By Brenda Goodman, CNN

(CNN) — Millions of dollars have been pulled from state and local vaccination programs with no explanation, after a review of the funding agreements by the US Department of Health and Human Services.

Affected programs say they will probably have to cut staffers and services because of the shortfall, and they worry that vaccination rates will also drop as they lose the ability to assist people who are low-income or uninsured.

Immunization programs across the country are already struggling to address an increase in vaccine-preventable diseases. These include pertussis – also known as whooping cough – which has sickened more than 10,000 Americans and killed five children this year, as well as a smoldering outbreak of measles that has killed three people in the

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