The Clinton administration unveiled another part of its childhood immunization plan this week, signaling again that it is serious about seeing improvements in access to health care, especially for children. Legislation introduced in Congress would provide for the government to buy vaccines from pharmaceutical companies and give them free to all children regardless of need. The legislation also directs states to set up immunization registries to keep track of each child's immunization records.
The plan attempts to reverse a dangerous decline in childhood immunization rates that has led to outbreaks of measles and other diseases that vaccines can easily prevent. But drug companies insist that government pricing will cut their profits and thus their incentive to invest in research and development of new and better vaccines. The vaccination battle is seen by many people as the prelude for an even stronger attack on pharmaceutical prices and profits that could come as part of the administration's health-care reform agenda. So don't expect the drug companies to let this plan sail through Congress without a fight.
Although the cost of vaccines has risen dramatically in recent years, money is not the only barrier to immunizations. Many private doctors have stopped giving vaccinations, since they are available much more cheaply at public health clinics. But for many parents, clinics are too far away or open only at inconvenient hours, and the multiple visits necessary to keep a child on schedule with immunizations can be a real hardship. Drug companies point out that the 11 states that already provide free vaccines do not have appreciably higher vaccination rates. Eliminating cost as a barrier is important, but so is the improvement of the delivery system.
However, an earlier part of the administration's immunization plan was a $300 million component included in the economic stimulus package. That money is earmarked for improving access and delivery for immunizations by allowing public health clinics to stay open longer, hire more nurses and conduct outreach and education programs.
In Maryland, the General Assembly appears likely to approve two immunization measures. One bill would allow parents to designate other adults to sign consent forms for vaccinations, an arrangement that gives official recognition to the realities of child-rearing today. Another bill directs the Department of Health and Mental Hygiene to come up with a plan for a childhood immunization registry to be presented to the General Assembly before the 1994 session.
Both measures deserve passage. State efforts, coupled with the administration's broader vision, should enable this country to boost immunization rates to respectable levels.