Clinton free vaccine proposal challenged Some providers say cost is not necessarily major barrier

April 03, 1993|By Jackie Powder | Jackie Powder,Staff Writer

Some area health care providers question whether providing free vaccines is the best way to achieve the Clinton administration's goal of immunizing all young children.

Health experts say barriers other than cost prevent many children from being properly immunized.

"We have many patients who are not immunized, but it has nothing to do with accessibility or free care," said Dr. Ruth Ashman, chief of pediatrics for the Johns Hopkins Medical Services Corp., which operates several clinics throughout the Baltimore area.

"In some of our clinics in the inner city, people's lifestyles are sochaotic, and their priorities are with other things, like getting food."

Under President Clinton's universal immunization proposal, announced Thursday, the federal government would buy all vaccines from drug companies and provide them at no cost to public health clinics and private physicians, where patients now pay for their shots.

The immunization program would cost up to $1.5 billion a year, beginning in 1995, and would create a national tracking system to make sure that all children are protected against disease. The Clinton administration has said that only half the country's 2-year-olds are fully vaccinated against such diseases as polio, measles and whooping cough.

Diane Dwyer, the chief of clinical epidemiology for the state Department of Health and Mental Hygiene, said that in Maryland, 90 percent of children aged 6 months have started receiving vaccines. But only 55 percent are fully vaccinated by age 2.

Dr. Felix Kaufman, a pediatrician with a private practice in Towson, said that with free vaccines readily available at county health clinics throughout the state, availability isn't the problem.

"The concept of providing immunization to all kids, it's absolutely a first priority," said Dr. Kaufman. "But I'm not sure that the money [in Clinton's plan] wouldn't be better spent by finding out how to get these families into the clinics in the first place."

Dr. Ashman said that even when the state provided free transportation to patients at many of Johns Hopkins' inner city offices, people didn't take advantage of the service.

"We may have to look at other ways of getting immunizations to the families," she said. "I don't think it's as simple as saying, 'We've got immunizations, come and get them.' "

Despite doubts about some aspects of the immunization program, health care providers agree that for families who have no health insurance, it will be a great benefit.

The standard series of 12 immunizations and three oral polio doses, which all children should receive by age 2, costs about $325 through a private physician, including charges for office visits and administering the shots, Dr. Kaufman said.

Karen Stott, community relations director for the Baltimore County Health Department, said that providing free vaccines is only part of the solution. More of an effort must be made to distribute information about available health services to "hard-to-reach" populations.

"The program has to be developed further before we could say it's a good program," Ms. Stott said. "So far it's only an idea."

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