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1. Improving the quality and quantity of immunization services
   
2. Reducing vaccine costs for parents
   
3. Increasing community participation, education and partnerships
   
4. Improving systems for monitoring diseases and vaccinations
   
5. Improving vaccines and vaccine use.
   

At the same time, the Administration and Congress have committed substantial new resources for immunization since 1993, including significant budget increases for service delivery improvements and for purchase of vaccines for needy children.

Childhood immunization rates have now reached all-time highs, with 90 percent or more of America's toddlers receiving the most critical doses of vaccines for children by age 2 and three diseases being reduced to goal levels. In addition, reported levels of disease were at or near record lows in 1998. While overall childhood immunization rates for infants and toddlers are at a record high of 80 percent, about 900,000 children under age 2 still have not received all their immunizations.

For the most critical childhood vaccines, vaccination levels are nearly the same for preschool children of all racial and ethnic groups, narrowing a gap that was estimated to be as wide as 26 percentage points a generation ago. However, minority children still lag somewhat behind white children when overall vaccination rates are compared. In 1998, while 83 percent of white children have received the recommended series of vaccinations by age 2, only 74 percent of African-American children and 77 percent of Hispanic children had received this series.

To help close these gaps, President Clinton announced a plan as part of his Racial and Ethnic Health Disparities Initiative to eliminate disparities in childhood immunization by 2010, including interim goals for immediate progress. On April 17, 2000, Secretary Donna E. Shalala kicked off National Infant Immunization Week (NIIW) by releasing a new public awareness campaign urging all parents, particularly Hispanic and African-American parents, to immunize their children. The Spanish-language public service campaign features a color poster, a video news release, and new television and radio public service announcements that remind parents that children should receive all of their recommended vaccinations by age 2 to protect against 10 preventable childhood diseases.

Today, Secretary Shalala announced new steps to encourage states to use Medicaid funding to support development and operation of immunization registries. In a letter to state Medicaid directors, HHS described a new simplified process for obtaining federal Medicaid funds to help support the registries.

PROBLEM:

While childhood immunization rates for the most commonly recommended vaccinations are at an all-time high of 80 percent, about 900,000 children under age 2 still have not received all their immunizations.

GOALS:

The Childhood Immunization Initiative is working to build a comprehensive vaccination delivery system. It integrates efforts of the public and private sectors, health care professionals and volunteer organizations. The goals, as set in 1993:

• To ensure that at least 90 percent of all two-year olds receive each of the initial and most critical doses of vaccines, and to eliminate or reduce vaccine preventable childhood diseases.

• By 2000, ensure that at least 90 percent of all two-year-olds receive the recommended series of vaccinations, and that a system is in place to sustain high immunization coverage.

The Clinton Administration has increased the resources devoted to immunization efforts. The Centers for Disease Control and Prevention (CDC) manages the Childhood Immunization Initiative. In all, funding for childhood immunization has more than doubled since FY 1993. The President's FY 2001 budget includes $608 million for vaccine purchase and $391 million for immunization program activities.

THE INITIATIVE:

The Childhood Immunization Initiative focuses on five areas:

1) Improve the quality and quantity of vaccination delivery services --

• The FY 2000 budget includes $139.5 million for Section 317 grant program operational activities.

• CDC is providing funds and assistance for access to public health clinics and private providers.

2) Reduce vaccine costs for parents --

• The Vaccines for Children program was designed to provide publicly-purchased vaccines to the nation's eligible children, starting in October, 1994. Eligible children include those without health insurance; those who are eligible for Medicaid; American Indians, Alaska Natives, and underinsured children, but only if served by a Federally qualified health center or a rural health clinic.

• Today, the Vaccines for Children program is going strong, with all 50 states participating in the program. Enrollment of private providers into the Vaccines for Children Program has almost doubled since the beginning of the program in October 1994. Over 30,500 private provider sites (which may include multiple providers per site) and approximately 10,700 public clinics are enrolled in the program.

• Total federal vaccine purchases in FY 2000, including grant funds for states as well as the VFC, are estimated at $604 million, which includes funds for new vaccines not purchased in FY 1993 such as Varicella, Hep B/Hib combination, DTaP, and Hepatitis A. President Clinton's FY 2001 budget includes $608 million for vaccine purchases.

3) Increase community participation, education and partnerships --

• Over the last few years, CDC has made significant progress in establishing public and private partnerships. Community outreach activities have focused on increasing parental awareness of the need to immunize children; improving community involvement in immunization programs; expanding national partnerships; and building coalitions to facilitate prevention strategies.

• The official kick-off event of the 2000 National Infant Immunization Week (NIIW) was in Houston, Texas, on April 15th. CDC National Immunization Program Director Dr. Walter A. Orenstein participated in immunization awareness activities in the city, which is an area with low immunization coverage rates and a large Hispanic population. On April 17th, Secretary Shalala participated in the Washington, DC, kick-off to NIIW at an event hosted by a local day care center.

• CDC assisted states in creating 21 coalitions and expanding 18 existing coalitions at the state and local level.

• Toll-free information services refer callers to local immunization providers and provide information in English and Spanish. The toll-free numbers are: 1-800-232-2522 for information in English and 1-800-232-0233 for information in Spanish.

• In an effort to raise immunization rates among Hispanics, Secretary Shalala introduced a national Spanish language media campaign during the 2000 National Infant Immunization Week. The Spanish-language public service campaign features a color poster, a video news release, and new television and radio public service announcements that remind parents that children should receive all of their recommended vaccinations by age 2 to protect against 10 preventable childhood diseases. The TV PSA, entitled "Hero" and featuring a firefighter, is designed to reach Hispanic fathers with children under two. The radio PSA is being distributed to over 250 Spanish-language stations in the top 25 Hispanic markets. The posters are being distributed to community centers, community leaders, churches, schools and health care facilities.

4) Improve systems to monitor diseases and vaccinations --

• Improved monitoring systems for vaccine-preventable diseases will help spot problems early and enable action to prevent a few cases from escalating into epidemics. An electronic system for reporting supplemental information on vaccine-preventable diseases using the National Electronic Telecommunications System for Surveillance (NETSS) is operational in 46 states, New York City, Washington DC, and Puerto Rico.

• Since 1994, the National Immunization Survey (NIS) has been used to provide immunization coverage for the nation, all 50 states and 28 large urban areas. The NIS provides, for the first time, states and cities with an accurate measure of vaccination coverage rates compiled from a national independent survey that allows a comparison of immunization coverage levels. The NIS provides an early warning system for potential problems and monitors the introduction of new vaccines into the recommended childhood immunization schedule.

• Assessments to measure immunization coverage in clinics are being conducted in all 50 states. These assessments have led to increased coverage in many areas. For example, in Houston, seven out of eight public clinics assessed showed increases in coverage.

5) Improve vaccines and vaccine use --

• The initiative supports research into new vaccines and vaccine combinations to reduce the number of shots children must get, to simplify the vaccine schedule, and to ensure safe and effective vaccines.

OTHER CHILDHOOD IMMUNIZATION EFFORTS:

• By the year 2010, the Initiative to Eliminate Racial and Ethnic Disparities in Health will work to achieve and maintain

• childhood immunization rates of 90 percent for all population groups. As part of this effort, in FY 2000, CDC has allocated $30 million for a community-based demonstration program in up to 32 communities, which will focus on eliminating racial and ethnic health disparities. The President has requested $35 million for this program in FY 2001, and the President's FY 2001 budget also includes $1.1 billion for Community Health Centers to enhance health services targeted to reducing health disparities.

• On July 28, 1998, Secretary Shalala announced new child care regulations, which include a provision to help more children in child care receive the immunizations they need, on time. The new rule requires that all children receiving federal child care assistance be immunized according to State public health agency standards.

• Immunization programs on the state and local levels are collaborating with WIC programs (Special Supplemental Nutrition Program for Women, Infants, and Children) to focus on children's immunization. For example, some state WIC programs are providing on-site immunization services, checking the immunization records of WIC participants, and including immunization information in WIC food packages.

• HHS, the Department of Housing and Urban Development and the Corporation for National Service have joined forces to increase immunization rates among children living in public housing. The partnership focuses on improving information about immunizations for public housing residents, enlisting residents in designing outreach strategies, and improving access to health services for those in public housing.

CHILDHOOD IMMUNIZATION BACKGROUND:

• Immunizations are one of the most important ways parents can protect their children against serious disease. Infants and young children are particularly vulnerable to infectious diseases. That is why it is critical that they are protected through immunization. Children who are not immunized increase the chance that others will get diseases.

• Childhood vaccines prevent ten infectious diseases: polio, measles, diphtheria, mumps, pertussis (whooping cough), rubella (German measles), tetanus, Haemophilus influenzae type b (a cause of spinal meningitis in children), varicella (chicken pox), and hepatitis B.

• Each day, 11,000 babies are born who will need 16 to 20 doses of vaccine before age two.

• States require children to be immunized in order to enter school, and 95 percent or more of American children are adequately vaccinated by kindergarten. Yet about one million pre-school children are not adequately protected against possibly fatal illnesses.

• With increasing numbers of children more readily exposed to infectious disease in day-care settings and elsewhere, complete immunization by age 2 is critical.

• Failure to immunize can lead to new outbreaks of disease. In 1989-91, a measles epidemic resulted in more than 55,000 reported cases, 11,000 hospitalizations, and more than 120 deaths. Over half of the deaths were children under 5 years of age.

• Vaccines are cost-effective. More than $13 are saved for every $1 spent on measles/mumps/rubella vaccine and more than $27 are saved for every $1 spent on diphtheria/tetanus/pertussis vaccine. More than $5 are saved for every $1 spent on varicella vaccine.

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Note: For other HHS Press Releases and Fact Sheets pertaining to the subject of this announcement, please www.os.dhhs.gov/news/press/ .