BILL ANALYSIS
SB 249
Page 1
SENATE THIRD READING
SB 249 (Cox)
As Amended August 20, 2009
Majority vote
SENATE VOTE :36-0
HEALTH 16-0 APPROPRIATIONS 15-0
-----------------------------------------------------------------
|Ayes:|Jones, Fletcher, Adams, |Ayes:|De Leon, Nielsen, |
| |Block, Carter, | |Ammiano, |
| | Conway, De Leon, | |Charles Calderon, Coto, |
| |Emmerson, Gaines, Hall, | |Davis, Duvall, Fuentes, |
| |Hayashi, Hernandez, | |Hall, Harkey, Miller, |
| |Bonnie Lowenthal, Nava, | |John A. Perez, Skinner, |
| |V. Manuel Perez, Audra | |Audra Strickland, |
| |Strickland | |Torlakson |
|-----+--------------------------+-----+--------------------------|
| | | | |
-----------------------------------------------------------------
SUMMARY : Requires the Department of Public Health (DPH) to
include, as part of information about meningococcal disease DPH
is already required to develop, information pertaining to
children between 11 and 18 years of age; authorizes DPH to
include in the information a recommendation for meningococcal
vaccination; and, authorizes the California Department of
Education to add the information on meningococcal disease to
health education materials sent to parents of children between
11 and 18 years of age.
EXISTING LAW requires DPH to develop information about
meningococcal disease, including symptoms, risk, treatment, and
vaccination, and to make that information available to each
public and private degree-granting postsecondary institution and
upon request.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, no direct fiscal impact assuming the information DPH
currently has posted on their web site meets the requirement of
this bill. If additional information needs to be developed, a
one-time federal funds cost of $20,000-$30,000 will be incurred.
COMMENTS : According to the author, in August 2007, the United
States (U.S.) Centers for Disease Control and Prevention (CDC)
SB 249
Page 2
and Advisory Committee on Immunization Practices (ACIP) issued a
recommendation to vaccinate children ages 11 to 18 years at the
earliest opportunity to prevent invasive meningococcal disease.
The author states this recommendation is supported by the
American Academy of Pediatrics, the American Academy of Family
Physicians, and others. The author contends this bill would
help ensure that parents, health care providers and others are
educated about the disease, the recent ACIP recommendations, and
the availability of a vaccine to prevent meningococcal disease
in 11 to 18 year olds.
According to CDC, meningococcal disease is caused by Neisseria
meningitidis, or the meningococcus, and is a potentially severe
bacterial infection that can cause meningitis, bloodstream
infection, and localized infections. Although meningococcal
disease is not common in the U.S., the disease is of concern
because it can progress rapidly and lead to death within hours
of onset. Meningococcal disease takes several forms, including
meningitis, which is characterized by fever, headache, and stiff
neck, and in some cases, nausea, vomiting, and changes in mental
status. Another form of meningococcal disease, meningococcal
bacteremia, is a bloodstream infection characterized by sudden
fever and, in severe cases, small red or purple spots or red or
purple discolorations on the skin. Meningococcal bacteremia can
lead to joint infection, pneumonia, organ system failure, shock,
and death. According to DPH, approximately 10% of persons with
meningococcal disease die from the infection, and 11%-19% of
those who survive suffer long-term complications, such as limb
loss, neurologic disability, or hearing loss.
Meningococcal disease is spread by respiratory droplets or
secretions (from coughing, sneezing, and kissing) of people with
the disease or healthy carriers of the meningococcus who have no
symptoms. Infants are at greatest risk of meningococcal
disease, although DPH reports that the incidence among
adolescents and young adults has been increasing.
Two meningococcal vaccines are available in the U.S. These
vaccines prevent two of the three meningococcal disease types
most common in the U.S. and a type that causes epidemics in
Africa. The federal Food and Drug Administration approved
meningococcal polysaccharide vaccine (MPSV4) in 1981. In
January 2005, the meningococcal conjugate vaccine (MCV4) was
licensed for use among persons 11 to 55 years of age. According
to CDC, MCV4 is the preferred vaccine for people two to 55 years
SB 249
Page 3
of age, but MPSV4 can be used if MCV4 is not available. Only
MPSV4 is approved for persons older than 55 years.
In June 2007, ACIP recommended routine vaccination of all
persons 11 to 18 years of age at the earliest opportunity.
Thus, the current ACIP and CDC recommendation is for all
children to receive MCV4 at their routine preadolescent medical
visit (11 to 12 years of age) or at the earliest opportunity for
11 to 18 year olds, and, for those who have never gotten MCV4,
at high school entry. CDC and ACIP further recommend routine
vaccination for people at increased risk, including college
freshmen living in dormitories and others.
In 2000-01, outbreaks of meningococcal disease in young adults
in five California public schools focused attention on this
disease. In response to the outbreaks, SB 212 (Oller), Chapter
374, Statutes of 2001, requires DPH to develop a meningococcal
disease strategic prevention plan. DPH convened a working group
and published the Meningococcal Disease Prevention Plan in
September 2002. The working group adopted recommendations for
vaccine use and information, education, and training, including
recommendations to follow ACIP guidelines and that DPH make
information on meningococcal disease and prevention available to
college-bound and other high school seniors. Accordingly, DPH
developed materials about meningococcal disease and vaccine for
students, including the "Vaccinate Before you Graduate" campaign
aimed at high school students. DPH also developed a brochure
aimed at freshmen in dorms, and sent letters to colleges to
inform them of the availability of the brochure for download and
inclusion in registration materials. DPH also posts all
meningococcal disease materials on its Web site and distributes
the materials to local health departments.
Analysis Prepared by : Allegra Kim / HEALTH / (916) 319-2097
FN: 0002194