Federal Health Officials Extol High U.S. Vaccination Rate

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July 6, 2000 (Washington) -- Good news on the vaccine front: The vaccination rate for U.S. children has reached its highest rate ever, according to statistics released Thursday by the Department of Health and Human Services.

"Thanks in large part to these high immunization rates, we have seen a breathtaking decline in suffering and death from most vaccine-preventable diseases," said Health and Human Services (HHS) Secretary Donna Shalala, PhD, in a news release.

Overall, about 80% of preschoolers got their scheduled inoculations in 1999, a figure similar to the previous year. The state-to-state vaccination rate varied from Vermont's 90.5% at the top to Oregon's 72.3% at the bottom, according to the CDC.

Four particular vaccines showed a big jump, based on a study published in the July 7 issue of the Morbidity and Mortality Weekly Report, a publication of the CDC. The vaccination statistics show that 93.5% of preschoolers are getting immunized against Haemophilus influenzae type B (Hib), 95.9% of children are receiving three doses of diphtheria, tetanus, and pertussis (DPT) vaccine, and almost 90% are taking the hepatitis B shots. And for the first time, more than half of the children surveyed has gotten the relatively new chickenpox vaccine.

HHS says that the number of kids protected by vaccination has gone up from 55% in 1992 to its current 80% level. However, the news isn't all good. There are pockets of medically under-served people in cities like Houston, Chicago, and Detroit where the vaccination rate is just 60%. And an estimated 900,000 U.S. children weren't vaccinated last year.

Although Shalala told those attending the CDC's National Immunization Conference here that the government has made "extraordinary strides," she also said that the number of vaccinated children needs to be 100%. The CDC says 11,000 babies are born every day in the U.S., creating an ongoing challenge.

In an effort to reach full vaccination coverage, Shalala announced a $100 million "new, major investment" intended to encourage state Medicaid plans to develop vaccination registries that would help doctors keep track of what shots a child needs, even if the child moves from health plan to health plan.

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"I'm talking about confidential information systems used by providers to determine vaccine needs as well as to help them remind parents and other caregivers when their child is due for a vaccine," Shalala told the group.

On the question of helping the 20% who've fallen through the vaccination safety net, Shalala tells WebMD that part of the problem is finding ways to overcome racial and ethnic disparities. Another issue is that several new vaccines have become available in recent years.

"It's a mixed bag, and as we introduce new vaccines, it's hard to get the numbers to 100%, because it takes awhile to ... ramp up on a new vaccine," Shalala says. She insisted that the government would try to reach the 900,000 unvaccinated children in various ways.

"It's not just one thing. ... It's a lot of little things," Shalala says.

Just last month a report issued by the Institute of Medicine for the U.S. Senate Appropriations Committee warned that the nation's immunization system was "unstable," particularly in its efforts to reach the poor.

"If the 80% [immunized] is a result of still having those large, much more poorly immunized populations in those pockets, then that's not a good situation," Bernard Guyer, MD, chair of the report panel, tells WebMD.

Still others fear that the high immunization rate itself could be bad news, at least in some cases. Jane Orient, MD, executive director of the politically conservative Association of American Physicians and Surgeons, says public health officials are using coercive tactics to get children vaccinated, ranging from requiring the shots before school enrollment to denying families welfare payments if their children aren't vaccinated.

Orient also disputes the notion of giving hepatitis B shots to newborns, because the infection is rare among the young. However, she concedes that vaccinations for tetanus, diphtheria, and pertussis are still necessary.

"We should go back to the idea where it was a matter of the doctor making a recommendation to the parents on an individual basis," Orient tells WebMD.

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