Jackson County health officials warn falling vaccination rates, funding gaps threaten local vaccine access

Ray Daligalecki, assistant director at Jackson County Public Health, told the Jackson County Health and Environment Committee on a standing presentation that declining vaccination coverage and shrinking federal and state support are creating strains on local vaccination services.

"The evidence is quite clear. Vaccines are one of the greatest public health achievements in history," Daligalecki said, outlining declines in childhood immunization and pressures on local programs.

Daligalecki said Eastern Jackson County vaccination rates have fallen for three straight years for DTaP (diphtheria, tetanus and pertussis), MMR (measles, mumps and rubella) and polio. He said MMR coverage in Eastern Jackson County was once about 95 percent before the COVID-19 pandemic and is now as low as 86 percent in parts of the county—roughly 9 percentage points below the commonly cited community-immunity threshold for measles.

The county official told the committee that measles and other outbreaks carry substantial local costs: smaller responses can cost communities hundreds of thousands of dollars, while larger outbreaks can run into the millions. He cited recent national and regional measles activity as an example of fiscal and operational strain on health systems.

Daligalecki described changes at the federal level—shifts in advisory panels and proposed budget reductions for vaccine research and public-health programs—as drivers of uncertainty for the annual respiratory vaccine rollout. He explained the usual process by which vaccine formulations are selected in the winter and spring, production is scaled in summer, labeling and coverage are finalized by the FDA and CDC, and supplies arrive in fall. This year, he said, "the dominoes are missing, wobbling, or stalled," complicating timing and access.

At the local level, Daligalecki urged attention to the Section 317 vaccine program, which the health department uses to provide vaccines for uninsured and underinsured adults. He said Jackson County Public Health served just over 1,600 clients through the program but state pass-through funding covered roughly 665 of those people. The health department absorbed about $113,000 in uncompensated vaccine costs this year and estimates the annual Section 317 funding gap at roughly $112,000 to $125,000; he warned the shortfall is likely to grow if state funding declines.

Daligalecki also outlined operational strengths the county uses to deliver vaccines: a rideshare transportation program, a mobile clinic with dozens of community events this year, low-cost services compared with many private clinics, and cultural health navigators who provide interpretation for about 35 percent of clients.

He said post-pandemic costs are rising, with labor up about 10 percent year over year and vaccine and supply costs up about 56 percent. He recommended intentional preventive-public-health funding, consolidation or coordination of overlapping administrative efforts, and targeted investment to close the Section 317 gap so the county can avoid larger downstream health-care costs.

Committee members asked for more detail. Committee Chair Jalen Anderson requested a copy of the presentation; Daligalecki agreed to email it and to return for monthly updates. Legislator Lauer and Legislator Megan Smith praised the department’s recent national accreditation; Daligalecki said accreditation demonstrates the county provides the basic foundational public-health services expected for residents.

Daligalecki also urged modernization of local surveillance systems — for example, wastewater monitoring — to better detect respiratory and other pathogens as testing and mandatory reporting have declined since the COVID-19 emergency response. He noted the county has detected mpox in wastewater and said similar tools could be used to monitor polio, measles and opioid activity.

At the close of the meeting, Committee Chair Anderson announced a public hearing on an ordinance related to the undesignated fund; the announcement listed either Sept. 15 or Sept. 22 at 1 p.m. as possible hearing dates.

For the record, Daligalecki said that the health department can prepare a budget-level estimate for a program that would avoid turning away uninsured or underinsured residents.

The presentation focused on public-health program continuity and planning; the committee did not take formal action on the recommendations during the session.