Prevention Matters

“Herd immunity” is one of the most important concepts behind vaccination – the idea that once a certain percentage of the population is vaccinated against a particular illness, the entire population will be protected even if not everyone has been vaccinated. While the concept has often been demonstrated, it has been hard to prove, but an innovative study published in the Journal of the American Medical Association provides such proof.

In a study funded by the American and Canadian governments, scientists from several Canadian universities and St. Jude’s Children’s Research Hospital in Tennessee conducted their research in 49 remote Hutterite farming colonies in western Canada. The Hutterites have similar roots to the Amish and live in small, isolated communities, making them perfect subjects for this research.

In 25 of the colonies, all children ages 3 to 15 received seasonal flu shots. In 24 other colonies, the same age children received the hepatitis A vaccine instead. In the colonies without the flu vaccine, more than 10 percent of the population had seasonal flu during that year’s flu season; less than 5 percent of the population in the vaccinated colonies did. This translates to a 60 percent “protective effect” for the whole community and suggests that giving flu shots only to children would still protect the elderly, even if they were not directly vaccinated.

While CDC recommends directly vaccinating high-risk individuals, such as the elderly, and has moved to recommending universal vaccination for the recent H1N1 epidemic, this study provides important evidence for the existence of herd immunity and supports the practice of vaccinating children to prevent further spread of influenza in the population.

Rebecca Barson
Consultant, Partnership for Prevention

Yesterday, the Robert Wood Johnson Foundation launched a new interactive map that provides the latest data on tobacco policies by state. Using information courtesy of the Americans for Nonsmokers’ Rights and the Campaign for Tobacco-Free Kids, the map focuses on three different aspects of tobacco policy: 1) smoke-free laws; 2) cigarette tax rates; and 3) tobacco control spending. “Users will be able to see whether a state is ahead or behind the curve in protecting and promoting health,” says Michelle Larkin, J.D., M.S., R.N., leader of RWJF’s Public Health Team.

With its array of colors and pop-up menus, the map points out that Rhode Island and Connecticut have the highest tax rates in the U.S.--$3.46 and $3.00, respectively. The map also shows that North Dakota is the only state that spends 100% or more of state funding for tobacco control relative to the Centers for Disease Control and Prevention recommendations.

Brandi Robinson
Program Associate, Partnership for Prevention

As the nation waits for the House of Representatives to pass health reform legislation, the US Senate took action yesterday to approve S. 1147, legislation to prevent tobacco smuggling and ensure the collection of all tobacco taxes. The vote on the bill, the “Prevent All Cigarette Trafficking Act of 2009 ” (PACT) was unanimous. Welcome news indeed since in recent months finding unanimity on any issue in the US Senate has been a tough task.

During Senate debate, chief sponsor Senator Herb Kohl of Wisconsin told fellow Senators: “Without innovative enforcement methods, law enforcement will not be able to effectively address the growing challenges facing them today. The PACT Act sets out to do just that by empowering states to go after out-of-state sellers who are violating their tax laws in Federal court.”

Kohl added that “the bill will keep tobacco out of the hands of kids…The PACT Act contains a strong age verification section that will prevent online sales of cigarettes by requiring sellers to use a method of shipment that includes a signature and photo ID check upon delivery.” The PACT Act also gives state and local governments direct rights to enforce the Act against illegal Internet sellers in federal court (while protecting State and Tribal sovereignty and immunity rights).

Partnership believes the most important impact of the legislation is closing a loophole that has allowed Internet tobacco sales to circumvent the payment of State sales taxes. Once the bill becomes law States will be free to increase their tobacco excise taxes without fear that out-of-state tobacco sellers can circumvent state tax requirements by selling cigarettes on the Internet.

The House bill HR 1676, passed back in May of 2009 on a vote of 397-11. The options ahead are for the House to either accept the Senate bill as passed or develop an amendment resolving minor differences between the two versions of the legislation. Given overwhelming support for the legislation there is reason to be hopeful final action will be completed so it can be forwarded to the President for his signature this Spring.

Ripley Forbes, Director, Government Affairs
Partnership for Prevention

US Surgeon General, Regina Benjamin told Congress yesterday that obesity “may dramatically impact the quality and longevity of life for an entire generation of children.” In forceful testimony before the Senate Committee on Health, Education and Pensions, Benjamin noted “the prevalence of obesity has increased dramatically in the United States, tripling among children and doubling among adults. Today, two-thirds of adults and nearly one in three children are overweight or obese.” She explained that from 1980 to 2008, obesity among adults rose from 13.4% to 34.3% and among children, rates rose from 5% to 17%.

The solution isn’t easy or quick but it is obvious and encouraging that the Obama administration is engaged. The Surgeon General explained that last month the President established a new Task Force on Childhood Obesity and charged it with reviewing all Federal programs dealing with child nutrition and physical activity and developing a national action plan. The National Action Plan is scheduled to be completed by May 9. Perhaps no less important, is the very visible role and support to this effort being given by First Lady Michelle Obama and her commitment to end “childhood obesity within a generation.” Her “Let’s Move” campaign is being supported by an innovative series of new web-based tools including the next generation Food Pyramid and USDA’s Food Environmental Atlas. These projects will help families make healthier food and physical activity choices and better understand national and local trends on food decisions.

Benjamin concluded her testimony with a simple but powerful message. “Instead of bombarding people with lists of what not to do, we need to empower them with what to do to promote health. Healthy eating and physical activity should be something all Americans want to do, not something they feel they have to do. We need to encourage people to take up activities that they enjoy, like swimming, dancing, or biking. We need to show them how healthy foods can be affordable, accessible, and delicious.”

Sage advice from the nation’s Family Doctor.

Posted by:
Ripley Forbes
Director, Government Affairs, Partnership for Prevention