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1992.01.10 :  Detroit Childhood Immunization

Contact:  HHS Press Office (202) 245-6343
January 10, 1992

     DETROIT, Mich. -- HHS Secretary Louis W. Sullivan, M.D.,
today was joined by Governor John Engler and Mayor Coleman Young
to unveil the Detroit early childhood immunization plan -- the
fourth of six plans developed to address under-immunization of
America's youngest and most vulnerable citizens and to ensure 90
percent of children under 2 are fully immunized by the year 2000.
     Secretary Sullivan said, "With health care costs stretched
to the limit, we can't afford NOT to immunize our youngest
children.  For every $1 spent on measles, mumps and rubella
immunization, for example, $14 in costs to society are saved."
     Secretary Sullivan was accompanied by U.S. Department of
Agriculture Assistant Secretary for Food and Consumer Services
Catherine Bertini; HHS Assistant Secretary for Health James O.
Mason, M.D., who heads the Public Health Service; Surgeon General
Antonia C. Novello, M.D.; and William L. Roper, M.D., director of
the Centers for Disease Control. 
     Under-immunization of our nation's 2-year-olds gained
widespread attention recently with the largest reported measles
outbreak in the nation in 20 years -- with more than 27,600 cases
and 89 deaths reported in 1990.  The immunization plan for the
Detroit area is its contribution to the nationwide effort to
provide more innovative and effective means for vaccinating
children who are not now being reached.
     President Bush proclaimed early childhood immunization a
priority for his administration in a Rose Garden ceremony for
immunization experts on June 13.  At that time, he called on
Secretary Sullivan and leading public health officials to travel
to Dallas, Phoenix, Rapid City (South Dakota), Detroit, San Diego
and Philadelphia to see what could be done by local health
officials to get "kids (vaccinated) at an earlier age...To solve
the problem of late immunization, we've got to assault it from
all angles and levels with public health efforts, with creative
partnerships between the nonprofit and the private sectors, with
conscientious action on the part of parents, teachers and
citizens."
     A recent analysis of Detroit's 2-year-old population showed
that only 57 percent of these children had received the measles,
mumps and rubella (MMR) immunization, and only 31 percent had
received all vaccines (4 DTP, 3 OPV and 1 MMR).  The Detroit plan
attempts to correct this situation by improving service delivery. 
For example, it will:
     o    establish new walk-in immunization clinics offering
          immunizations Monday through Friday, over four hours
          per day (e.g., Herman Kiefer Complex, Beryl Spruce and
          Harper-Gratiot);

     o    establish a rotating team composed of at least one
          Public Health Nurse and one clerk to extend hours for
          immunization services from four to eight hours at Grace
          Ross, Eastside, Bruce Douglas and Northeast;

     o    establish a new immunization service in conjunction
          with the WIC (Women, Infants and Children) supplemental
          food program;

     o    establish linkages between immunization activities and
          Detroit area maternal and infant outreach or maternal-
          child health (MCH) programs;

     o    establish and provide free immunization services to
          children 0-4 years of age residing in and/or about
          Detroit's public housing projects;

     o    assess the immunization status and immunize the
          eligible pediatric in-patient population at Children's
          Hospital.

        The City of Detroit proposes to implement a multilingual
"Bring Your Record Campaign" to stimulate parents of at-risk
children to keep good records, keep appointments and ensure their
children are fully immunized.  The campaign will include a
variety of materials (posters, billboards, transit cards and
pamphlets) and will be promoted simultaneously by primary care
centers, WIC centers, evening clinics, private health care
providers, Children's Hospital and government agencies. 
Immunization information packets that are audience-appropriate
would be distributed through existing outreach programs like
Healthy Start, Latino Outreach Program, Operation Get Down and a
number of others.

        The plan allows for tracking and assessing immunization
levels through unique partnerships with social and health
services, such as, Maternal and Child Health/Maternal and Infant
Outreach programs, EPSDT, and Detroit Housing Department, to name
a few.

     Dr. Sullivan complimented the Detroit Health Department on
an "outstanding plan" for immunizing children age 2 and younger. 
"When implemented," Secretary Sullivan said, "the plan will
ensure that our most vulnerable, younger children are protected
against eight preventable diseases which can cripple, impair and
kill--diphtheria, tetanus, pertussis or whooping cough, polio,
measles, mumps, rubella and bacterial meningitis." 

     The Detroit effort fits into the ongoing national
immunization initiative, Dr. Sullivan said.

     o    The federal immunization budget has more than doubled
          in the past three years, growing from $98.2 million in
          FY '88 to $217.5 million in FY '91.  
     
     o    The Detroit early childhood immunization plan is the
          fourth of six local area plans being developed around
          the country   --Dallas, Maricopa County (Phoenix) and
          (Rapid City) South Dakota have completed their plans;
          and San Diego and Philadelphia are in development. 
          These cities are representative of areas around the
          nation and the immunization problems they all face. 
          These plans, when completed, will be used to guide over
          56 other immunization project areas around the country
          as they develop their community-specific plans over the
          next 12 months.  The aim is to have local plans in
          place, nationwide, to address the under-immunization
          needs of individual communities.

     o    The ongoing national immunization initiative consists
          of several key actions to address under-immunization
          problems.  For example:

          --   development of new standards for immunization
               practices to be adopted by all public and private
               vaccine providers in America;

          --   sponsorship of 18 new intervention and assessment
               demonstration projects in 14 different cities and
               states to test the effectiveness of new approaches
               to raising immunization levels;

          --   formation of an immunization unit in the Healthy
               Mothers-Healthy Babies Coalition specifically to
               address health issues for these constituents,
               including infant immunization; 

          --   formation of a federal interagency coordinating
               committee to unite all key federal partners with a
               role in immunization.

     Getting children immunized in order for them to go to school
is not enough, Dr. Mason said:  "We as a nation do a great job of
getting our kids immunized by the time they go to school --
partly because many school systems require it.  But the outbreak
of measles shows our kids are vulnerable to fast-moving,
potentially crippling epidemics because we are not reaching our
children at the appropriate times -- starting at 2 months and at
specific times during the first 2 years of life."

     At the local press conference, Dr. Sullivan reiterated HHS' 
commitment to the immunization goal.  He said the Centers for
Disease Control, a Public Health Service agency within HHS, is
committing resources, both people and dollars, to several
immunization projects -- (1) pilot projects linking immunization
with WIC services, (2) school-based retrospective surveys to
assess community-wide immunization levels, (3) pilot tests of new
computer software for the purpose of clinic-based immunization
assessment and (4) an evaluation of the perinatal Hepatitis B
screening and vaccination program.  CDC technical experts in data
systems management, program administration, evaluation and
information-education outreach also provided assistance to
Detroit in developing its plan.  Dr. Sullivan also stated that he
looked forward to coming back to see Detroit's progress in
implementing the plan.

     The Detroit plan was developed by the city health department
in cooperation with public and private sector agencies within the
community.  Once implemented, these activities will raise
immunization coverage levels and, as a result, reduce the number
of children who would otherwise suffer from vaccine-preventable
disease.
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