02/21/1996 09:30 AM Senate HES

 SHES - 2/21/96                                                                
                                                                               
        SB 185 IMMUNIZATION RECORD UPON CHILD'S DEATH                        
                                                                               
 CHAIRMAN GREEN introduced  SB 185  as the next order of business              
 before the committee.                                                         
                                                                               
 DR. JOHN MIDDAUGH, Epidemiology Section of the Department of Health           
 & Social Services, pointed out that SB 185 does not specify for               
 what purpose the information would be collected.  He assumed that             
 the information would be collected in SIDS cases and other                    
 unexplained deaths of children which could be related to                      
 vaccinations in order to illuminate these potential connections.              
 Dr. Middaugh expressed concern about the logistics of the bill as             
 well as the science and value of collecting such information.  Many           
 studies reviewing the association of vaccinations with SIDS and               
 unexplained deaths in children have been performed, particularly              
 reviewing the relationship between the administration of DPT and              
 SIDS.  Those studies have demonstrated that there is no causal                
 relationship between a child receiving a vaccination and                      
 subsequently dying of SIDS.                                                   
                                                                               
 The logistics of collecting this information is difficult and                 
 possibly even unworkable.  Dr. Middaugh informed the committee that           
 there are 11 different standard vaccines children receive 23                  
 separate times in their first seven years.  He pointed out that               
 children move around and go to multiple providers.  Also some of              
 the information to be collected under SB 185 is not routinely                 
 recorded on a child's vaccination record.  Therefore, the ability             
 to collect the information is questionable.  Even if the                      
 information could be collected, Dr. Middaugh questioned the                   
 scientific value of the information because it would not review               
 other important considerations.  Dr. Middaugh informed the                    
 committee that Dr. Gessner was present and could discuss some                 
 research being done with SIDS.  Dr. Middaugh noted that work is               
 being done to understand and improve the prevention activities.               
                                                                               
 Number 557                                                                    
                                                                               
 DR. BRAD GESSNER, Maternal Child & Family Section of the Department           
 of Health & Social Services, said that he was a pediatrician and an           
 epidemiologist.  He viewed the issue as mainly in children less               
 than one year of age.  The majority of children dying under the age           
 of one die from prematurity and congenital anomalies which normally           
 happens in the first 28 days of life.  Generally, SIDS' deaths                
 occur after that period, around the 90th day of life.  Dr. Gessner            
 agreed with Dr. Middaugh that there is no evidence in the                     
 scientific literature that there is a relationship between SIDS or            
 unexplained infant deaths and vaccine delivery of any type.                   
 Current literature suggests that placing an infant on its back to             
 sleep can reduce the SIDS rate.  Also an increased SIDS rate has              
 been found when smoking occurs during pregnancy and post-pregnancy.           
 Dr. Gessner pointed out that the Infant Mortality Review Committee            
 was established in order to review the causes of infant death in              
 order to address SIDS in Alaska.  SIDS rates in Alaska are higher             
 than other states.  Three years of data confirms that there is a              
 relationship between infant deaths and maternal smoking and sleep             
 position.   Dr. Gessner stated that the data does not illustrate              
 any relationship between infant deaths and vaccine delivery.                  
                                                                               
 SENATOR LEMAN asked if the information requested last time was                
 available; the information regarding the number of deaths of                  
 children under seven which were unexplained.                                  
                                                                               
 TAPE 96-12, SIDE B                                                            
                                                                               
 In response to Senator Leman, CHAIRMAN GREEN said that she had                
 received some information, however it did not exactly answer the              
 question.  There is a list of the unknown causes of death, but                
 there is not a list of the other causes of death of children under            
 seven.  She informed the committee that on average, 29 deaths                 
 annually were listed as resulting from SIDS and three deaths                  
 annually from unknown causes.  Those numbers come from an average             
 of 151 each year.                                                             
                                                                               
 SENATOR LEMAN said that he would review the information and be                
 prepared to continue this discussion in the next committee of                 
 referral.                                                                     
                                                                               
 Number 577                                                                    
                                                                               
 SENATOR LEMAN moved that SB 185 be moved out of committee with                
 individual recommendations.  Hearing no objection, it was so                  
 ordered.