Apologies if you, like Morrissey, are fed up with the all the hoopla surrounding Britain's big day tomorrow. When it comes to the Royal Wedding (or the Wedding of the Century, D-day, take your pick) there's no rest for the weary. After much speculation over the decision for post-wedding entertainment, The U.K.'s Daily Mail reports that Ellie Goulding has been asked to perform at the after-dinner reception at Buckingham Palace, following Prince William's marriage to Kate Middleton. Goulding will honor the couple with her cover of Elton John's classic "Your Song" (embedded below), and is reportedly the only musician slated to perform for Will, Kate and 1,900 of their closest family and friends. So, no pressure or anything.

The royal couple are apparently big fans of the 24-year-old, whose 2010 album Lights helped her star rise in the U.K., receiving Critics Choice at the Brit Awards and landing at the top of the BBC Sound of 2010 poll. Overall, Goulding is a sensible choice; her music is current yet still appropriate for 90-year-olds. But if Will and Kate were secretly hoping to catch Queen Elizabeth break it down to "'03 Bonnie and Clyde," Beyoncé and Jay-Z are probably still available.

HMOs have varying approaches to promoting new chicken pox vaccine

AP Online October 28, 1998 | PHIL GALEWITZ AP Business Writer PHIL GALEWITZ AP Business Writer AP Online 10-28-1998 NEW YORK (AP) _ When the nation's first chicken pox vaccine was approved in 1995, it won the endorsement of federal health officials and the American Academy of Pediatrics.

But Robert Steele, a Springfield, Mo., pediatrician, decided his 2-year-old son Ryan could live without it.

Steele had doubts the vaccine would give a lifetime of immunity. While childhood chicken pox is usually a mild affliction that leaves kids immune the rest of their lives, Steele feared the vaccine would eventually lose its potency and leave Ryan vulnerable in adulthood, a time when the disease can turn deadly.

Steele's concerns as a parent and a doctor are the reasons why public health officials are having a hard time trying to raise acceptance of the chicken pox vaccine to the levels of other childhood immunizations. in our site chicken pox vaccine

It's a problem made worse because the managed care insurance industry, which usually wins praise for its focus on preventing illnesses, has failed to wholeheartedly recommend the new vaccine.

That resistance can be seen clearly when examining how well health maintenance organizations have done innoculating its customers.

Nationally, HMOs last year vaccinated nearly 39 percent of children for chicken pox, according to a National Committee for Quality Assurance survey of 447 health plans. While the HMO chicken pox vaccine rate was higher than the 26 percent U.S. average, it still was only about half the vaccination rates for other childhood diseases.

Although all HMOs pay for the chicken pox vaccine, the National Committee's report found immunization rates varied from 15 percent to 76 percent. The range mirrors the different approaches and attitudes HMOs take toward the vaccine.

Some plans such as Aetna-U.S. Healthcare have aggressively tried to persuade parents to use the vaccine by sending mailings to parents and paying doctors bonuses for high immunization rates.

Other plans, including United Healthcare and Foundation Health, say they cover the $41 vaccine, but do little else to increase its use. PacifiCare, the giant 1.8 million member California-based HMO, was ordered by the state last spring to stop discouraging doctors from giving children the vaccine.

How HMOs and other types of managed care promote the vaccine to doctors and consumers is a big factor determining whether the vaccine becomes part of standard pediatric medicine, health officials say.

Health plans will soon face a similar test when they decide whether to cover or promote the new vaccine for rotavirus, the leading cause of childhood diarrhea. The FDA approved the vaccine in August; health plans are now awaiting the Academy of Pediatrics' recommendation before determining coverage.

Widespread vaccination could prevent 1 million American preschoolers every year from getting diarrhea caused by rotavirus and keep 34,000 out of the hospital, said manufacturer Wyeth-Ayerst Laboratories.

Like chicken pox, rotavirus is rarely fatal, which may cause some HMOs not to promote it the same way they do vaccinations for polio or measles, child health experts say.

``If managed care plans are not enforcing these things we could end up with a lot of susceptible kids,'' said Dennis Murray, a professor of pediatrics at Michican State University.

Jodi Kroeger, a spokeswoman for Merck & Co., maker of the chicken pox vaccine, responded to concerns about its long-term effectiveness by saying it has worked well in Japan for over 20 years.

Dr. Richard Nelson, a pediatrician at the University of Iowa and an official with the Academy of Pediatrics, said HMOs have no excuse not to actively promote the chicken pox vaccine. ``When you are not promoting it and informing people you are exposing yourself to liability when someone has an adverse reaction to the disease,'' he said. chickenpoxvaccinenow.net chicken pox vaccine

The federal Centers for Disease Control and Prevention estimates 4 million cases of chicken pox occur each year in the United States and result in 5,000 to 9,000 hospitalizations and 100 deaths.

Humana Inc. officials say they promote the chicken pox vaccine no differently than other child immunizations. The Louisville-based health plan admits it has trouble convincing parents that chicken pox can be dangerous.

``The vast majority of parents view this as a minor illness that they went through it and their kids will make it through,'' said Dr. Matthew Emons, Humana's director of health improvement.

Seattle-based Group Health Cooperative of Puget Sound downplayed the chicken pox vaccine for its first three years. As a result just 16 percent of its customers got the shot, according to the National Committee.

Group Health this year softened its position, and now tells its doctors to give parents information about the vaccine. The plan also recommends giving the shot to 11-year-old children who have not had the disease. The federal government recommends doctors give it at one year.