Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: The Future of Pediatric Vaccines

Category: Access To Children's Health Care


President Clinton has been blasting the vaccine industry. He said in speeches recently that they have been gouging the public and spending more on advertisement and less on research and development. He pledged to pump in another 300 million to help states provide vaccines to more children. Is all this talk going to improve our vaccination rates for our young children? I certainly hope so, but I somehow doubt it. In my opinion, the problem with our low vaccine rate is multi-fold. First, we have a two tier system in which middle class and wealthy can go to any doctor any time they want and get their vaccines in the doctor's office. Unfortunately, this is not the case for many working people who don't have medical insurance and many of our poor. They have difficulty getting into doctor's offices because of inability to pay and are not reminded to get their vaccines on a timely basis. Vaccines are available to them through our public health clinics but they frequently fall through the cracks, not arriving on the right day or keeping their records or returning for their follow-up. Also their child is frequently sick on the day they arrive at the public health clinic and they are advised to return when the child is well. As you see, this is a "Catch 22" situation and so the months roll by and the children end up not getting their vaccines. Presently, Louisiana is typical of most of the country with about a 50% vaccine rate for children under age 2. This means that when kids most need vaccines such as diphtheria, whooping cough, tetanus, polio, hemophilus influenza, and measles, mumps and rubella only about half of our children get them. Later, when they try to enter school at age four, five or six and their records are incomplete, they are finally sent back to the health units or doctor's offices and begin to catch up their vaccines. By this time however, the most critical window of time in which they needed to receive the vaccine is already passed. What are some potential solutions to our vaccine problem? The first thought that comes to my mind is to get the lawsuits off of the backs of health units and doctor's offices and to encourage competition among vaccine makers. Obviously, getting lawsuits out of the picture is not going to be something the U.S. trial lawyers are in favor of and since they make up a large part of our state and national Congresses it is not likely to happen. Nevertheless, as in all of medicine, concern about lawsuits is a major cause for an over-protective environment. The Childhood Vaccine Injury Compensation Act of 1986 has taken some of this pressure off of our backs, but not all of it.

Second, let each state decide how they want to handle vaccines. For some smaller states, buying the vaccine at a wholesale rate and distributing them free to all children works. This probably would not work, however, in every state.

Third, we must work on a simple computer code system, perhaps with social security numbers, so that every baby born could be tracked easily to make sure they get their immunizations in a timely manner and their needed health visits through some type of medical facility. We must begin to invest money in prevention if we are serious about lowering the higher cost of disability and suffering which occurs later.

I am sure we will hear much more about vaccines, and children and health care changes in the upcoming months. Please, let's encourage our legislators to strive for prevention, full funding for routine child health care including all needed vaccines, and a one tier system for all our children.