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Surgeon General Launches Immunization Campaign

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Washington--Calling the current measles epidemic a medical "crisis,'' Surgeon General Antonia C. Novello, joined by Hollywood stars and a national pediatrics association, last week launched a nationwide effort to increase immunizations among preschool children.

"I know that everyone in this room would jump from your seat and take off in a dead run to grab a child from the path of a car," Dr. Novello told reporters here.

"We are at that point with regard to immunization," she said. "We need to reach these children and protect them from harm."

The measles epidemic is the focus of the new "National Immunization Campaign." The number of measles cases has skyrocketed in recent years, from an all-time low of 1,500 cases in 1983 to 18,193 cases in 1989 and 27,672 cases in 1990. Last year, 89 deaths were believed to be measles-related, Dr. Novello said.

Outbreaks of rubella, or German measles, whooping cough, and polio are also on the rise.

The campaign is a joint effort of the Surgeon General, the American Academy of Pediatrics, and the Children's Action Network--a group of entertainment-industry leaders.

Such celebrities as Debbie Allen, Chevy Chase, Denzel Washington, and Robin Williams are expected to lend support to the campaign, which is designed to heighten public awareness about the need to immunize children as early as 2 months of age and to urge improved overall health care for children.

Nationally, activities will include print, radio, and television public-service announcements featuring Bill Cosby and other celebrities; a toll-free telephone number offering immunization information; movie trailers for use in theaters; and immunization themes in TV programs.

The campaign will also work with professional associations and health-care providers to coordinate the delivery of immunization services.

On the local level, the campaign is targeting nine "high-risk" communities--Chicago, Dallas, Houston, Los Angeles, Miami, New York, Philadelphia, Washington, and Huntington, W.Va.--to encourage grassroots activities by health-care providers and community groups.

During National Immunization Week, Sept. 21-29, the campaign will offer immunization screenings, free or low-cost vaccinations, and follow-up information at health-care sites in the target cities.

Nationwide, nearly one-third of 2-year-olds do not receive the proper vaccinations; as many as half of inner-city 2-year-olds are not fully immunized, according to the Surgeon General's office.

In a related event last week, a Gallup Organization poll commissioned by the American Academy of Pediatrics showed that while 9 in 10 households reported that their children had received vaccines for measles and polio, just 28 percent said they had immunized their children between 1 and 2 years of age.

States Demand 2 Shots

States have also stepped up their efforts to combat the epidemic.

Beginning this fall, 29 states, Puerto Rico, and the District of Columbia will require students who are entering either kindergarten or a higher grade to prove they have received two doses of the measles vaccine.

Until this year, entering students in virtually all states only had to prove that they had received one dose of the vaccine.

Medical experts recommend that children receive their first measles vaccination at 15 months, the youngest age at which the vaccine potentially can provide a child with lifetime immunity to the disease.

Recognizing that the vaccine does not provide immunity to about 5 percent of the children who receive it, the American Academy of Pediatrics in 1989 recommended that children receive a second dose on entering middle school or junior high school. Later that year, the Centers for Disease Control recommended that children receive the second dose before entering elementary school.

John A. Orvis, a public-health adviser in the cdc's immunization division, said his agency recommended that timing because children typically will see a physician at that time to get other required shots. In contrast, he said, states following the aap's recommendation probably would see a more immediate drop in the number of older students with measles.

Data collected by the cdc show that 21 states, Puerto Rico, and the District of Columbia now require students to have the second dose in order to enter kindergarten. Some of these states will also require older children to be immunized for a second time in order to enter the 6th, 7th, 8th, or 9th grade.

Eight other states will require middle-school and junior-high age students to get a measles booster shot.

But according to the Gallup survey, only 30 percent of households reported having a child who had received a second dose of measles vaccine. Forty-seven percent reported that no child had gotten a second immunization.

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