Louisiana AAP Statement on Public Health and Vaccines – February 19, 2025

On February 19, 2025, the Louisiana Chapter of the American Academy of Pediatrics and Chapter President Joseph Bocchini, Jr., MD, FAAP, published the following statement directed to leaders at the Louisiana Department of Health.

February 19, 2025 Subject: Public Health and Vaccines To: Dr. Ralph Abraham, Surgeon General Louisiana Department of Health Email: Ralph.Abraham@la.gov Dr. Wyche Coleman III, Deputy Surgeon General Louisiana Department of Health Email: Wyche.Coleman@la.gov Dr. Pete Croughan, Deputy Secretary Louisiana Department of Health Email: Pete.Croughan@la.gov Mr. Michael Harrington, Secretary Louisiana Department of Health Email: Michael.Harrington@la.gov Sirs: The Louisiana Chapter of the American Academy of Pediatrics, with a membership of seven-hundred-sixty-two pediatric practitioners who work daily to improve the lives of the children of Louisiana and their families, believes that vaccines are a cornerstone of public health and preventative medicine. Two of the core missions of public health are protection of the public, which includes control of infectious diseases, and prevention, which includes promotion of and access to vaccines. As pediatricians, we are committed to protect children from vaccine preventable diseases and utilize the evidence-based recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the American Academy of Pediatrics to guide our immunization practices in our offices and clinics. We expect Public Health Departments to do the same. Based on when we began our careers, we can each tell you about families who have been negatively impacted by a vaccine preventable disease and our experience with the remarkable disappearance of devastating illnesses due to the introduction of safe and effective vaccines. Years of peer reviewed research have proven that vaccines are safe and effective. Due to the implementation of our evidence-based vaccine policies over the past fifty years we have achieved remarkable control of several serious and life-threatening infections. Some of these infections have been nearly eliminated, but the causative agents continue to circulate and therefore, a decrease in vaccination rate can lead to a reemergence of these infections in our communities. We are already seeing outbreaks of measles in communities in many areas of the US amongst unvaccinated persons, including a large ongoing outbreak right now in Texas. In 2024, Louisiana experienced more cases of pertussis than we have seen in years, and this pertussis outbreak has continued into the first months of 2025. The 2024-25 influenza season is the worst the US has experienced in 15 years, leading to excess hospital admissions, crowding of emergency rooms and clinics, and so far, resulting in over 13,000 deaths, including 68 children. To address these and other infectious disease threats, such as the possibility of Avian influenza becoming more pathogenic for people, a strong commitment to support vaccine policy is required from our State governmental leadership and from our Public Health Department. Misinformation, misstatements, the failure to educate the public about the safety and effectiveness of vaccines, reducing vaccine access by eliminating mass vaccine opportunities, and vague statements from public health leadership about the application of universal and seasonal vaccine policies and individual vaccine effectiveness

decrease trust in physicians, our public health programs, and vaccines. The February 13th statement undermines physician providers rather than supports them in their efforts to inform their patients of the risks and benefits of vaccines. The statements broadly referring to the effectiveness or lack of effectiveness of unspecified vaccines make the job of providing sound medical advice more difficult. Members of the LA AAP report increasing vaccine hesitancy and refusal over the past few years, and a rapid escalation in the past year. Louisiana immunization rates are decreasing. Children are at an increasing risk from vaccine preventable diseases. Public health and pediatricians must continue the long-term partnership required to achieve high immunization rates. Medical decisions are made between a physician and a patient. However, public health has an important role in serving as an access point for persons without a primary care physician and a source of information and recommendations for the public. Public health must be actively involved in informing the public of the importance of vaccines. High immunization rates help create community immunity which offers protection for those who cannot receive a vaccine due to a contraindication, are too young to receive a vaccine or do not respond to the vaccine. Public health recommendations are also important for adult immunization rates since many adults utilize pharmacies rather than their physicians’ offices for their vaccines. A recently published report showed that for children born from 1994-2023 in the United States, nine of the vaccines we recommend for routine immunization of children will have prevented an estimated 1.1 million deaths, 32 million hospitalizations and 508 million lifetime cases of illness. These vaccines also will have saved $508 billion in direct medical costs and $2.7 trillion in indirect costs to society. We have made significant gains in the prevention of serious and life-threatening infections in children through policies for utilization of safe and effective vaccines. Our children and their families reap significant benefits from our highly successful immunization program. The recently stated policies of the Louisiana Department of Health are a significant step backwards and put children and their families at risk for reemergence of diseases vaccines have controlled. We are happy to meet with you to review the settled evidence of vaccine safety and effectiveness which form the backbone of our current strategy of immunizing children with all recommended vaccines at the time they are indicated. Sincerely, Joseph A. Bocchini, MD, FAAP President