County may stop giving immunizations for international travel

Sedgwick County’s health department would stop providing certain types of immunizations for international travel under a current proposal.

County manager Michael Scholes’ recommended budget calls for an end to providing vaccines for diseases or infections like yellow fever and typhoid fever prior to international travel. The county’s final budget will be adopted Wednesday.

Scholes says the decision will give the health department a chance to “reutilize and actually focus” on other services.

“It seemed like low-hanging fruit,” Scholes said.

Chief financial officer Chris Chronis tied the decision back to one of Scholes’ guiding principles for the county budget: reduced government funding to services that can be provided by non-governmental groups or through the private sector.

Dillon’s and AFC Doctors Express on North Rock Road, for instance, provide yellow fever vaccinations, according to the Centers for Disease Control and Prevention.

“We don’t think that we should be in the business of using our resources to compete with the private sector,” Chronis said.

The program cost about $138,143, according to the budget. But it made about $137,660 in revenue by charging for vaccines.

That makes the proposal essentially revenue-neutral: the county will save approximately $483 by eliminating the program.

Since 2011, the county provided 5,779 vaccines under the travel immunization program, which included yellow fever vaccines, injectable and oral typhoid fever vaccines and a travel immune serum for Hepatitus B.

Yellow fever vaccines are available at the Dillon’s at Central and Rock for $175. AFC Doctors Express’s supplier charges $250 for the yellow fever vaccine and another $85 for the doctor’s visit. The county’s health department offers yellow fever vaccines for about $118 now.

‘It’s all about access’

Tom Moore, a physician with Infectious Disease Consultants of Kansas specializing in travel-related diseases, called the move “short-sighted.”

“I just don’t understand that if it’s revenue-neutral,” Moore said. “It’s all about access.”

Moore said a traveler can get the oral typhoid vaccine by prescription, but that the primary care physicians’ office would probably have to order it from a supplier, which would take longer. Typhoid fever immunizations are recommended for travel to south Asian countries like India, Pakistan and Bangladesh, Moore said.

Moore took more issue with yellow fever vaccines being taken away. Yellow fever vaccines are recommended for people traveling to countries in sub-Saharan Africa or South America, like Brazil.

“There’s not enough call for it for a private primary-care physician to get it and keep it on the shelf,” Moore said. “Short of creating a separate travel clinic, we’ve relied on the county health department for supplying that vaccine.”

“There are a lot of people in Kansas who go on missionary trips that are funded by their church or funded by donations,” Moore added. “They need these vaccines to do this work.”

Alyssa Schoenwald, 23, traveled to Cambodia for work with Samaritan’s Purse, a North Carolina-based Christian organization that does international relief work. She got her typhoid fever immunization at the health department before she left.

“If they do take away the program, will they let us know where to go instead?” Schoenwald asked. “It’s a serious thing to have your immunizations before you go abroad.”

Commissioners on program

Chairman Jim Howell said it was once difficult to get vaccinated before going overseas, citing his experience in the military before deploying to countries like Saudi Arabia.

“So the health department did this because you couldn’t just go someplace else to get them as a matter of necessity,” Howell said. “They went out of their way to stock these things so that people could at least get immunizations at someplace local that would have it. And that’s not true anymore.”

“If it can be done in the private sector and it’s not going to be a disservice to anybody to do it that way, why not let it stay in the private sector?” Howell said. “The necessity part of this has changed.”

Commissioner Dave Unruh, who opposed cuts to the health department last summer, said ending the program is “probably a good business decision.”

“If that’s being provided, then there’s no particular advantage to anyone for us keeping the program,” Unruh said.

But Commissioner Tim Norton said he would rather not see any more cuts to health and human services.

“There may be somebody else that does it, but are they as accessible as the county health department? Do people know where those other places are?” Norton asked.

“Fortunately, the budget hasn’t been finalized,” Norton said. “There’s still time to make some nuance changes.”

This story was originally published August 9, 2016 at 6:51 AM with the headline "County may stop giving immunizations for international travel."