Gov. Jared Polis signs executive order on vaccinations

Gov. Jared Polis signs an executive order on vaccinations at Children's Hospital in Denver.

Gov. Jared Polis issued an executive order Thursday intended to tackle Colorado's subpar vaccination rates for kindergarten students and other children.

The announcement came the same day that the Colorado Department of Public Health and Environment (CDPHE) announced vaccination rates for kindergartners had taken another hit.

In some parts of the state, rates are "dangerously low," below 20% in some places, the agency announced Thursday.

Colorado is going in the "wrong direction" on immunizations, Polis said at a Thursday press conference at Children's Hospital in Denver, where he made the announcement.

Despite his issuance of an executive order, Polis calls himself "pro choice" on the issue of vaccines and said he supports Colorado families' rights to make their own healthcare decisions without a "heavy-handed mandate" from the state. 

While immunization rates for K-12 students are over 94% for four of the five required vaccinations, that's not the case for kindergartners.

CDPHE data shows rates for the measles-mumps-rubella (MMR) vaccine had dropped in the last year from 88.7% to 87.4%. Colorado ranks 50th in the nation for MMR vaccination rates for kindergartners.

Vaccination rates also dropped for Hepatitis B, polio and chickenpox. Only the rate for the DTaP (diphtheria, tetanus and whooping cough) vaccinations increased.

The executive order is a different way to approach the vaccination issue, he said.

"This approach will respect" Coloradan's wishes while still raising vaccination rates, he added.

It includes nine directives to the CDPHE and the Colorado Department of Healthcare Policy and Financing (HCPF). Among them:

  • work with communities with low immunization rates "to determine root causes, identify local strategies and provide educational information" on vaccines.
  • "study the views of parents and develop and implement a public education and outreach campaign to address vaccine hesitancy and access issues, subject to available funds." (The governor noted that the executive order does not include funding and that the steps contained within it will be covered by each department's existing resources.)
  • incentivize doctors, primarily Medicaid providers, that will "influence clinical practices" and help implement best practices. That includes participation in the state's Vaccines for Children program that pushes for improved vaccine access in under-served areas.
  • study the potential for "local immunization drivers," including school- or community center-based vaccination and/or mobile immunization clinics. 
  • propose to the State Board of Health that it should consider "better alignment" between Colorado's immunizations practices with national best practices recommended by the Advisory Committee on Immunization Practices.

Polis pointed out that the state needs a "more consistent exemption" policy. That includes a standardized form. 

The state has an exemption process and standard forms for medical exemptions, but not one for non-medical exemptions, according to Tony Cappello, the division director for disease control and environmental epidemiology at CDPHE.

A standardized form will help schools, Cappello explained, because right now schools have to decipher between the state's official form and whatever parents want to submit for non-medical exemptions.

"This will help with data collection and research so we can better identify some of the items" tied to the executive order, he said.

If that sounds familiar, it should. House Bill 1312, one of the most contentious bills of the 2019 session that ultimately died during the last week, also sought a more uniform process for non-medical exemptions.

The bill's sponsors, Democratic Rep. Kyle Mullica of Thornton and Republican Sen. Kevin Priola of Henderson, were both on hand to cheer the signing of the executive order. However, it doesn't preclude lawmakers' continued efforts on this issue, both said.

Mullica said that the executive order is a good first step but not a permanent solution, and that the legislature can continue to explore and come up with solutions.

"These are all preventable, harmful diseases," he said. "If someone came in here with measles and coughed, those germs would stay in the air for three hours."

"I view the executive order as a chapter in the story of protecting public health," Priola said.

The legislature will continue to collaborate on fixes, but the order will also give certainty and help start to dig the state out of its last place among vaccination rates, he added.

Cappello pointed out that the state must take action to increase those rates. Vaccinations are one of the top "public health achievements of our time; they save lives and save money."

Cappello also said that 9,400 children in Colorado last year sought care for vaccination-preventable illnesses, at a cost of some $55 million. Vaccines are a gift that annually save the lives of more than 42,000 children nationwide, he added.

It isn't only the so-called "anti-vaxxers" who don't vaccinate their children. Cappello pointed to other barriers, such as a lack of access to vaccines in rural parts of the state. The executive order will allow CDPHE to form new partnerships to address those barriers, he explained.

Lesley Thompson was at the press conference to support the executive order. She lost a 2-year-old grandson to meningitis, a vaccine that isn't even recommended in Colorado.

The federal Advisory Committee on Immunization Practices, however, recommends vaccinating children at 11 years old, she noted. But the more people who get the vaccine means more protection for everyone else, she said, adding that one in five may carry the virus without showing symptoms. 

One of the most oft-cited reasons parents don't vaccinate is a concern that ingredients in some vaccines may lead to autism. Leslie Vinson of Parker is a medical lab scientist who works in immunohematology. Both of her children have been fully vaccinated and both are on the autism spectrum.

The one and only study that attempted to make the connection between the two used falsified data and has since been debunked, even by its author, Vinson said, adding, "there's no foundation" for linking autism and the MMR vaccine.

Vaccines are a community safety tool, and everyone who can be vaccinated should be vaccinated in order for the "herd effect" that drives vaccine efficacy to work, she said.

"Those of us who can be vaccinated have an obligation to do it," she said.

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