As a rule of thumb, each $1 spent to immunize a child saves $10 in future health care costs. Most countries recognize that a childhood immunization program is basic to public health and make early immunization a priority. With only three exceptions, countries in the Western Hemisphere can boast of immunization rates of more than 80 percent for children 2 years of age and older. The exceptions? Haiti, Bolivia and the United States.
Children are required by law to be immunized when they enter school, but younger children need protection, too. The fact that immunization rates for pre-school children in this country now hover between 40 and 60 percent -- and in many inner city areas drop as low as 10 percent -- suggests the depths of the health care crisis.
A number of factors contribute to the problem. In part because of higher liability costs, the price of vaccines has risen dramatically in the past decade, and immunizations are often not covered by private health insurance. In 1982, for instance, the cost of all the shots recommended for a child was about $23 from a private physician and less than $7 from a public health clinic. By 1991, recommended immunizations cost almost $200 from a private physician, and about $90 from a public clinic. The Clinton administration is reportedly considering making vaccines available free of charge to all children. That would be a big help, but there are other obstacles.
Access is one. Even the most conscientious parents can find themselves in a bind trying to get children to crowded clinics during working hours. If the clinics are not conveniently located, a parent can easily lose a full day of work.
Another obstacle is the task of keeping up with the immunization schedule. Families may have difficulty keeping track of which child needs which shot, and when. In a transient society, records can easily be lost in the move from place to place. Any solution should include a national registry to keep track of each child's immunization record.
All these factors will be crucial to improving immunization rates. But the crucial challenge is simply deciding that keeping children healthy is an important national goal.