Funding of the US Centers for Disease Control and Prevention (CDC) immunisation program is threatened by the Republican's proposed American Health Care Act (AHCA), said Owen Dyer from Montreal, Canada, in an article published in the BMJ.

The proposed act will also remove funding from vaccination programs in individual states, heart disease screening programs, and programs for reducing nosocomial infections and antibacterial resistance, and will provide no funding for the CDC's blood lead surveillance program. Under the AHCA, the federal Prevention and Public Health Fund established by the Affordable Care Act would end from October 2018, and no replacement has been suggested.

Over 500 organisations including charities, local health departments, public health organisations and universities have signed an open letter warning President Donald Trump of the consequences of repealing the funding under the proposed AHCA.

According to Shelly Diaz from the CDC, the Prevention and Public Health Fund has grown from 2.8% of the CDC total program budget in 2010 to 12.4% of the budget in 2016 ($324 million), accounting for over 50% of the costs of the health and immunization program. Loss of the funding would reduce the ability of the CDC to prevent pandemic influenza and other vaccine-preventable infectious diseases. The Prevention and Public Health Fund also provides funding for CDC grants to states for public health and social services, totalling $625 million.

"CDC has estimated that vaccination among American children born from 1994 to 2013 would prevent around 21 million admissions to hospital and 732 000 deaths over the course of their lifetimes, with a net savings of $295bn in direct costs and $1.38 trillion in total societal costs," Owen Dyer commented.

"Americans will be at greater risk from vaccine preventable disease, foodborne infections, and deadly infections contracted in hospitals" if preventive funding is lost, said Tom Frieden, former director of the CDC.