*This is an archive page. The links are no longer being updated. 1991.00.00 : Immunization Initiative Contact: Bill Grigg 202/245-6867 1991 Press Release (No Date) IMMUNIZATION INITIATIVE Immunizations are among the most vital and cost-effective medical interventions available. They save countless lives and prevent untold illness and suffering. They also allow significant savings in health care costs. Yet, despite the availability of vaccines, many preventable illnesses and deaths are still caused by infectious diseases in the United States each year. Prior to the licensure of measles vaccine in 1963, an average of 500,000 to 1 million cases of measles was reported annually. Of that number 500-1,000 people died per year. Despite exceptional progress made in the control of measles since 1963, the nation has experienced a marked resurgence in measles cases and a number of urban epidemics of measles during 1989 and 1990. In the last 2 years, 45,000 cases of measles and over 100 deaths occurred. Almost one-half of all cases have occurred in unvaccinated preschool children. I. BACKGROUND Few measures in public health surpass the effectiveness of immunizations. In the United States, 90% or greater reductions from peak reported incidence have been achieved for diphtheria, measles, mumps, pertussis, polio, rubella, congenital rubella syndrome, and tetanus. Even with the recent resurgence of measles, reported cases are still only a fraction of the cases reported in the pre-vaccine era. This success is due to the availability of highly effective vaccines and the high immunization levels achieved prior to and at the time of school entry through the enforcement of school immunization laws. Since the 1981-1982 school year, immunization levels against all routinely used vaccines have been 95% or greater among children entering school. II. THE MEASLES EPIDEMIC Measles cases and deaths have risen sharply to more than 18,000 cases and 41 deaths in 1989 (the largest number of reported cases since 1978 and the largest number of deaths in almost two decades). The epidemic intensified during 1990, with over 27,000 reported cases and 60 confirmed deaths. The current epidemic has hit the Nation's youngest and most vulnerable children hardest. Minority children residing in urban areas faced a 7 to 9 times greater risk of measles than white children of comparable age. Measles vaccine coverage is reported to be as low as 50% among 2-year-olds in some inner-city populations. The principal cause of the measles epidemic is not failure of the vaccine to protect but failure to deliver the vaccine to susceptible children at the recommended age. Children in the United States should be vaccinated routinely against 8 diseases. The immunization series begins at two months of age with vaccination against diphtheria, tetanus, and pertussis (DTP), polio (oral polio vaccine [OPV]), and Haemophilus b influenzae and ends in the second year of life with the addition of measles, mumps, rubella, and the final doses of the other vaccines. Only 4-5 health care provider visits are needed to prevent these diseases in the vast majority of preschoolers. Despite the relative simplicity of the immunization schedule, many children, particularly in the inner cities, are not being vaccinated on time. Though state and local health departments hold primary responsibility for childhood immunizations, the federal government--through CDC--has worked closely with them to reach the current high levels of immunization among children entering school. Specifically, CDC: o Provides financial assistance through grants to all states and major city health departments to support immunization outreach programs. o Buys vaccines in bulk for state and local health departments so they receive the benefits of better prices for vaccine. o Assigns more than 600 CDC specialists as public health advisors to work in states and municipalities. Some 85 of these public health advisors provide technical assistance and coordination for immunization programs. o Supports demonstration programs to develop new and better ways to provide immunizations. For example, current support for efforts to provide immunization through agencies where other social services are available. The CDC budget for immunization activities has grown from $98,198,000 in 1988 to a current budget of $217,531,000. The budget proposed for fiscal 1992 is $257,845,000, an increase of nearly 20 percent over this year. III. ACTIONS A number of activities are planned or underway to improve immunization coverage among our nation's preschoolers. Chief among these are: 1. Pilot demonstration projects have begun in three cities (New York City, Jersey City and Chicago) to evaluate the most cost-effective approaches to integrating immunization services with the routine services being delivered by the agencies which run the Women, Infants and Children program (WIC) and the Aid to Families with Dependent Children program. Such programs offer another access point to children. The goal of these demonstration projects is to make immunization more "user friendly" through one-stop- shopping-type techniques. Among the approaches being evaluated, for example, involves screening the children when they come with a parent to a WIC facility and then providing immunizations to those who need them at a facility set up in the same building, next door or nearby. 2. Secretary Louis W. Sullivan and other distinguished HHS health officials with special expertise in this subject -- including the head of the Public Health Service James O. Mason, Surgeon General Antonia C. Novello and Centers for Disease Control Director William Roper -- will travel with teams of immunization experts to six locations: Philadelphia, Detroit, Phoenix, Dallas, San Diego and the area around Rapid City, S.D. Since much of the success of the effort to raise immunization levels will have to come from work done at the state and local level, the federal government's foremost health leaders will work with state and local officials in developing or refining their state or city plans to raise immunization levels to 90% by 2 years of age. 3. The Healthy Mothers, Healthy Babies Coalition will undertake new efforts to increase the awareness of parents and guardians of the importance, efficacy, and safety of childhood immunizations; develop informed advocates and community leaders for adequate resources for immunization services; and, promote the optimal use of resources by fostering collaboration among public and private health care providers and the community. To steer the new efforts, an Immunization Education and Action Committee has been formed within the coalition. The committee is chaired by Dr. Antonia Novello, Surgeon General of the United States. 4. Standards of immunization practice for use in publicly- funded Federal clinics are currently being developed. The standards are aimed at ensuring that administrative and medical barriers to immunization be removed and that immunizations are available and accessible, particularly in high risk, inner-city populations. Some of these standards for clinic immunization practices are expected to apply to providers in private practice as well, particularly those calling for the simultaneous administration of needed vaccines and those calling for the elimination of invalid contraindications. 5. A government-wide Interagency Committee on Immunization has been convened by the National Vaccine Program to develop a plan to improve immunization services. The plan is focused on improving the health care delivery infrastructure for immunization. ####