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Clinton Compromises on Immunization Proposal

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WASHINGTON--Facing pressure from Congress and the pharmaceutical industry, the Clinton Administration last week backed off from its $1.1 billion-a-year proposal to buy up and provide vaccines to all children regardless of their families' ability to pay.

Instead, the Administration unveiled a less costly plan that would provide vaccines against the most common childhood diseases only for children receiving Medicaid or for those who lack health insurance.

Children whose health plan does not cover vaccines would also be covered. Some experts estimate that half of all health plans do not cover vaccinations.

Secretary of Health and Human Services Donna E. Shalala said at a hearing on the bill last week that she is considering "provisions to try to prevent insurance companies from dropping immunization'' benefits once the plan is in place.

The Administration estimates that the compromise will cut the annual cost of the program by $300 million.

Congressional leaders had been warning the President that he lacked sufficient support for his original plan, which would have made the federal government the sole purchaser of childhood vaccines.

Pharmaceutical makers also opposed the plan, arguing the resulting revenue losses would retard their future research efforts.

Details Sketchy

Although details of the plan were still being developed last week, eligible patients would likely obtain the free vaccines from their doctors by checking a box on medical-intake forms. Doctors would be entitled to "sufficient free vaccines'' from the government to serve needy patients.

Pharmaceutical companies remain dubious that safeguards exist to insure that only eligible children receive the vaccines.

"While the new proposal represents a step in the right direction, it's not a big enough step,'' said Pamela Adkins, a spokeswoman for Merck & Company, one of the nation's largest vaccine makers.

The scaled-back proposal is a victory for lawmakers who had argued against subsidizing vaccines for middle-income and wealthy children.

But some child-health advocates were disappointed. Lisa Tate, a spokeswoman for the American Academy of Pediatrics, said, "We would prefer the universal purchase, but obviously Congress will not let that happen, so we'll take what we can get.''

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