Updated 4:50 p.m.
Illinois Gov. JB Pritzker says he plans to boost access to vaccines after doctors warned him about a potential measles outbreak in the state.
There have been more than 600 confirmed measles cases in 22 states since Jan. 1, including seven cases in Illinois, according to the Centers for Disease Control and Prevention.
“We are taking the threat posed by a rise in measles cases very seriously and are committed to taking action to keep Illinoisans safe,” Pritzker said in a statement today.
The Illinois Department of Public Health plans to boost access to vaccines with a variety of efforts. They include setting up mobile health units in neighborhoods with low vaccination rates and working with churches to offer vaccination clinics after services and during vacation Bible school.
Illinois also is studying schools at risk for outbreaks, where fewer than 95% of students are vaccinated. That’s an issue WBEZ recently highlighted. The state has identified a few barriers to access, including long wait times for shots at local health departments.
What’s not clear, though, is how Pritzker is going to address a particular problem: getting more doctors to immunize low-income children.
Illinois physicians have been sounding the alarm about kids who are covered by the state-run Children's Health Insurance Program, known as CHIP. Doctors say these children are especially at risk of triggering an outbreak because some physicians stopped vaccinating them after a major policy shift by Pritzker’s predecessor Bruce Rauner in 2016 made it too expensive.
The CHIP program covers kids whose parents make too much money to qualify for Medicaid, a government-run health insurance program for people who are low-income and disabled. But the parents don't make enough to afford more expensive private insurance.
There were about 324,000 children in Illinois enrolled in CHIP at some point in the 2017 fiscal year, according to the nonprofit Kaiser Family Foundation, which tracks health care issues.
Earlier this month, 54 pediatricians sounded the alarm in a letter to Theresa Eagleson, director of the Illinois Department of Healthcare and Family Services. The agency oversees CHIP.
“Many providers have stopped vaccinating (CHIP) patients altogether and direct them to the Board of Health clinics,” the letter said. “These patients experience fragmentation of care and missed opportunities to be vaccinated and end up in our offices missing multiple vaccines. In light of the current measles outbreak, this could lead to a public health crisis with disastrous consequences.”
Rauner’s policy shift required doctors to buy pricey vaccines for children on CHIP, then wait months to get reimbursed, if they did at all.
Before the rule change, physicians got vaccines for free from the state for kids on CHIP as part of the Vaccines For Children program, known as VFC. In the program, the federal CDC buys vaccines at a discount and distributes it to agencies including state health departments to immunize low-income children, including those on Medicaid.
But Illinois wasn’t supposed to give free vaccines to doctors to immunize kids on CHIP. So Rauner changed the rules.
Since his 2016 policy shift, 28% of Illinois health care providers have left the VFC program, according to a WBEZ analysis of Illinois Department of Public Health data. There are now about 800 doctors and public health departments around the state in the program (the data doesn’t include Chicago providers).
In suburban Cook County, nearly one-third of providers have dropped out. In neighboring McHenry and Will counties, it’s closer to 40%.
Dr. Giulia Mobarhan of Chicago said she’s stopped vaccinating kids on CHIP, except for flu shots, because of the expense. Her small pediatric practice on the Northwest Side couldn’t afford to buy the vaccine up front and wait to get paid back.
“We actually tried for a month to buy it, and the financial burden of it was too high,” Mobarhan said.
It can cost up to nearly $2,000 for the more than a dozen shots children receive in the first year of their lives. There’s another $230 for a kindergartener, and $530 for a sixth-grader. The cost can fluctuate depending on what brand of vaccine physicians buy.
Instead, Mobarhan and other doctors told WBEZ they send CHIP patients elsewhere, including to the west suburban Cicero Health Department. Some children come from communities at least an hour away, including Joliet and Lemont, said Tina Kane, the Cicero Health Department’s immunization coordinator.
In a statement that included Pritzker’s remarks, the Illinois Department of Public Health said it continues to recruit and retain providers to the VFC program.
“IDPH is currently working across agencies and with the governor’s office to identify ways to help reduce the burden of the program on providers, and to help them be compliant,” the statement said.
It’s not clear how Illinois officials plan to reduce the burden. But Dr. Ngozi Ezike, a pediatrician and the new head of the Illinois public health department, said she and other state leaders hope to have a solution in the coming weeks.
“We’re working on this actively, like every single day,” Ezike said in an interview. “Time, energy and effort is being expended into creating the pathway back to a system where we can get more providers on board to give immunizations.”
Kristen Schorsch covers Cook County politics for WBEZ. Follow her @kschorsch.