BILL ANALYSIS �
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 2069
AUTHOR: Maienschein
AMENDED: April 24, 2014
HEARING DATE: June 25, 2014
CONSULTANT: Moreno
SUBJECT : Immunizations: influenza.
SUMMARY : Requires the Department of Public Health to post
educational information on its Internet Web site, in accordance
with the latest recommendations of the Centers for Disease
Control and Prevention, regarding influenza disease and the
availability of the flu vaccine.
Existing law:
1.Requires the Department of Public Health (DPH) to administer
various programs for the protection of public health.
2.Requires DPH to submit a biennial report to the Legislature on
the immunization status of young children in the state and the
improvements made in ongoing methods of immunization outreach
and education in communities where immunization levels are
disproportionately low.
This bill:
1.Requires DPH to post educational information on its Internet
Web site, in accordance with the latest recommendations of the
Centers for Disease Control and Prevention (CDC), regarding
influenza disease and the availability of the flu vaccine.
2.Requires the educational information to include, but not be
limited to:
a. The health benefits of a flu vaccine;
b. That the flu vaccine may be a covered benefit for
those with health insurance coverage;
c. That flu vaccines may be available for a minimal
fee to those individuals who do not have health
insurance coverage; and,
d. The locations where free or low-cost flu vaccines
are available.
1.Permits the department to use additional available resources
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to educate the public about the information described in 2)
above, including public service announcements, media events,
public outreach to individuals and groups who are susceptible
to influenza, and any other preventive and wellness education
efforts recommended by public health officials.
2.Makes findings and declarations related to the flu,
complications of the flu, and the flu vaccine. States
legislative intent to increase the average number of
Californians who receive a flu vaccine.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, this bill would have minor and absorbable costs to
DPH.
PRIOR VOTES :
Assembly Health: 19- 0
Assembly Appropriations:16- 0
Assembly Floor: 75- 0
COMMENTS :
1.Author's statement. According to the author, this bill is
intended to better educate the public about the benefits of
obtaining an annual flu vaccination. As the flu season winds
down, the number of statewide deaths due to severe influenza
continues to rise - well over 300 people under the age of 65 -
as California public health officials continue to investigate
additional cases. California has seen three times the number
of deaths reported in all of last year's flu season, which
took the lives of 106 people. Medical experts and CDC believe
annual influenza vaccination is the most effective method for
preventing influenza virus infection and its complications.
Although vaccination coverage has increased in recent years
for many groups recommended for routine vaccination,
considerable room for improvement remains. The CDC estimates
seasonal influenza immunization rates for individuals age 6
months and older for California is 44.2 percent compared to 45
percent nationally. Since February 2010, the CDC`s Advisory
Committee On Immunization Practices (ACIP) voted for universal
flu vaccination in the United States to expand protection
against the flu to more people. This bill seeks to have DPH
be more assertive in educating Californian's on the
recommended measures people can take to protect themselves
from flu deaths by taking a number of prescribed steps within
their current budget. Part of this information is to make
people aware that many are eligible for free flu vaccinations
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as part of wellness care under the Affordable Care Act. In
reading the many news articles this year on the flu and deaths
suffered, the author was taken with how many commented that
they did not believe healthy, active and young people could be
vulnerable to the flu. The author states that an active
campaign by the state will assist in informing people about
the benefits of a flu vaccination before it is too late.
2.Influenza. According to DPH, the flu is a contagious
respiratory illness caused by flu viruses, that can cause mild
to severe illness and at times can lead to death. The best way
to prevent flu is by getting a flu vaccination each year.
The CDC recommends a yearly flu vaccine for everyone six
months of age and older as the first and most important step
in protecting against this serious disease. While there are
many different flu viruses, the flu vaccine is designed to
protect against the three main flu strains that research
indicate will cause the most illness during the flu season.
3.ACIP recommendations. In February 2010, the ACIP, which
advises the CDC on vaccine issues, voted to recommend that all
people aged six months and older obtain a flu vaccine.
However, the CDC also points out that while everyone should
get a flu vaccine each flu season, it is especially important
that the following groups get vaccinated either because they
are at a high risk of having serious flu-related complications
or because they live with or care for people at high risk for
developing flu-related complications: pregnant women; children
younger than five, but especially children younger than two
years old; people 50 years of age and older; people of any age
with certain chronic medical conditions; people who live in
nursing homes and other long-term care facilities; and, people
who live with or care for those at high risk for complications
from flu.
4.Seasonal flu immunization rates. According to CDC estimates,
the California rate of immunization was below the national
average during each of the last four flu seasons for
individuals age six months and older, as the table below
illustrates.
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5.Previous legislation. AB 689 (Bonta), of 2013, would have
required each general acute care hospital to offer an onsite
flu vaccine annually to all patients prior to discharge, as
specified, and required hospitals to inform patients they may
be required to pay for the vaccination. AB 689 was held in
the Assembly Appropriations Committee.
AB 106 (Berg), Chapter 378, Statutes of 2007, required general
acute care hospitals to offer, prior to discharge,
immunizations for flu and pneumococcal disease to its
inpatients aged 65 years of age or older, as specified.
AB 699 (Chan), Chapter 589, Statutes of 2006, required
manufacturers or distributors of the influenza vaccine, or a
non-profit health care service plan that exclusively contracts
with a single medical group in a specified geographic area to
provide or arrange for the provision of medical services to
its enrollees, to report the amount of the influenza vaccine
that has been shipped, and the name, address, and, if
applicable, the telephone number of the recipient, to the
California Department of Health Services (predecessor to DPH)
upon request. Required entities that possess the flu vaccine
or conduct flu clinics to cooperate with local health officers
in determining local inventories.
AB 1711 (Strickland), Chapter 58, Statutes of 2005, authorized
a registered nurse or licensed pharmacist in skilled nursing
facilities to administer flu and pneumococcal immunizations to
a patient over 50 years of age, pursuant to standing orders
and without patient specific orders, if the immunization
standing orders that are not patient-specific meet prescribed
federal recommendations and are approved by the medical
director of the facility.
AB 691 (Daucher), Chapter 36, Statutes of 2004, required
specified nursing facilities to offer immunizations for flu
and pneumococcal disease to residents that are 65 years or
older.
6.Support. The American Federation of State, County and
Municipal Employees, AFL-CIO (AFSCME) states this bill would
help hospitals combat the flu by educating discharged patients
about the vaccine available to protect them from contracting
the virus. AFSCME also notes, given the level of misdirected
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hysteria surrounding the use of vaccinations, it would benefit
patients to have access to information regarding the
advantages of vaccinating against preventable ailments. The
California Hospital Association and the California Children's
Hospital Association state that educating the public on the
availability of vaccinations that can prevent a potentially
deadly virus infection is a critical component in reducing the
severity of the annual flu season. Sanofi-Pastuer writes that
this bill requires DPH to better inform the public about the
health benefits of annual flu vaccine without mandating
hospitals and others to provide information to patients, and
is a low cost requirement that possibly counties can duplicate
and further share this information. Biocom states that many
families are coping with losses that likely could have been
prevented had one gotten a flu shot and it is critical we make
this information available by every means possible.
7.Policy comment. It appears that DPH already posts on its
website information related to the flu vaccine, including
content from the CDC and a link to an interactive map so that
people can locate where flu shot clinics are located. It also
appears that while lower than the national average,
California's rate of immunization has been climbing and was
near to the national average for the last flu season. The
need for this bill is unclear.
SUPPORT AND OPPOSITION :
Support: American Federation of State, County and Municipal
Employees, AFL-CIO
American Academy of Pediatrics
Biocom
California Academy of Physician Assistants
California Children's Hospital Association
California Hospital Association
California Pharmacists Association
March of Dimes
Sanofi-Pastuer
Oppose: None received.
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