*This is an archive page. The links are no longer being updated. 1992.02.13 : Philadelphia Childhood Immunization Contact: HHS Press Office (202) 245-6343 February 13, 1992 PHILADELPHIA, Pa. -- HHS Secretary Louis W. Sullivan, M.D., today met with local participants to unveil the Philadelphia early childhood immunization plan -- the last and the largest of six urban and regional plans developed to remedy the under-immunization of America's younger children. The six plans will be used to guide approximately 80 immunization project areas and large cities as they develop their plans in *This is an archive page. The links are no longer being updated. 1992. The aim is to have local plans in place nationwide and thus ensure that at least 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 dollar spent on measles, mumps and rubella immunization, for example, $14 in costs to society are saved." Secretary Sullivan was accompanied by HHS Assistant Secretary for Health James 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 two-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. In the Philadelphia epidemic of 1990-91, there were 1,559 reported cases, including nine deaths (compared to only 16 reported cases in 1986). As a result of the upsurge, President Bush proclaimed early childhood immunization a priority for his administration in a Rose Garden ceremony before Congressional leaders and 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..." The president said, "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, and with conscientious action on the part of parents, teachers, providers and citizens." Responding, Philadelphia has developed a city-wide plan that represents a collaborative effort of more than 75 major health, social, religious, business, civic agencies/organizations in the region. Representative of the noteworthy commitments in the plan, the Children's Hospital of Philadelphia and the St. Christopher's Hospital for Children have agreed to make immunizations available to pediatric inpatients before they are released from their care. St. Christopher's has also committed to administering immunizations or referring to their hospital outpatient clinic those children seen in their emergency room. Many of the victims of the Philadelphia epidemic were children under 5. Many resided in the city's most socioeconomically disadvantaged neighborhoods. In Philadelphia, the fifth largest city in the United States, there are approximately 60,000 children under 2. As many as 10 percent of those children reside in public housing or shelters for the homeless. In a recent retrospective study, 54 percent of those surveyed were not fully immunized. Some of the most significant commitments of the plan include innovative solutions in service delivery in the public/non-profit sector, through community linkages and in the private sector. For example: o SERVICE DELIVERY will focus on the (1) implementation of expanded services in the various health centers, hospitals, private practitioners' offices, and alternative delivery sites, such as, public housing developments and homeless shelters, (2) development and implementation of policies to expedite immunization, and (3) exploration of new ways to deliver services. o SERVICE LINKAGE will be established with the Philadelphia Department of Public Health's Office of Maternal and Infant Health, including its Healthy Start Initiative to reduce infant mortality in the area west of the Schuylkill River, so that these programs offer immunization services to their clients. Additional linkages will be established with the city's WIC (Women, Infant and Children) nutrition centers, Aid to Families with Dependent Children offices, day care facilities, Head Start centers, Department of Human Services offices, EPSDT screening sites, and managed care organizations. o OUTREACH AND EDUCATION will depend on community-based organizations playing a vital role in the outreach effort which will focus on the development of educational materials, professional education, and a mass media campaign to maintain public awareness. o TRACKING efforts will include implementation of a computerized management information system to track immunization data -- something the city currently does not have. o EVALUATION will consist of analyzing results of the expanded immunization services against baseline data. Surveillance/disease investigation activities will be broadened to include immunization of eligible household contacts against all vaccine-preventable diseases. o RESEARCH will examine the knowledge, attitudes, beliefs and behaviors of health care providers and consumers to identify factors contributing to low immunization levels and appropriate interventions will be developed based on findings. Dr. Sullivan complimented the Philadelphia Department of Public Health 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 Haemophilus influenzae type b which causes bacterial meningitis." The Philadelphia effort fits into the ongoing national immunization initiative, Dr. Sullivan said. o The federal immunization budget has more than tripled in the past four years, growing from $98.2 million in FY '88 to $297 million in FY '92. The FY '93 budget request adds another $52 million for childhood immunizations, for a total of $349 million. o The Philadelphia early childhood immunization plan is the last of the six local area plans developed around the country in 1991-92--Dallas City and County, Maricopa County (Phoenix), South Dakota State (Rapid City), Detroit City, San Diego County, and Philadelphia County. These areas are representative of others around the nation and the immunization problems they face. The plans will be used to guide approximately 80 immunization project areas and large cities as they develop their plans in *This is an archive page. The links are no longer being updated. 1992. The aim is to have local plans in place nationwide, to address the under-immunization needs of individual communities. o To support these plans, HHS/CDC will be awarding $46 million in FY *This is an archive page. The links are no longer being updated. 1992. 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 16 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 Education and Action Committee in the Healthy Mothers-Healthy Babies Coalition specifically to address infant immunization; -- formation of a federal interagency coordinating committee, the Interagency Committee on Immunization, to unite all key federal partners with a role in immunization. Getting children immunized at 4 or 5 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 outbreaks of measles show 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 two years of life." At the local press conference, Dr. Mason said the Centers for Disease Control -- the Public Health Service's "Prevention Agency" within HHS -- is committing people and dollars to several immunization projects: (1) pilot projects coordinating immunization with both WIC and AFDC 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 program administration, evaluation, data systems management, coalition-building, and education provided assistance to Philadelphia in developing its plan. ####