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    Federal Health Officials Extol High U.S. Vaccination Rate

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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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