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Distribution Snag Means Free-Vaccine Program Is Delayed Indefinitely

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In at least 21 states and the District of Columbia, full implementation of the new federal Vaccines for Children Program has been delayed indefinitely, federal officials said last week. The program was to be up and running nationwide beginning Oct. 1.

The snag has come in finding a way to distribute free vaccines to private health-care providers, some of whom might not see drug shipments until next year.

There has been no such delay in supplying the medicines to public hospitals and clinics, officials said, largely because states already had a way to do that.

Last week, however, the Centers for Disease Control and Prevention, which is administering the program, was negotiating with vaccine manufacturers to have them deliver drugs directly to private providers in the states that cannot handle such distribution, said Laurie Johnson, a C.D.C. public-health adviser.

Ms. Johnson said officials have no idea how much longer the talks will take. The two sides are trying to work out what price the manufacturers may charge for these direct shipments, she said.

Some states, such as New York and Texas, scrambled to set up their own temporary distribution systems after the Clinton Administration decided over the summer to abandon plans to use a central, government-run warehouse to distribute vaccines. (See Education Week, Sept. 7, 1994.)

Getting drugs to thousands of private health-care providers was an unfamiliar logistical task for states. Many--including California, Pennsylvania, Maryland, and New Jersey--have simply been unable to offer the free vaccines to private providers, a central feature of the program.

Enacted by Congress last year, the Vaccines for Children Program is part of President Clinton's childhood-immunization initiative. Poor children, Native Americans, the uninsured, and those whose insurance does not cover vaccinations are eligible.

The young patients who are losing out on a new benefit, at least temporarily, are mainly uninsured children who go to private health-care providers. Instead of being able to give the children a free drug, physicians must still either charge for the medicine or refer the youngsters to a public-health clinic, said Dr. Donald Williamson, who heads Alabama's public-health department.

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