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C.D.C. Head Backs Linking Immunizations, Federal Poverty

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Benefits By Ellen Flax

Washington--The U.S. Centers for Disease Control supports the idea of requiring preschool-age children to be immunized against common diseases in order for their families to receive federal poverty benefits, the agency's top official said last week.

At a hearing before the House Subcommittee on Health and the Environment, William L. Roper, the director of the cdc, said he would favor a policy linking a family's continued enrollment in public-assistance programs with the immunization status of its young children.

While a child's immunization status should not be used as a criterion for his family's initial enrollment in such a program, Dr. Roper said, it could be used to determine the family's eligibility for future benefits.

"The intent is to help children enrolled in public-assistance programs, not to punish them," he said.

Dr. Roper made his comments at a hearing on the nationwide measles epidemic. During 1989, more than 18,000 cases of measles were reported, the largest number since 1978 and more than 10 times the number of cases reported in 1983, when there was a record-low number of cases.8The measles caused 41 deaths in 1989, the largest number of such deaths in almost 20 years.

Last year, the epidemic intensified, with more than 26,000 cases and more than 60 deaths reported.

A disproportionate number of cases and deaths occurred among unvaccinated preschool-age children. Although virtually all children meet states' requirements to be vaccinated against the measles by the time they enter school, many children, especially those from poor and minority backgrounds, do not receive the vaccines while they are infants and toddlers, as is recommended by the cdc

At the hearing, Dr. Roper did not say whether he was supporting a legislative or a regulatory change to link immunization status with government-assistance programs.

He said cdc demonstration projects were under way in Chicago, Jersey City, N.J., and New York City to evaluate different ways of providing immunization services to recipients of federal benefits, including giving vaccinations at benefits offices or escorting children to nearby clinics for "express lane" immunizations.

Representative Henry A. Waxman, Democrat of California and the subcommittee's chairman, said he did not support Dr. Roper's proposal. Before the government can talk about cutting off benefits, he said, it has to make a better effort to immunize poor children against diseases.

But Mr. Waxman praised President Bush's proposed budget for the 1992 fiscal year, which contains nearly $258 million for immunizations--a $40-million increase over this year's level and the program's first significant boost in a decade.

"After years of neglect, the immunization program can begin to repair its losses and perhaps begin the task of lowering childhood disease," Mr. Waxman said.

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