their children vaccinated in time with a form of policy pr broad education efforts and in closing i'd like to thank the committee for addressing its issue. vaccine refusal was one of the growing public health threat of the time if we continue to allow for nonmedical exemptions the rate of the vaccines will continue to fall and more outbreaks will undoubtedly follow. as the leader in a children's hospital. next to arkansas and mississippi, three states all have area different policies for granting exemptions to vaccines which makes a tremendous problem for us and a threat to the children we serve many of whom are too young to be vaccinated or are compromised and prone to diseases. i urge the committee to continue solutions that will harmonize public health policy in this area and also protect children
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thank you for inviting me to testify against community herd immunity for the vaccine preventable diseases. my name is john boyle and i'm the president and ceo of the foundation that represents people with primary immunodeficiency diseases that are a group of more than 350 rare and chronic disorders which parts of the body immune system are missing or functioning improperly. it's maybe 250,000 people diagnosis in the u.s. alone that is about one in 1200 or constituents. these are caused by genetic defects and are not contagious. there's a variety between the different forms, but one thing that unites all of us, we are
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immunocompromised meaning we are vulnerable to even common viruses and bacteria. i have a form i was diagnosed with when i was six months old when a respiratory infection nearly killed me. in short i don't produce antibodies that i'm able to be here today because they receive weekly infusions from other people through a plasma product. these give me back some of what i am missing but i'm still susceptible to infection and because i was diagnosed early and they receive therapy, my health is better than most with this. however a simple cold can wreak havoc with me or other members of the community. we are vulnerable to communicable illnesses. now for some members of the community, infections are truly a life and death matter. all of you probably remember david vetter, the boy and a plastiin aplastic bubble boy wid
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immunodeficiency disorder. children born with this, or any other form face multiple challenges with simple everyday pathogen. exposing these children to something as severe as measles could be life-threatening. printing the community where the vaccine uses being questioned are afraid to chat and debate could send their children outside because they know the history, the science and the math. if people stop vaccinating, the safety net of the community immunity will dissolve into their children will be among the first casualties. of course this doesn't just affect children but it affects adults, too. there is newborn screenings, most members of the community through years or decades with serious recurrent infections without knowing they have a compromised immune system. i'm concerned for the health of this segment of the community, the undiagnosed if community
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immunity fails they don't even know that they need to take precautions. those of us who know we have it do what we can to avoid exposure to infections but the undiagnosed lack this knowledge and are even more at risk some are actually dangerous to us. those in the field of immunology have studied this to produce evidence-based guidelines to safeguard those with an article discusses this regarding which are either indicated or not but also addresses the growing neglect of the societal adherence to the routine vaccinations if states are important it is for the family
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members into those with deficiencies to receive all in order to protect the family member who has t pi. we depend on community immunity. we depend on vaccines. i understand the concerns some new parents have particularly given that misinformation on social media but that fear can override the facts. history has shown us that it were and they are necessary and mathematics has shown the odds of children having a healthy way for mac toots greater if they've had their vaccines it's bringing back the plagues of the past while both of us will suffer first and suffer more of the loss of community immunity is a
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threat to all of us. we need to band together to just go the myths, combat campaigns and help ensure measles and other preventable diseases are put in place. my mother is an anti-vaccination advocate for those that caused autism, brain damage and do not help and benefit the society despite the fact such opinions have been debunked numerous times by the scientific community. my entire life i went without numerous vaccines against measles, chickenpox or even polio. however, in december when i was a teen i began catching up on my missed immunizations despite my mother's approval.
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eventually, i'm able to sit here today. why i've come here and what i want to talk about i had to share some details about my home life and death bringing. i grew up understanding my mother's belief that vaccines are dangerous and she was open about these views both online and in person she would voice concerns and these were met with strong criticism. over the course of my life, seeds of doubt were planted questions arose because of the backlash my mother would receive, but over time that didn't lead anywhere. now, it's important to understand as i approached high school band began to think for myself, i saw the information and the defense of the vaccines outweigh the concerns heavily. i began leading debate clubs at my school and preserving through above all else and i realized one certain quality to debate and conversations in general when it comes to the controversial discussions, which is that there seems to always be two sides to a discussion. there always seems to be a
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counterclaim or rebuttal and always something to strike back with in terms of debate. this isn't true for the vaccine debate and i approached my mother with this concern that she was incorrect. i approached my mother numerous times trying to explain that vaccines are safe and that we should be vaccinated, approaching both articles of the cdc explaining that the ideas that vaccines cause autism and are extremely dangerous were incorrect. one instance i approached my mother with information from the cdc that claims vaccines do not cause autism she responded with that's what they want you to think of skepticism and worry were taking the forefront in terms of the information this reaffirms the evidence on an anecdotal level was even greater than the deeply rooted misinformation among other interacted with and that is what i want to focus on today.
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to combat preventable disease outbreaks, information is in my mind the forefront of this matter. another would've turned anti-vaccine groups online and social media looking for evidence and defense rather than officials had critical sources. this may seem to be malice because of the danger but this isn't the case my mother came in the sense of loving her children and being concerned. this information spread and that's not necessarily justifiable but i carry this knowledge with me that it was with respect and love that i disagreed with my mother and with the information provided by continued to try to explain that it was misinformed from ideas that can they cause autism, brain damage and the outbreak is a concern to society in america were ideas pushed by the sources that she would go to and for certain individuals and organizations to spread this
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misinformation they instill fear into the public for their own gain selfishly knowing that it is incorrect. for my mother her love and affection and care as a parent t was used to push imaging to create false distress and they spread misinformation and should be the primary concern of the american people. they've placed more strides can be done almost 80% of people according to the research center for them to the internet for health related questions. i further explained more statistics and evidence in my written testimony. in terms of what i'd like to walk away with today &-and-sign allies with although my mother returned to very illegitimate sources that did not have peer-reviewed evidence or information, i quickly saw the evidence he claims for myself for not accurate and because of that and my health care professionals i was able to speak with and the information provided to me i was able to make a clear, concise and scientific position. approaching this issue with the concern of education and addressing the information
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properly can cause change as it did for me. now also the debate around the vaccines isn't this is why education is important and also misinformation is dangerous. thank you. >> thank you, mr. speaker -- mr. lindenberger and thank you for coming from ohio to be with us. we have many senators interested the chief of one of the country's leading children's hospitals o were defeated and tt comes with you in memphis and says when his parents as they
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don't want their child vaccinated what do you say to that parent? >> one issue we have to talk about -- >> i want to focus on autism, when do they say that? this was a concern raised about 20 years ago when there was a fraudulent paper published linking the vaccines to autism. it was published in the united kingdom in the respected journal, it was a physician who published it and he was unfortunately paid by a set of attorneys more than 400,000 pounds to falsify information because they were suing the government of england against vaccines so this was found to be wrong and he lost his medical license they said it
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is no longer valid. >> d. with other papers or journals that agree there haven't been that agreed with that position but other scientific research done in the interim bu that have shown the opposite that they are not linked and the institute of medicine here are the highest authority on these issues and declared they are against the formerly basically a closed issue. >> as you talk with parents is that persuasive with a mother who is concerned about her child and who has heard that vaccines cause autism? >> if there is a rapport with a physician before the opinion of the parent but also for the position of the physician, you can say things like that and say the evidence is clear i believe you should do this and they will trust that information. >> in your opinion there is no evidence, no reputable evidence that vaccines cause autism?
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spinet absolutely no evidence at this time that vaccines cause autism. >> doctor omer, do you agree with that and doctor wiesman? >> i do. >> mr. boyle. >> i do. >> mr. lindenberger. >> i do. >> doctor wiesman, without extensions, you are a public health officer and as a former governor, i generally have a bias towards washington not telling states what to do on many [inaudible] with washington, d.c. not telling states what to do. senator murray is correcting me. so, what advice do you have about the state exemptions and the effect on the concern we see today in the pockets of measles across the country? >> i think as we heard earlier, the choice to sort of make exemptions for difficult to get
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is as burdensome as not getting the vaccine is as incredibly important in washington state as you know we have two bills right now bu that are looking to remoe the personal exemptions from vaccines for school entry and childcare entry. i think that's one of the tools we have for this and i would also say in washington state another problem we have is 8% of our kids are out of compliance with school records so we don't even know if they were vaccinated or would like exemptions and we have to tackle that problem as well which is a resource issue for schools and public health i appreciate
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confirming advantage in the case of an identifying exposure sites, crafting community messages. there's a lot going on but it's really scary to imagine how much worse this outbreak would be if not for all of the tireless work of so many officials on the ground. but we all hope that we are able to not just respond to outbreaks but also focus on preventing them in the first place and i wanted to ask you how have initiatives that the public-private partnership vaccination northwest in your department proactive communication with parents have young children helped in building confidence? i'm important to trust this information not just on vaccines but childhood development and if that relationship that we buildt with parents through that
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mailing that is incredibly important when i go out to the public and i see a new parent i will often ask them do you get this little may for the health department and they say we love it it is great information so that is important. the partnership we have is a research initiative to try to best understand how we actually address the vaccine has a tendency. there've been two studies done when looking with healthcare providers on how to best train them around communications with their patients. unfortunately, that work didn't find that it made a difference in terms of addressing the hesitancy or efficacy around feeling confident in those conversations. the other piece is one with parents training them on how to have a conversation with parents and how to share information at pta meetings etc. and that did
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find an increased and reduced hesitancy. >> as the vaccination rates drop levels we need to keep each other safe. your research has been seen and likewise is really critical and we know some parents are making decisions about whether or not to vaccinate before they even have their child. i want to ask you what are the implications of some of these decisions and what have you learned about the factors that we sometimes hesitate to vaccinate? ..
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we have the appreciation of vaccines and severity and more questions than safety. in that context focusing before the baby is born we are working, our group is doing with a new university of colorado. we are in this is an investment
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due to funding of the national institute for allergy and infectious diseases. we will be looking at the use of the best evidence and packaging it and seeing if that has an impact not just maternal but the intervention being performed in pregnancy leading to childhood fox nation rates increase. the initial result are promising but to come back to the idea that we need to continue to invest in the best science for vaccine behavior as we do for vaccine safety and vaccine a the oc. >> thank you, senator murray, senator isaacson. >> thank you all for your testimony. what you're in school are you? >> i'm a senior in high school. >> when did you start doing the investigation and research on vaccinations questioning. >> my mother would vocalize her views of vaccines throughout my entire life.
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it was a progression to start see evidence as i would start to see people, i suppose, try and counterclaim with her. and argue online. i would say she would have this backlash that she was here information. on facebook should share a video of people would say that's incorrect and false. as a child, that intrigued me and i disagree with my mom and looked over years. >> does your mother get most of her information online questioning. >> one either through facebook or through social media platforms like facebook and other. >> were to get most of your information questioning. >> not facebook, cdc, information from organizations like institute of medicine, i try my best to look at accredited sources. >> i would love to be a thanksgiving dinner at your house. [laughter] it would be a heckuva
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discussion. doctor omer thank you for being here and think for the work. he does a phenomenal job and infection is disease and all kinds of things like that. what is on the horizon that would join this group of people that would might want to be immunized for later on questioning. >> there are several exciting developments. one of the big gaps and vaccine has been the fact that there's a gap between the baby is born and when we start vaccinating. that's due to immunological reasons. one of the more exciting developments in this area is the area of maternal immunization re- vaccinate mom, and have the privilege to be in those trials. too not just protect the mother but the baby is also as well. the vaccines are against arrest gustatory sensitive virus. in the idea that vaccine is being developed against group b
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streptococcus so there are several other horizons. the fields expanding. >> do those vaccinations take place in the mother before the baby is delivered? >> yes. >> it would transfer to the baby in the course of gestation. >> exactly, the first had the name of the mother's gift. i think it's an appropriate name for this kind of strategy where maternal antibodies protect the baby. >> i've been to africa were cdc and the number of times and senior work in the field that they do. i don't know of any organization that does more for healthcare in our country that cdc does. how much do you use cdc for resource in your work at emory? >> a lot. cdc is a national treasure. the firefighting function that i talk about that they perform with the local health department is unique. the european cdc is relatively new and has a narrow mandate. people have looked at the effectiveness of national public health agencies in europe have
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clearly come out with the understanding that our cdc is very strong. i'm not trying to put on any other country or agencies because they are trying their best. but the kind of investments have gone into building this cooperative framework of the cdc being the technical public health agency but working closely with the state and local health departments is done really wellin this area. >> i don't think you're putting them down at all. it's a world healthcare center in cdc and were lucky to have in the united states of america. but the world considers it their health center and cdc is doing another job incubating. they are a great resource. i think all of you being here today. don't forget about thanksgiving dinner one day to meet you and your mom. [laughter] >> senator baldwin?
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>> thank you, and 2015 this committee held a similar hearing to discuss the research of vaccine preventable diseases in response to a multi- state measles outbreak. the program has saved lives by preventing and reducing the outbreak of vaccine preventable diseases like measles. which has one of the most effective vaccines. so, i am troubled that we are here again facing another preventable outbreak in several states that have similarly been exacerbated by a surge of misinformation surrounding vaccine safety. i believe we must do a better job to prioritize and cutting edge financing public education surrounding vaccine safety. younger children and those with compromised immune systems have a higher risk of measles
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complications. with the breath of this information and with the media and online about the science behind vaccines, doctor wiseman and doctor omer, what role the state health departments play in arming community leaders like school officials and providers with information and scientific resources on vaccine safety? as a follow on, what can congress do to to improve the public health prevention to not see another brick in the future questioning. >> states and local health department are the leaders and communities around these health strategies to engage their communities around vaccine information.
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they help provide health education, they work with the school systems in the work with healthcare providers to make sure that healthcare providers have information that they need. it really takes a sort of coordinated effort. honestly, that system is crumbling. the sort of resources that are going into prevention in our state, local, tribal and territorial health agencies has been decreasing. we are really not up to the task. for example, i had a call with cdc and number of months ago. we had do this every two weeks. they were on a call talk about hepatitis a outbreak that is occurring throughout the country in many communities. they are encouraging us to do proactive fox nation campaigns with homeless in injection drug users which is where this is being sought. i don't have the resources. i asked my staff what would a plan look like. it would probably cost $5 million. i don't have those resources. i don't have the staff there. that is very, very concerning to
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me. i forgot your second question. >> how can congress help? >> so i answered that right there. including investing in research around how the social research around how it is we communicate with folks about vaccines and have a national campaign. we really need to get on this. >> to add to that, in addition to research investment in high-quality research i think the congress can work on making vaccine counseling reimbursable. that is a specific tool that physicians can use at the frontlines of these conversations happening everyday. take the blueprint that i mentioned that is already there that was developed by the national vaccine advisory committee that has a specific space recommendations to have that implementation. to continue to support cdcs
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outbreaks that shouldn't be taken for granted. last thing, specific to have prior to ties in the such as the example for this country, but everywhere else as well. having a robust vaccine system is not only a tool to retain confidence in the vaccines but it's the right thing to do. these are some of the specific things that congress can do. >> i only have a few seconds left. i will ask a question and maybe if we run out of time you can submit information for the record. i followed of course things that are happening since 2007 a company called lujan in madison,
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wisconsin is working to develop a flu vaccine based on technology that was discovered and invented at the university of wisconsin. as we have heard today, highly effective vaccines have played a critical role in advancing public health throughout the world. i think there is more that we can do to support the development of better vaccines to protect individuals from an illness that results in literally thousands of deaths each year. mr. boyle, can you describe why it's important for congress to continue to support this medical research that advances the development of more effective vaccines for common illnesses like the flu? specifically for vulnerable populations? >> sure, let me try. one of the challenges that i s see, when i think about my colleagues and friends who sometimes struggle with whether to get the flu vaccine.
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it's basic issues of fears of things like needles. they don't want to get a shot, they are scared of that. for that reason i know that things like the flumist and others are attractive. the problem is within our community, a live virus such as that has been used in the past is a problem. we are a bit torn in that we want something to be easy in efficacious, something that will be widely adopted, but at the same time we have to be concerned about those who are undiagnosed. there is a bit of a balance there. further investigation to help understand what new technologies could be made to reduce the burden of getting a vaccine for the flu or anything more communicable would be phenomenal. but at the same time i will have to work with the cdc and others in order to balance out the needs of those who are actually going to be affected by that
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negatively. but we are in it together. the continue conversation in exploration is important in our community and other emmanuel compromised communities will be delighted to be part of this conversation. >> doctor pol. >> thank you. thank you for your testimony. for much of modern history science and freedom have lived in relative harmony. traditionally as medical style discoveries came about, like smallpox and polio vaccines, antiseptics or in about x the results were overwhelming that over time the vast majority of the public accepted these advances voluntarily. in fact, innovations like the smallpox had to overcome initially great public prejudice. doctor boylston learned about the middle eastern technique from his servant, his pastor caught matters.
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his first patient was actually his son. incredibly brave choice. the consensus of the medical community was entirely opposed to that at the time. the lie vaccine was about one in 50 of those would die from the vaccine. yet the death rate from smallpox was about 50%. the government did not mandate the vaccine, but within two generations it was accepted enough that george washington insisted that martha be vaccinated with a small small box vaccine before visiting him. today though persuasion has taken to a whole host of vaccines. including vaccines for nonlethal diseases. sometimes the vaccines mandated as when the government mandated a rotavirus vaccine that would later recall because it was causing intestinal blockage in children. i am not a fan of government coercion. but given the choice i do believe the benefits of most vaccines outweigh the risk.
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but it is wrong to say there is no risks vaccines, even the government admits that sometimes children are injured by vaccine since 1988 over $4 billion has been made out from the vaccine injury compensation program. despite the government admitting to it and paying $4 billion for vaccine injuries no informed consent is used or required when you vaccine your child. this may be the only medical procedure today in the medical world where an informed consent is not required. proponents of mandatory fox nation argue the parents refuse to vaccine their children risk spreading the disease to the community. there doesn't seem to be enough evidence that this is happening and reported as assistant six but it could happen. it's a fear of this is valid, are we just find the next we will be mandating flu vaccines question works between 12050 6,000 vaccines die from affluent america.
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if the current science only allows for educated guessing when it comes to the flu vaccine, each year before the flu back strain is known. scientists put their best gas into the vaccine. some uses completely wrong. we vaccinate for the wrong strand of flu vaccine. but yet five states already mandate flu vaccines. is it really appropriate to mandate a vaccine that more often than not vaccinates for the wrong solution ran. as we contemplate forcing parents to choose this or that vaccine it's important to remember that force is not consistent with the american story. nor is force consistent with the liberties that are your father saw to make it to america. i don't think that you have to have it one or the other. i'm not here to say don't vaccinate nurses, i'm all for the persuasion. i vaccinated myself and my kids. for myself and my children i believe the benefits of vaccin s
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greatly outweigh the risk. but i don't favor giving up on liberty for a false sense of security. thank you. [applause] >> do you yield back? senator warren? >> thank you, mr. chairman. we heard today about how important vaccines are to controlling many diseases. i went to 0 in on one that we are battling right now in massachusetts. since last april 318 outbreak associated cases of acute hepatitis a virus have been reported in the commonwealth of massachusetts. pepe is a contagious virus that causes liver infection and older children and adults that acquire could get fever, nausea and in rare cases the righ death.
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in massachusetts for people hovered he died since the outbreak began. we did not used to have a hepatitis a vaccine at all. but in 1995 in 1996 the food and drug administration approved to hepatitis a vaccines and soon after cdc recommended the fox nation for certain populations including routine vaccinations of children living in areas with elevated rates of the virus. doctor, you study infectious diseases, what impact of the hepatitis a vaccine have on the national race of the virus christmas. >> thank you very much senator warren. hepatitis a can be very serious feared disease. in particular high risk groups. the vaccine came out in the 1990s is a very safe and very effective vaccine. we see the tremendous decrease in the rate of the disease. we see more than a 50 fold decrease nationally.
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eliminating a lot of the disease in children and foodborne outbreaks. but there's still a lot of public health work to do. which is illustrated by the outbreak. >> that is a question that i want to ask. we developed the vaccines, rates are way down, we now have a vaccine preventable, virus here. why are we seeing so many hepatitis a cases emerging are questioning. >> we are seeing the vaccine administered in childhood, it's only been around for about 20 years severe 21 years or older you probably haven't had it. it is recommended that high-risk groups, recreational drug users, part of the clubroom in massachusetts, be vaccinated. but we haven't got to all the scripture. efforts to find the high-risk individuals which are well-defined and to get them to vaccine would help prevent these outbreaks in the future. >> this is the part, we've been battling the opioid crisis for years. hepatitis a is just another
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place we need to fight on this. but we are learning from this. just the past october, the cdc committee since recommendations in the 1990s helped the rates of the virus declined sharply, added persons experiencing homelessness to the list of those recommended to get hyper titus a vaccine. i see that you all are nodding. in massachusetts the public health workers, the community health centers in the jails have sprung into action to try to get the vaccine to those who are most at risk. doctor wiseman. as secretary of the washington state department, you oversee the public health response. what can we be doing to ensure that local public health officials have the resources that they need to be able to do the work question for. >> thank you. really, part of this is making sure that the prevention of public health funds is funded and that we look at the funding
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for the cdc. we have been asking the state territorial health officials and public health for increasing the cdc budget 22% by fiscal year 22. >> okay so we're talking money now. whether it's a situation like hepatitis a outbreak in massachusetts or the measles outbreak in washington state, how do the presented cost of a vaccine program compare to the containment and treatment cost of an outbreak? >> in general, we know that every dollar spent on vaccines you save about ten. it's definitely a cost-effective intervention. >> the more we do on the front and to ensure that everyone gets access to the vaccines, the less we will see individuals contracting hepatitis a, measles, whooping cough, all of the other vaccine preventable diseases. this administration has
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repeatedly sought to cut the prevention and health fund. which supports immunization programs and they continued their efforts to weaken the medicaid program which covers all the recommended vaccines for children and for many adults as well. i am glad that most of my colleagues are on the same page about the importance of vaccines. let's make sure we are also on the same page about the importance of public health funding. some people get access to those vaccines. thank you. >> senator robert. >> thank you, mr. chairman. i'm in a go a little cross current, here. i want to state that the importance of vaccines in infants and young people cannot be overstated. i understand that. i want to talk about the seniors who are also at increased risk
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of experiencing serious and life-threatening effects of vaccines. we have quite a few gin aryans in the senate that get vaccinated. more especially with flu. doctor boyle, you touched on this with a reference to this topic on the effect of a herd immunity syndrome which i appreciate particular settings in which adults and seniors are more sips of circle if they are not vaccinated. i have to figure out if we can look for ways for federal programs can help by removing barriers to services like vaccines. in providing the right incentives for people to use them. what procedural theories insist to get seniors to proper
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education. many give you a personal illustration. a young lady, and her 80s, she was young. [laughter] she made sure that all six of her children got flu shots. and in turn, although their grandchildren and that was a bunch of folks. and then yet she got the flu in kansas this time around. bad. just a very bad flu season. for some reason, she didn't get a flu shot. so here she is, a mother who has told her kids get vaccinated. and they share half. and then in her own situation she didn't get the flu shot. along with her husband. we lost both.
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the sniffles became the flu, the flu became serious, and we get into ammonia and all sorts of other problems. i'm not going to go into what kind of treatment they receive. but they were very important folks and pillars of the community. they were still very active. i sometimes think that the octogenarian characters, while in the senate we are known as potted plants. doctor omer you written about vaccine confidence and i'm interested how this applies to adults in recent years posting outbreaks of vaccine preventable diseases under their important factor cdc also noted a drop in immunization rate from hospitalization deaths in the last flu season. i don't get it. i don't understand why in a period of your life you would be
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saying i need a flu shot and then respond to why you didn't do it. when he does get around to do it. i don't know if any of you would like to offer any opinions or talk about young people all the time but there are people who still contribute to the society even though there is no bar graph after 80. anybody want to, questioning. >> thank you, senator. the story that you narrated is not unique unfortunately in this country. and throughout the world. it's one of the highest chris groups for complications o after influenza. the vaccines are slightly less effective in elderly but that's the reason we need more of them to be vaccinated. this is one of the gaps that i was talking about. we don't have evidence for several groups. including the elderly. this is not a group that is actively opposed to vaccines. they have the concept of vaccines. and they have seen what diseases
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can do. but at that time and a lot of the discussion has revolved around childhood vaccines. we need evidence-based strategies to communicate not just to the elderly but also to the health systems. the providers who deal with the elderly don't have the muscle memory to talk about vaccines and to make it part of the routine clinical practices. there is a lot to be done and thank you for highlighting that issue. >> mr. chairman my time has expired. i want you to know that we did not plan this. before the committee hearing. but he hit the nail on the head. i think it's an issue that we overlook. thank you. >> thank you. senator kaine. >> vicki mr. chairman and take it to the witnesses it's been a fascinating topic. timely, i noticed yet another
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study is coming out in the last 24 hours. a study dealing with a very significant longitude and studies children in denmark that demonstrates no link between the mmr vaccine and autism. it's a timely data to have this hearing. i want to ask the question about fox nation shortages. it's a former governor that worries a lot. the problems in the supply chain that could lead to shortages of medications. in 2017 outbreaks of hepatitis a increased demand and constraints to that vaccine. many constituents have contacted my office about their inability to access the shingles vaccine. last year i joined a bipartisan group with members of this committee, urging commissioners
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to put together a task force on the shortage of drug vaccines. i look forward to read that report and it's on the verge of being published. the committee has completed the work and is close to publication and might be worthy of consideration when it's done. what more can we do, all directed to doctor omer and doctor recent weidman. >> all-star downturn it's my calling. one thing that we need to invest in vaccine research is figuring out new technology for producing vaccines. we use a technology and it's a long labor is process and we have to move towards new technologies around cell -based or content vaccines so that we can produce a more quickly and ensure the safety. it is a problem with the vaccine shortage. >> one of my mentors has said a few times that it's not a
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vaccine in a vial is 100% safe and 0% effective. developing a vaccine is not sufficient. we need to have a stable supply of vaccines. that requires, a federa federald thinking in response from regulation to working with our research entities to say there is a robust pipeline of new vaccines. there are multiple approaches. bodies through multiple mechanisms in it creates an intellectual marketplace of ideas. there's more than one strategy that we are focusing on at the science level, we have more likelihood on heavy products that compete with each other and give us more option in the country. working with manufacturers, ensuring that we understand that there's a stable in a factory
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pipeline. the third thing, sometimes in certain dynamics one policy intervention is florida. which interventions and flu vaccines that would be required in an epidemic. they're not interested to ensure a stable pipeline and so interventions and investments whether such are more direct, straddled that divide. it will require an nationwide national response, not just a federal response for the united states and other parties as well. >> thank you for that. i have another question. >> very quickly. three quick issues, having a
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federal by that gives them some surety will make them produce more which will help the vaccine shortages. the second, we have a problem not so much for shortage but with distribution. a logistics effort and we can do better with that with the local level being able to make sure every physician practice or hospital has on. in the third is to reinforce the importance of national stockpile which keeps his vaccines in reserve where we might need th them. >> in my last half minute, i want to compliment you and in jefferson in virginia one of the things he said that so powerful is progress in government and all else that depends on the broadest possible diffusion of knowledge to the general population. he believes that the diffusion of knowledge and giving people knowledge will enable them to victory decisions. fake knowledge, misinformation, intentionally misleading information can also be disseminated. in the social media age with the internet, competition between the true and the valid and the fake and the dangerous, even the
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manipulated by people who want to do is heart is very difficult. but i think it's interesting that your mother and you have reached your conclusions because you had internet and tools to do your research. so the difference between your mother and you that you're using the same tools for reaching different conclusions. but your critical thinking skills and willingness to share your story. >> went over time. but, on that, part of the issue is being able to inform people about how to find good information. with my mother, it wasn't that she didn't have the information but she was disbelieving. and the best part of the attack, the cdc was made out to be a fraudulent group pushing back out of his vaccines for its own reason. i wanted to comment on that. >> my turn question let me give
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some color to what senator paul said. you may or may not know my position and i know there are people who have not been vaccinated that require liver transplantation because they end up with terrible diseases. whatever reason they just didn't understand fox nation was important. it's important to point out that even if flu shots are not completely effective they do mitigate. so there is a cross benefit that will decrease the severity. number one, hospitals commonly require employees to be immunized. because they understand that immunity is important and if a nurses aide does not immunize she could be a typhoid mary bringing disease to the uncompromised. the federal government requiring, there is a statue requiring the vaccine information statement that should be given is a federal requirement. in the name of liberty we should therefore reply upon states and
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local teas to make further requirement. that is important to know not to be misled regarding that. secondly, the next thing we should point out and read terms of requirements, the requirement is that you cannot enter school unless you vaccinated. if you are such a believer in liberty that you do not wish to be vaccinated, there should be a consequence and that is that you cannot infect other people. mr. boyle, if your child is born with the name mean you know deficiency and someone comes to your school who is not vaccinated and the lack of her immunity means that your child who no-fault of their own, cannot be immune is a victimless crime that somebody doesn't get vaccinated in your child's eyes? my gosh, you're the guy who is representing those people and whatever the reason doesn't work but they're susceptible. remember a particular tragic
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case in washington, d.c. about two years ago. and when under chemotherapy for cancer, and someone brought needles to the school and i think i remember that child died. remember that correctly? >> yes it died a number of years later from a follow-up. >> so the parent has had the child vaccinated, but now she's on cancer chemotherapy and she's immunocompromised and she's in school thinking that she can be a normal child even though she's not cancer chemotherapy. but because somebody else made a decision not to vaccinate their child her child dies. if you believe in liberty, that's fine. don't get immunize. but i don't think that you need to expose others to disease. >> you are in a state with a practice with people from three different states. hats off to mississippi. they always have a high
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humanizatioimmunization rate. >> mississippi does not allow any nonmedical exemptions and they have nearly a one 100% rate of immunizations at school entry that they pay a lot of attention to it. in the middle they allow religious exemptions and in tennessee we have about a 97% fox nation rate in kenner garden in entry. but we have seen the rate of nonmedical exemptions under the religious exemption triple in the last ten years. you can predict where that's going. arkansas allows both religious and it's around 93 to 94% below the community immunity. reporter: nonetheless presented themselves customer. >> all of these are rare and we see things from all states.
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tennessee we get about one a year measles case. always imported from the outside of the united states. >> we have immunity that was to protect and bringing in others disease. the problem seen in california, oregon and washington there pockets were slow and it could happen in tennessee next week. even though were 97%, there are plenty of communities below that level we may be operating in the community. >> we have a bunch of docs and people, i can't help but notice that your beer is not as heavy as other people's. >> said this is not a total, you don't have to be an md or phd, her masters of health to understand these issues. you just need to bring a critical factory to it and understand it is not just the individual who is affected. but it's the individual that they went to school with. >> i spoke to my family physician and she encouraged me to it get back. even a school of was told i was
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a babe going to be able to attend. that also pushed me to it look further into my vaccines. because i saw the present being imposed. >> i'm out of time. and i will defer to myself. [laughter] but i thank you very much. and thank you for carrying the people you went to school with as much as you care for yourself. >> i yield my time. >> thank you. for having this hearing. thank you all for being here. i have the great fortune of having a grandfather who is a pediatrician and he practice medicine from 1921 to 1985. my childhood was filled of his accounts of the changes that he saw on the medical landscape over the course of his career. i still remember him describing what it was like to see somebody suffer from lockjaw. which is tetanus. the jaw locks, the swallowing
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stopped, the breathing stopped, the muscle spasms. and talking about what a difference it made when the tetanus vaccine became available. i remember my mother who had three children, youngest born in 1960, remarking during my childhood that now there was a vaccine against rubella, german measles. pregnant women didn't have to worry nearly as much about going out of the house during pregnancy. accidentally contracting german measles that could be so damaging to the fetus. i think it's incumbent on all of us to remember the stories because to a number of you have made the point that without this experience of what these diseases actually do and mean we have gotten less vigilant of a society about the importance of this. the importance of vaccinations,
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i want to follow up with you, you talk about the importance and work you're doing to help pregnant women get vaccinated. no the in the united states is almost all vaccines are managed dirt to fit infants with the tran12. so for the first two months of their lives they rely on the antibodies of their mothers. the antibodies moms during pregnancy. we know that vaccines are currently available are critical for pregnant women and their babies. in these populations create a greater risk including premature birth delivery, hospitalization or in severe cases death. but astonishingly, only about half of women receive the flu vaccine during pregnancy. with infant mortality rates reaching startling numbers in the united states in recent years it is critical that we
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take basic steps to help women and babies during childbirth. what do you think is a leading cause to the low number of vaccinated pregnant women. and what we do moving forward to help improve these numbers and keep mothers and babies saved. >> there are several causes. there are only few women who are our wrote to vaccines. there is a huge gap, which is the fence a group. that's an opportunity to persuade and educate, and have the meaningful conversations. in terms of how to intervene, we propose a model and it's a practice provider and patients. we choose it for pregnant women because pregnancy is not an apology, to physiological state to be in. in evaluating strategies. to this strategy, for example, standing borders. which use behavioral practice
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into vaccinated. working on the supply side. working on physician communication and some persuading them. in the particular reasons there is focus on the baby. this is one of the other universal things that mothers are both motivated to prove check the baby and scared to harm the baby. as we generate safety evidence we need to find better ways and evidence based that is diluted to the community as well. >> thank you. with my limited time i will also ask doctor mccullers as a practitioner i am curious about how you go about communicating with parents who are having fox nation hesitancy.
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among parents who choose not to vaccinate their children, what the most common reason? in moving forward what can we do to help ensure the parents are educated about vaccinations. >> ten years ago there was one common reason of autism in right now there's a whole bunch of reasons. in minor concerns that come up. but the most important thing for pediatrician or a family practitioner or nobody is just to listen. understanding respect what the concerns are. they are different for every person. and really individualized the approach of education you'll get. there are a lot of concerns that are floating around. the have an individual message. >> absolutely. directed at the particular concern. thank you very much. >> senator smith. >> vicki mr. chair and thinking
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member murray thank you all for being here appreciated. in 2017 my home state of minnesota experienced the largest measles outbreak that we have seen since 1990. between march and august of that year we had 75 cases of measles and 21 related hospitalizations which are state department of health is a model for great department of health the stepped in and did a remarkable job working with children's hospitals in a whole range of other partners. i know you've been dealing with us in washington and some of my colleagues have gone the specifics. but can you just tell us and summarized how does the federal government the a good partner in the state department and how they dealing without prescription. >> personal, the centers for disease control is amazing.
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they have lined up the technical experts around measles and actually sent people out to our state based on a request. so that is incredibly important. i think again, we need to be looking at how is it that we get to the cdc director in my state last week. how do we get to the hearts and minds of people around vaccine and to not put science on the shelf. we need to have this national conversation and national campaign that is based on evidence and that we developed the evidence to help us communicate. it is a response effort and happened at the local level. we need to remember that. which means we have to fund our local health department, adequately so they have the staff resources to be able to respond actually to prevent these. work with communities in advance, these pockets of communities that have the unvaccinated.
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>> biscuits to another question related. in minnesota when we saw the measles outbreak we saw some communities that were disproportionately affected. in order to communicate and hear well the concerns and the issues of these communities it was important to have culturally competent specific kinds of outreach. can you talk a little bit about what you have seen in the models in the area questioning. >> the good models are having folks on your staff that are culturally diverse. knowing these communities inside and out as being really important. we have to have employees who reflect the face of the community. that is a challenge for a lot of us. we are not there. i think it is because community development outreach work, building the relationship with informal leaders, communities, about church leaders, elders, tribal communities or whatever. those trusted folks there that people listen to and engage them in health promotion work. >> thank you. >> anybody else want to comment.
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and how we have cultural connection outreach in the area questioning. >> if i may add, a specific example was standing out for many of us in the community. there were several visits by folks who are not enthusiastic about that. so the response is also an example of how to engage communities. and how to not just the health department but other apartments get together and work to the community itself and to bring up the recent fox nation. they have the tools in one of the evidence-based that you live to have it is these -based approach. you don't just talk about the vaccine but you talk about the disease itself. that is what it's all about. >> i would also add that when we were talking about a diverse group addressing specific communities, i would dress on a
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bias level that for young people especially moving into adulthood on a medical level. it should be important. because once you come of age at least for me, most of my friends need to understand they can get vaccinated despite the parents wishes. once you move on to your own and start a career, that pushed to explain to young people is especially important. >> vicki. >> to add onto that, as were talking about the cultural issues here. one of the things that i found that what the cdc and others have provided. one of the other pieces of the communication that are missing are the stories. something that connects a person and not persuaded by fax to the knees. if someone is tia or auntie is receiving chemotherapy and is compromiseimmunocompromised. trietire back to the personal in
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their community. as much as we talk with these campaigns in these next steps, that's another layer to adding to everything else that needs to happen. >> thank you. >> senator casey. >> thank you, mr. chairman. i want to thank you and doctor cassidy and ranking member murray for presiding over this hearing it is an important set of issues. i want to start with mr. landenberger. i would like to be able to think or believe that when i was in my first year of high school i would like to be able to believe at that age i could do what you've done today. the answer is probably no. there may be some answers of the committee that could but i'm not one of them. second i want to say how difficult this would be no matter what age or what station in life because it's a difficult topic and you also have personal stories to tell which is difficult in private. let alone in a private setting. you've done something that we
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don't have to do. people are pretty good at immunizing dividing. and we are really categorical. for someone disagrees not that always bad. you have been able to be very clear about where you stand and what you believe. and bear witness to the truth without being categorical and demonizing. that is not only helpful for this topic by instructive the rest of us here. in both parties and both house . >> i wanted to ask you, if you could share additional ideas about the you develop over because what the experience you had. and how it effectively reach out to parents and concerns so that they are confident in the advice of the doctors and don't hesitate to have their children immunized.
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>> thank you for that question actually. there's an important distinction to make between the information provided. as we discussed earlier, where people don't resignation well the data numbers and they have better stories. you see with a lot of the interfax communities large portion of the foundation that they billed to community with parents is on a very energetic level. sharing stories and experiences. that speaks volumes because the lease for my family, my mom could reaffirm because she knows people and she sees stories. the correlation is we don't a lot of factors involved. even though i can say that, i've seen that portion of what we have missed and to address your question, the story of people suffering, the stories of minimal diseases ravaging countries and nations is extremely important in the side effect of complications of these diseases impose. measles is a misinformed belief that it's not dangerous.
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but measles is one of the biggest killers and infants because the dangers imposes to young children. he see the upper 80% in certain statistics or children five and under. when you convince parents the information is incorrect and that their risk that is a much more substantial way to cause people to change her mind. >> that is helpful. and i appreciate your testimony. we are a little low on time and i'll ask one more. i want to get to the issue of prevention which repeat over and over again. we know that vaccines provide the best type of prevention not only for the individual but for the population and by way of immunotherapy that we first talked to today. my question for you can you describe based upon your own experience in own work and research but both in terms of
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your search and research in patient here. what are some of the symptoms and outcomes of typical vaccine preventable diseases for children and adults. >> there is a wide spectrum depending on what disease you're talking about. obviously these are diseases that cause severe diseases and death or they would not of been targeted 50 years ago. i think one of the things as physicians and as providers that we don't realize how bad it was. i trained at a time where meningitis was discouraging everybody got chickenpox. i seen three or four kids denies almost comatose and with brain damage and some dying. that vexing came in when i was in my pediatric residency and the disease disappeared overnight. trainees don't see that and to understand just about these diseases are.
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because they've never experienced. >> because of advancements. >> education and the ability to spread that message. >> more questions for the panel and i want to thank everyone for being here. >> i think everyone for participating. the hearing record will remain open for ten days. they may submit additional information if they would like. take you for being here the kid amenity is adjourned. [inaudible]
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[inaudible] 50 tonight on book tv at 8:
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eastern, a discussion of "unmasking the administrative state." >> no one understood at that accepting the legitimacy of the administrative state you had abandoned the necessity of establishing the separation of powers as a viable way of working our national government. tonight at 11:00 eastern, the 20th annual frederick douglass book prize. are eric's winners armstrong dunbar -- erica armstrong dunbar. and doug jones recounts his prosecution of two former kkk members who were involved in the 1963 birmingham church bombin

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