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Shift in Vaccine Program Could Snag Distribution, States Say

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Washington

Several states, eager to get free vaccines to children under a new federal program, are concerned that the Clinton Administration's decision to scrap the program's distribution plan will stall the effort.

The Administration decided last month not to distribute the free vaccines using a central, government-run warehouse--an idea that has been maligned by child-health advocates, federal auditors, and members of Congress.

Instead, the Vaccines for Children Program, approved by Congress last year, will use a "private sector" distribution system that is still being worked out, according to federal and state officials.

The vaccine program is scheduled to begin Oct. 1, and a spokeswoman for the federal Centers for Disease Control and Prevention, which runs it, said those plans have not been affected by the sudden logistical change.

But public-health officials in some states questioned whether they will be able to get the drugs to all of the health-care providers who want them, even if the free vaccines are made available to them on Oct. 1.

The Vaccines for Children program is one part of President Clinton's childhood-immunization initiative. It is designed to provide free vaccines for poor children, Native Americans, the uninsured, and those whose health insurance does not cover vaccinations. A key element of the program is allowing children to get vaccinated at private medical offices as well as at public-health clinics.

The District of Columbia and 26 states--including California, New York, Pennsylvania, and Texas--had planned to depend, at least in part, on the federal distribution system. Ten of those states, including New Jersey, intended to rely on the federal system exclusively.

New York State 'Scrambling'

The Administration's recent announcement has some state officials worried that a new national distribution network may not be up and running by Oct. 1. They are either waiting with fingers crossed or scrambling to put together their own makeshift systems for getting the drugs to health-care providers.

"The decision not to have the central distribution system really caused a very large problem because the vaccines will still be available, but the federal method of distribution will not be," said Dr. Lloyd F. Novick, the director of public health for New York State, who oversees health programs outside New York City.

He said state officials were "scrambling" last week to sign up their own private pharmaceutical distributors to deliver to at least 800 points around the state for about six months. Dr. Novick said he was "hopeful" that they can meet the intended starting date.

In his state, Dr. Novick said, only about half of the 250,000 two-year-olds living outside New York City have been properly vaccinated.

Congressional criticism of plans to use a General Services Administration warehouse in New Jersey to store and distribute vaccines intensified this summer after the General Accounting Office released a report on the initiative. (See Education Week, Aug. 3, 1994.)

The report questioned whether the program would be ready to begin Oct. 1. Some of its criticisms were specifically aimed at the G.S.A. warehouse, which investigators noted does not have experience in shipping vaccines.

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