March 3, 2017

The Honorable Tom Cole Chairman House Labor, Health and Human Services, Education and Related Agencies Subcommittee
2358B Rayburn Office Building Washington, DC 20515

The Honorable Rosa DeLauro Ranking Member House Labor, Health and Human Services, Education and Related Agencies Subcommittee
1016 Longworth House Office Building Washington, DC 20515

Dear Chairman Cole and Ranking Member DeLauro,

As members of the Adult Vaccine Access Coalition (AVAC), we urge you to prioritize funding for immunization-related activities at the Department of Health and Human Services as you prepare the fiscal year (FY) 2018 Labor, Health and Human Services, and Education Appropriations bill.

AVAC includes more than fifty organizational leaders in health and public health who are committed to overcoming the barriers to adult immunization and to raising awareness of and engaging in advocacy on the importance of adult immunization. Our mission is informed by a growing body of scientific and empirical evidence that shows that immunization improves health, protects lives against a variety of debilitating and potentially deadly conditions, and saves costs to the healthcare system and to society. Immunization has demonstrated “effective prevention” in reducing rates of morbidity and mortality from a growing number of preventable conditions and has been proven to improve overall health in a cost-efficient manner. A top priority for AVAC is to achieve increased adult immunization rates through improving education and awareness of recommended vaccines and addressing challenges to access.

Immunizations are a highly cost-effective form of preventive medicine that help save lives by protecting the health and wellbeing of individuals and families in communities nationwide. Since their inception, vaccines have eradicated smallpox and polio in the US and have dramatically reduced the spread of many more crippling and
potentially life-threatening diseases such as diphtheria, tetanus, measles, mumps, and rubella. Vaccines also prevent the spread of common infectious and potentially fatal diseases such as chickenpox, influenza, hepatitis A, hepatitis B, meningococcal disease, pneumococcal disease, and whooping cough (pertussis). Vaccines not only help protect the immunized person but they can also help protect those around them who may not be able to be immunized because they are too young to be vaccinated themselves or suffer from a health condition that prevents them from being immunized. Maintaining herd immunity is essential to protecting and preserving the health and wellbeing of individuals and entire communities from vaccine preventable conditions.

Despite the demonstrated benefits of vaccination, every year, more than 50,000 adults die from vaccine-preventable diseases while adult coverage lag behind Healthy People 2020 targets for most commonly recommended vaccines (influenza, pneumococcal, tetanus, hepatitis B, herpes zoster, HPV). Millions more adults suffer from vaccine-preventable diseases, causing them to miss work and leaving some them unable to care for those who depend on them. Gaps in vaccine coverage leave our nation vulnerable to the resurgence of devastating disease outbreaks and also susceptible to emerging threats such as Ebola or Zika– for which the development of new vaccines is underway. Now more than ever, we must recognize the vital role of immunizations in helping to prevent, and mitigate disease outbreaks, and fully fund immunization programs.

As you consider the benefits of protecting adults against vaccine-preventable disease, the challenges and barriers currently impeding adult immunization, and the need to catalyze action to strengthen the vaccine infrastructure and delivery systems across the country, we urge you to prioritize the following immunization-related programs as part of your FY2018 appropriations request:

 CDC Section 317 Immunization Program. We ask that Congress provide $650 million for the national immunization program, also known as the 317 program, at the Centers for Disease Control and Prevention (CDC) again in FY2018. A robust immunization infrastructure is critical at the local, state and federal level to support and protect the population against common vaccine-preventable conditions, purchase vaccines for those in need, and provide rapid response to disease outbreaks or public health emergencies. These funds are essential to supporting core activities in the nation’s existing immunization system, and act as the backbone of our nation’s public health infrastructure by providing money to state and territorial immunization programs to distribute directly to local health departments. This national, state and local network provides a safety net to uninsured and underinsured adults, monitors the safety of vaccines, educates providers and performs community outreach, and conducts surveillance, laboratory testing, and epidemiology to respond to disease outbreaks. 317 program investments in Immunization Information Systems (IIS) also improve data exchange security standards and enhance interfacing with electronic health records (EHRs). IIS’ help to inform providers and support clinical decision-making in terms of a patient’s immunization status as well as help to identify recommended vaccines the patient may not have received. At the population level, an IIS can also provide data to guide public health strategies to improve vaccination rates and reduce vaccine-preventable diseases.

 National Vaccine Program Office. We urge Congress to provide $6.4 million in funding for the National Vaccine Program Office (NVPO) at HHS. These dollars, consistent with FY2016, will help ensure robust implementation of the National Adult Immunization Plan (NAIP). This comprehensive plan lays out overarching goals along with a series of tangible objectives aimed at raising adult immunization rates in line with Healthy People 2020 targets. The NAIP also contains specific milestones intended to monitor progress on improving adult immunization.

The future for adult immunization is bright but adequate funding will be essential to achieving success in addressing the current barriers and challenges to improved access and higher coverage rates for this population. We appreciate your consideration of funding for immunization programs at CDC and the NVPO. We look forward to working with your office as the FY2018 appropriations process moves forward. For further information, please contact the AVAC managers at 202-540-1070 or

Alliance for Aging Research
American College of Preventive Medicine
American Immunization Registry Association (AIRA)
Asian & Pacific Islander American Health Forum (APIAHF)
Association of Immunization Managers (AIM)
Association of Occupational Health Nurses (AAOHN)
Biotechnology Innovation Organization (BIO)
Gerontological Society of America
Hep B United
Hepatitis B Foundation
Immunization Action Coalition (IAC)
March of Dimes
National Association of City and County Health Officials (NACCHO)
National Foundation for Infectious Diseases (NFID)
National Hispanic Medical Association
Trust for America’s Health (TFAH)