The federal government has cut money earmarked to encourage vaccinations among Missourians as part of its mission to slash spending.
The cuts come as vaccination rates among Missouri children have gone down and as vaccine-preventable measles has gone up nationally.
The cuts, announced in March, were to grants to the Missouri Department of Health and Senior Services from the Centers for Disease Control and Prevention.
DHSS distributed the federal money in the form of grants and contracts to organizations such as the Missouri Immunization Coalition, which educates and advocates for immunizations.
“I’m really concerned about the effects it's going to have for our health and safety of the population here in Missouri,” said Missouri Immunization Coalition Executive Director Lawrence Simonson. “Continuing to defund any of the vaccination efforts that we're seeing at our local health department, those vaccination rates are going to continue to decline.”
According to DHSS spokeswoman Lisa Cox, the CDC notified the department it was cutting three funding streams worth $255 million.
DHSS representatives did not say how much of that terminated funding was earmarked for immunization projects.
“The termination of this funding impacts a number of projects currently underway supporting Missouri’s public health system, totaling about $135 million,” Cox said, adding the reduction in grants would likely affect employees of local and state-level agencies.
Federal sources also cut an additional $119 million for projects that were still being determined, Cox said.
“DHSS is working to understand the full impact of this federal action and searching for options to carry on some of this work,” she wrote in an email.
While the Missouri Immunization Coalition had been supported through other funding in the past, this year the $1.5 million DHSS contract using federal funds was the only money sustaining the group, said the organization’s president, Lynelle Phillips.
Phillips said vaccination education is more important than ever as cases of measles go up around the country. According to the CDC, more than 700 cases of measles have been reported in 25 states this year. Almost all are in people who are unvaccinated or whose vaccination status is unknown.
At the same time, vaccination rates among MIssouri schoolchildren have decreased, with 85% of private school kindergarteners and 90% of public school kindergarteners being fully vaccinated against measles, mumps and rubella, according to state health data.
“If measles hit St. Louis, it's hitting fertile ground because the immunization rate is so low for city kids in the school system,” Phillips said. “Those immunization rates don't raise themselves. That leaves our population at the mercy of whatever local health departments can muster.”
Other vaccine-preventable diseases, such as whooping cough, have also seen increases in cases. (Health officials said the rise in whooping cough cases is likely due to the infection returning to pre-pandemic levels.)
Immunization Coalition leaders were forced to cancel their spring conference at the last minute when its members learned of the cuts.
Two dozen states (but not Missouri) have filed suit to block the federal cuts to immunization and other public health programs.
In the lawsuit, the plaintiffs state HHS made the cuts because they were appropriated through coronavirus-era laws. The funding was no longer needed because the pandemic is over, HHS wrote in notices to governments, according to the lawsuit.
Heidi Lucas, the executive director of the Missouri Rural Health Association, said the federal funding for its own vaccination program had been halted.
“We received an email a couple weeks ago that basically said, ‘Your funding is stopped, effective immediately,’” she said. “We lost approximately a million dollars.”
The MRHA grant funding was being used to collect information about immunizations among adults who use rural health clinics, Lucas said. The information gathered would be used to help the organization educate providers about how to best talk to residents in a nonjudgmental and supportive way.
She said the funding was intended for influenza and COVID-19 vaccine research, but the lessons learned from the project could also be applied to other vaccines. Health providers are still the first place most people turn to when they have concerns or questions about immunizations, she said, so it’s important for workers to know how to discuss them with patients in a way that doesn’t feel punitive.
“We only had a couple of months left on the project,” she said. “All of the research was done. We paid for the research. We paid for how to have these conversations, the training, everything, everything is done. The only thing that was left was to get the information out….We have a lot of stuff in our back pocket, and just nowhere to put it.”
