BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                  AB 2009|
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                                 THIRD READING


          Bill No:  AB 2009
          Author:   Galgiani (D)
          Amended:  6/20/12 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  7-0, 6/13/12
          AYES:  Hernandez, Harman, Alquist, Anderson, DeSaulnier, 
            Rubio, Wolk
          NO VOTE RECORDED:  Blakeslee, De Le�n

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  73-0, 5/10/12 (Consent) - See last page 
            for vote


           SUBJECT  :    Communicable disease:  vaccinations

           SOURCE  :     Author


           DIGEST  :    This bill removes references to specific groups 
          of people who shall have priority for the state 
          administered influenza (flu) vaccines and updates it with 
          the recommendations from the federal Centers for Disease 
          Control and Prevention's Advisory Committee on Immunization 
          Practices.

           ANALYSIS  :    Existing law:

          1.Establishes the Immunization Branch within the Department 
            of Public Health (DPH) to provide leadership and support 
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            to public and private sector efforts to protect the 
            population against vaccine-preventable diseases.

          2.Requires DPH to provide appropriate flu vaccine to local 
            government or private, nonprofit agencies at no charge in 
            order that the agencies may provide the vaccine at a 
            minimal cost, at accessible locations, and in order of 
            priority, first for all person 60 years of age or older 
            and then to any other high-risk groups identified by the 
            United States Public Health Service.

          3.Requires that administration of the flu vaccine be 
            performed by a physician, a registered nurse, or a 
            licensed vocational nurse acting within the scope of 
            their professional practice acts, and requires that a 
            registered nurse or licensed vocational nurse demonstrate 
            satisfactory familiarity with specified immunization 
            procedures to a supervising physician.

          4.Permits physicians, nurses, physician assistants, medical 
            assistants, and pharmacists to administer immunizations 
            under specified circumstances.

          This bill removes references to specific groups of people 
          who shall have priority for the state administered flu 
          vaccines and updates it with the recommendations from the 
          federal Centers for Disease Control and Prevention's 
          Advisory Committee on Immunization Practices.

           Background
           
           Flu vaccination program for older adults.   California's 
          program, which would be amended by this bill, was designed 
          to use voluntary assistance from public or private sectors 
          in administering flu vaccines.  DPH provides participating 
          local governmental or private nonprofit agencies flu 
          vaccine at no charge in order for the agencies to provide 
          the vaccine for no more than two dollars per person to 
          offset administrative costs.  Agencies are tasked with 
          providing flu vaccine to individuals in all high-risk 
          groups, but first to those who are 60 years and older.  
          According to DPH, over the last decade, the pattern of flu 
          vaccine administration under this program has shifted 
          toward younger people: for example, in the 2000-01 season 

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          vaccine was administered to 15,456 people ages 18 years and 
          less, 146,722 people ages 19 to 59 years, and 546,047 
          people of age 60 or greater; by contrast, in the 2010-11 
          season, vaccine was administered to 121,675 people aged 
          less than 18 years, 315,512 people aged 19-59 years, and 
          165,243 people of age 60 or greater.  DPH indicates that 
          the increase in the number of individuals under the age of 
          60 who have received the flu vaccine is consistent with the 
          expansion in age groups prioritized in federal 
          recommendations to be immunized against influenza in the 
          last decade.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  Yes

           SUPPORT  :   (Verified  7/3/12)

          American Academy of Pediatrics California
          American Federation of State, County and Municipal 
          Employees
          California Academy of Family Physicians
          California Pharmacists Association
          California School Employees Association
          California School Health Centers Association
          California School Nurses Association 
          California Senior Legislature
          California State PTA
          Greater Los Angeles African American Chamber of Commerce
          MedImmune
          Service Employees International Union California

           ARGUMENTS IN SUPPORT  :    The American Academy of Pediatrics 
          indicates that children have a higher rate of influenza 
          infection than any other age group, are more contagious 
          than adults, and often spread the disease to vulnerable 
          groups including the elderly and infants, who are too young 
          to receive the vaccine.  The California Academy of Family 
          Physicians states that unvaccinated children can contract 
          and spread dangerous or life-threatening diseases and 
          lessen the effect of "herd immunizations" in the population 
          as a whole.  The California School Nurses Association adds 
          that for many school-aged children, seasonal influenza is a 
          yearly occurrence that causes school absences that 
          interfere with learning and the loss of work days for their 

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          parents/guardians; it is also not unusual for children to 
          return to school early and spread the virus to their 
          friends, teachers, and staff.  The California State PTA and 
          the Greater Los Angeles African American Chamber of 
          Commerce concur that seasonal flu in children can cause 
          absenteeism from school and impair learning, and ultimately 
          impact the entire community by disrupting work and child 
          care arrangements. MedImmune states that the requirement to 
          prioritize free flu vaccine for seniors in California was 
          added in the 1970s when Medicare did not cover flu vaccines 
          and the vaccine was not as readily available to seniors at 
          their local pharmacy or physician's office, but that now, 
          seniors are able to obtain a free flu vaccine fairly easily 
          while children do not always have the same coverage options 
          and as seniors and can benefit from free flu vaccine 
          administered by a school nurse or a clinic organized by 
          their local health department.  The American Federation of 
          State, County and Municipal Employees adds that this bill 
          would align California's prioritization of flu vaccine 
          administration with recommendations from ACIP.
          

           ASSEMBLY FLOOR  :  73-0, 5/10/12
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Beall, 
            Bill Berryhill, Block, Blumenfield, Bonilla, Bradford, 
            Brownley, Buchanan, Butler, Charles Calderon, Campos, 
            Carter, Cedillo, Chesbro, Conway, Davis, Dickinson, 
            Donnelly, Eng, Feuer, Fong, Fuentes, Beth Gaines, 
            Galgiani, Garrick, Gatto, Gordon, Gorell, Grove, Hagman, 
            Halderman, Hall, Harkey, Hayashi, Roger Hern�ndez, Hill, 
            Huber, Hueso, Huffman, Jones, Knight, Lara, Logue, Bonnie 
            Lowenthal, Ma, Mansoor, Mendoza, Miller, Mitchell, 
            Monning, Morrell, Nestande, Nielsen, Pan, Perea, 
            Portantino, Silva, Skinner, Smyth, Solorio, Swanson, 
            Torres, Valadao, Wagner, Wieckowski, Williams, Yamada, 
            John A. P�rez
          NO VOTE RECORDED:  Cook, Fletcher, Furutani, Jeffries, 
            Norby, Olsen, V. Manuel P�rez


          CTW:nl  7/3/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE


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