A shot in time

February 02, 1993

It's easy to forget that childhood diseases such as measles or mumps or whooping cough can be dangerous and even fatal. Easy, because immunizations make these diseases preventable. Childhood immunization is one of the most basic elements of any health care system -- and every dollar spent on immunizing a child saves $10 in future costs. So it says a great deal about the health care crisis in this country that one-fourth of America's pre-school children are incompletely immunized against preventable childhood diseases.

One problem is the cost. A decade ago, the price of a complete series of immunizations from a private physician was about $23. The whole series of recommended shots was available for a mere $6 or $7 from a public health clinic. Today, new vaccines and higher prices (largely due to increased liability costs) have raised the fees dramatically. The cost of immunizing a child through a private physician is now just under $200, and about $90 at a public clinic. Private health insurance does not generally cover the cost.

Those figures help account for the fact that among America's non-white pre-school children, immunization rates are now worse than Mongolia's. Sixteen other countries do a better job of protecting their children against polio. The measles statistics are equally telling: In 1990, more than 13,000 pre-schoolers came down with measles -- and 80 percent of those cases could have been prevented with a timely shot. Not surprisingly, 1990 saw a 68 percent increase over 1989 in the number of measles cases, and 89 people died from the disease, the highest number since 1971.

Against this background, the Clinton administration's consideration of a plan to vaccinate all children in the country can only be welcome news. The plan, which echoes some legislative efforts already percolating on Capitol Hill, would have the federal government and states buy up all childhood vaccines and make them available at no charge to private doctors and public health clinics. Without cost as a barrier, immunization rates would rise.

Pharmaceutical companies are critical of the plan, because it would crimp profits and, thus, hamper incentives for crucial research on new and better vaccines. These concerns are valid, but many health care experts think that they can be adequately addressed. Certainly the paramount goal -- giving young children a healthy start in life -- is worth the effort of working out a satisfactory solution.

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