Colorado governor signs executive order aimed at boosting statewide immunization rates

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Posted at 12:20 PM, Jun 13, 2019
and last updated 2019-06-13 23:20:27-04

DENVER – Colorado Gov. Jared Polis signed an executive order Thursday that aims to boost the state’s immunization rates, which are among the worst in the country for children.

Polis unveiled the executive order at Children’s Hospital Colorado alongside hospital and vaccination proponents and Rep. Kyle Mullica, D-Northglenn, and Sen. Kevin Priola, R-Henderson, who were two of the prime sponsors of HB19-1312, a bill that aimed to improve vaccination rates in Colorado that failed to pass the Senate before the end of the legislative session.

The executive order aims to give Coloradans a “third way,” as Polis put it at a news conference announcing the order, to increase vaccination rates aside from the government forcing people to get shots or simply allowing the rates to continue to fall.

For the last school year, the kindergarten MMR coverage rate was 87.4%, which is below the community immunity threshold of 92-94% to protect against measles. The coverage rate was also down 1.3% over the prior school year. Of the 12.6% of kindergartners who were not vaccinated with the MMR vaccine, only 4.5% claimed an exemption.

And a report from Children’s Hospital Colorado released in February showed that 9,424 children between 0 and 19 years of age were either hospitalized or admitted to emergency departments in Colorado in 2017 for treatment of vaccine-preventable diseases – costing a total of $55.5 million.

All but 278 of those visits were for influenza, however, and the flu accounted for $42.7 million of the total costs that year.

But Polis pointed out that vaccination rates have fallen among kindergarteners for every disease for which most are vaccinated except for the DTaP vaccine. And a nationwide measles outbreak continues to grow after the disease was thought to be eradicated in the early 2000s.

The order directs the Colorado Department of Public Health and Environment to take immediate action on a host of measures related to vaccination education and action.

It directs the CDPHE to study the root causes of low immunization rates in various parts of the state, find new strategies to improve the rates and to educate people on vaccines. It also aims to streamline the form process to make it easier on parents and to better educate parents who are hesitant to vaccinate their children.

Part of that, Polis and the other proponents said, will be studying why parents are hesitant to vaccinate their children in the first place and to develop specific plans for specific areas of the state, as there are different barriers to immunizations for people in different parts of Colorado, they said.

They will also study the impact of local immunization drives, school clinics and mobile services on local vaccination rates and increase education on yearly rates and options for emancipated teenagers over age 15.

The CDPHE will also be tasked with developing and implementing a public health education program to help clinics increase their vaccination efforts through the “use of evidence-based, well-established, and successful strategies.”

The order also directs the Colorado Department of Health Care Policy and Financing to put together a policy that will provide incentives to Medicaid Primary Care Medical Providers to provide increase vaccine access to underserved areas through the Vaccines for Children Program and study, along with CDPHE, a two-generation approach for vaccinating those using Medicaid.

The department will have to deliver progress reports to the governor starting on June 18, 2020 and every six months that follow, the order stipulates.

Polis and other proponents said that increasing the state’s vaccination rate would also go hand-in-hand with his administration’s goal of saving people money on health care, for which he has established an office.

“Let me be clear – vaccines are one of the most important developments in public health, Polis said, telling a story about a former congressional colleague whom he believes will be among the last afflicted with polio.

Mullica and Priola, who saw their bill near final passage but fail to do so when time ran out on this year’s session, praised the executive order but called it a first step in the process. Both said they would continue to work on a legislative fix next year.

Priola said he viewed the order as “a chapter in the story of protecting public health” but admitted it was “not the final chapter, but a commitment to continuing to educate and streamline processes.”

Mullica, an emergency room nurse, said that the falling vaccination rates had been called a “puddle of gasoline waiting for a match to be thrown on it.”

“This is a step in the right direction,” he said of the order. “It’s a step in the direction that we want to continue to create a safe community.”

Polis had some objections to House Bill 1312 during the session – pushing back on a requirement that exemption forms be filed in person.

And while he said that he gives his children their immunizations, he acknowledged that some groups, like Christian Scientists, object to general medical science.

“Nobody should be forced to do anything with their bodies,” he said. “I’m pro-choice.”

He added that he cherished the freedom of religion enjoyed by Americans as well but encouraged people to look to science for the best information – something CDPHE Disease Control and Environmental Epidemiology Division Director Tony Cappello, Ph.D. echoed.

“We also know that one of the barriers that we’re seeing is misinformation. That’s not just an issue in Colorado, but it’s an issue across the United States. We need to provide fact-based information to parents so they can make educate, informed decisions,” Cappello said. “This means dispelling misinformation about vaccinations and having correct information at the hands of parents so they can have it readily available when they need it and right away so they can make those informed decisions. This executive order addresses such barriers.”