By Jim McLean

KHI News Service



One-year-old Dakota Barngrover is held by his mother Tracy Barngrover while he receives routine immunizations at Dr. Dennis Cooley"s office in Topeka. A new report by the Immunize Kansas Kids project found that efforts to improve immunization rates in Kansas could succeed if more physicians followed Cooley"s example, providing full immunization services to their patients. Cost and administrative burdens have prevented many doctors from offering the service. (Thad Allton/KHI) TOPEKA, July 7 Over the years, attempts to increase the childhood immunization rate in Kansas have produced mostly short-term results.

But a new report released today by the Immunize Kansas Kids project has health officials and others hopeful a lasting solution is possible.

"The variety of approaches included in the IKK report form a good road map," said Richard Morrissey, interim health director at Kansas Department of Health and Environment. "This is doable. It"s not a problem that can"t be solved."

Up and down

When the immunization rate dipped in the early 1990s, KDHE responded with Operation Immunize. The rate went up, but only for a while.

By 2002, Kansas ranked 45th among the 50 states. In 2004, the National Immunization Survey by the Centers for Disease Control and Prevention showed only 77.5 percent of Kansas children between the ages of 19 and 35 months had received all their vaccinations good enough only for a ranking of 43rd.

Gov. Kathleen Sebelius that year formed a blue ribbon task force to study the problem and recommend solutions. By the next year, the immunization rate jumped to 83.8 percent, earning the state a ranking of 12th.

At a news conference called to highlight the progress, Sebelius said: "Four years ago, nearly a third of Kansas kids weren"t getting the critical immunizations they need to stay healthy. That was unacceptable, and it"s why we"ve made childhood vaccinations a priority."

Celebration was short lived. By 2006, the rate was back down to 79.2 percent and the state"s ranking had dropped to 35th.

Massachusetts ranked no. 1 with a rate of 86.9 percent. Nevada"s rate of 64.7 percent earned it last place in the rankings.

Morrissey has witnessed the immunization cycles first hand since coming to the agency in 1974.

"It"s important that they put the (immunization) data they hear about in context," Morrissey said. "I think it sometimes gets misinterpreted to mean that we have lots of kids running around unimmunized for long periods of time and that"s just not the case.



"We recognize that there are states that have done better jobs," he said. "But I think what the research tells us is that there isn"t just one reason why."

Root causes

Gianfranco Pezzino, interim director of public health studies at the Kansas Health Institute, agreed there isn"t a simple fix to the problem.

"Our rates tend to be unstable and too often at the lower end of the range because our immunization delivery system is weak," Pezzino said. "We don"t want to over-interpret the results of a single survey, we want to look at the root causes of the problem."

The IKK project was initiated in 2006 to do that. Funded by the Kansas Health Foundation and jointly administered by KDHE and the Kansas Health Institute, the project"s goal was to produce a lasting solution by identifying the specific barriers to improving immunization rates and crafting solutions policymakers, providers, parents and others could support.

In the report released today, the 32-member IKK steering committee proposed 31 strategies for improving and sustaining the childhood immunization rate. The recommendations address many of the cost and administrative issues that private physicians have cited as reasons they don"t provide immunizations. They also call for determining the feasibility of a high-volume, vaccine purchasing program to lower costs. And they urge acceleration of the immunization registry , a digital tool for keeping track of immunization records.



A preliminary cost estimate included in the report for some, but not all, of the final recommendations, was $1.6 million, to be spent over several years. The lead agencies participating in the project are now reviewing the recommendations and will report back to the team with revised costs, Pezzino said.



"This will be a multi-million dollar effort over several years," he said.



-Jim McLean is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at jmclean@khi.org or at 785-233-5443, ext. 123. Staff writer Sarah Green contributed to this report.