Some Worry Immunization Bill Has Serious Pitfalls

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WASHINGTON--Secretary of Health and Human Services Donna E. Shalala and child-health experts extolled the virtues of the Clinton Administration's plan to insure immunization for all children during a joint Congressional hearing last week, while drug-industry executives and some state health officials testified that the legislation has serious pitfalls.

The "comprehensive child-immunization act of 1993,'' introduced by six lawmakers last month, is intended to insure that all children are fully immunized against nine childhood diseases by age 2.

It would also set up a national tracking system for immunization records and establish educational campaigns. Some 40 percent to 60 percent of preschool-age children fail to receive the recommended vaccinations, according to the federal Centers for Disease Control and Prevention.

The estimated cost of the entire effort is $1 billion a year.

"From the pediatric perspective, immunizations delayed are immunizations denied,'' Dr. Ed Marcuse, the president of the pediatrics academy in Washington State, told the panel.

But while drug manufacturers voiced support for the educational aspects of the bill, they asserted that its provision for purchasing vaccines in bulk for free distribution to physicians, clinics, and some hospitals would "nationalize'' the pharmaceutical industry and threaten research-and-development efforts.

Access, not cost, is the reason for low immunization rates, they said, adding that parents who neglect to seek immunization for their children are a significant part of the problem. Even in states that provide free vaccines, immunization rates have only slightly improved, they contended.

Entitlement for Affluent?

Several lawmakers also expressed reservations that the bill would create an "unecessary entitlement'' for affluent children whose parents can already afford vaccinations.

Ms. Shalala responded that 60 percent of children whose families have incomes above the federal poverty level do not receive immunizations by the time they enter school.

"This is an American problem,'' she said. "It's not just for poor children. One wealthy kid who gets measles in this country is a danger to every child he or she comes in contact with.''

She added that the Administration is committed to removing "all barriers'' to vaccination, and that a "means test'' would impose cumbersome reporting requirements.

Sen. Edward M. Kennedy, the Massachusetts Democrat who is chairman of the Labor and Human Resources Committee, said he hopes to have the bill ready for a vote by the time the President's health-care-reform plan is unveiled next month.

Vol. 12, Issue 31

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