Reduced funding, increased vaccine prices prompt DSHS program changes

posted 01.05.12

Effective Jan. 1, the Department of State Health Services will implement changes to its two vaccine programs—Texas Vaccines for Children and the Adult Safety Net Program—to continue providing vaccine services to children and adults in greatest need while facing reduced funding on the state and federal level.

These programs are credited with providing public health leadership and resources resulting in significant improvements in vaccine coverage levels and decreased incidence of vaccine-preventable diseases across Texas.

Several factors play a part in this decision: decreased federal funding for vaccine purchases, reductions in immunization strategy general revenue funds, increased federal scrutiny and accountability for publicly-funded vaccines, and increases in prices for some vaccines.

DSHS released the following information in a bulletin that details the changes.

TVFC Program

• Children who have private insurance that covers vaccines will no longer be eligible for low-cost vaccines in public health department clinics, but instead will be referred to their medical home for immunization services. In some cases, local health departments may be the medical home that provides comprehensive health care services. In these cases, private insurance is accepted in those public health settings.
• Underinsured children will continue to receive immunizations from their medical home, federally-qualified health center, or rural health center. Additionally, in early 2012, DSHS will pursue delegation agreements with FQHCs and RHCs that should result in public health clinics also being able to serve underinsured children.
• DSHS will adopt the federal eligibility criteria for defining “underinsured” children. The federal criteria include children whose private insurance does not cover one or more vaccines or whose insurance caps vaccine coverage at a certain amount (once that amount has been reached, the child is considered underinsured).
• Individuals who begin a vaccine series while age 18 or younger (and TVFC-eligible), may finish that series at public health clinics that are ASN providers, provided the series is completed prior to their 20th birthday.

ASN Program

Effective January 1, 2012, the vaccines available through the adult program (for uninsured individuals who are 19 years of age or older) will be limited based on available funding. Initially the following list of vaccines will continue to be available, but as funds are identified, this list could change:

• Hepatitis B vaccine
• Measles/Mumps/Rubella vaccine
• Tetanus/Diphtheria/Pertussis vaccine
• Tetanus/Diphtheria vaccine

In addition, DSHS will provide other vaccines on a more limited basis in the clinics that are operated by DSHS in counties where there is no local health department. These vaccines include:

• Pneumococcal vaccine
• Influenza vaccine

Other vaccines and biological products will be available for adults based on recommended use in disease outbreak and emergency situations. These products include rabies vaccine, hepatitis A vaccine, varicella vaccine, and immune globulins. DSHS will work to ensure these products are available when needed to protect against diseases such as rabies, hepatitis A, measles, mumps, or hepatitis B.

Also, DSHS has announced a temporary policy to make meningococcal vaccine available through Jan. 31, 2012, to help support the new law requiring certain first-time college students to provide proof of meningococcal vaccination. DSHS is distributing this vaccine to public health clinics in limited amounts as resources allow. Since these supplies are limited, university staff and other community agencies should continue to refer students to their medicals homes, leaving the public health clinics as providers of last resort.

For questions about these policy changes or for other information regarding immunizations and vaccine preventable diseases, contact the DSHS Immunization Branch at (800) 252-9152.