President Clinton Launches New Effort to Increase Immunization Rates Among Children

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President Launches New Effort to Increase Immunization Rates Among Children
President Launches New Effort to Increase Immunization Rates Among Children

Builds Upon Unprecedented Progress to Target Children at High Risk

December 11, 2000

Today, President Clinton, joined by former First Lady Rosalynn Carter, will take strong new action to increase immunization rates among children nationwide. In an effort to build on the Clinton-Gore Administration's unprecedented progress in improving immunization rates, the President will issue an executive memorandum directing the Department of Agriculture (USDA) to assess the immunization status of the five million children under the age of five participating in the Women, Infants, and Children (WIC) program and refer them to a health care provider when appropriate. This memorandum will also direct USDA and Centers for Disease Control and Prevention (CDC) to develop a national strategic plan to ensure more accurate and cost-effective immunization assessment, referral, and follow-up for children at risk. In addition, President Clinton will announce that the American Academy of Pediatrics will instruct its 55,000 members to emphasize the importance of timely immunizations to their WIC-eligible patients and encourage them to take their records with them when they visit the WIC clinic so that WIC staff can assess their immunization needs.

CHILDHOOD IMMUNIZATION RATES ARE AT AN ALL-TIME HIGH, BUT MORE NEEDS TO BE DONE. Under the leadership of the Clinton-Gore Administration, childhood immunization rates have reached all-time highs, with 90 percent or more of America's toddlers receiving the most critical vaccines by age two. Vaccination levels are nearly the same for preschool children of all racial and ethnic groups, narrowing a gap estimated to be as wide as 26 percentage points a generation ago. Despite these impressive gains, however, immunization levels in many parts of the country are still too low.

Immunization rates for low-income, minority children are consistently lower than the national average. According to the CDC, low-income, minority children are less likely to be immunized than their counterparts. In fact, immunization rates in certain inner-city areas are at or below 65 percent, placing children at high risk for potentially deadly diseases such as diphtheria, poliomyelitis, measles, mumps, and rubella. These diseases are associated with birth defects, paralysis, brain damage, hearing loss, and liver cancer. In some of these urban areas, immunization rates are 20 percent below the national average.

Areas with lower-than-average immunization rates are at increased risk of potentially deadly disease outbreaks. Nationwide, there are a number of inner-city areas where childhood immunization rates remain significantly below the national average. These "pockets of need," which are home to traditionally underserved populations, are at high risk for disease outbreaks such as the measles epidemic of 1989.

Many under-immunized children are served by the WIC program. State data indicate that in 41 states, the immunization rates for children enrolled in WIC are lower than the rates for other children in their age group – in some cases, by as much as 20 percent. The WIC program, which serves 45 percent of infants nationwide and more than five million children under the age of five, is the single largest point of access to health services for low-income preschool children who are at the highest risk for low vaccination coverage.

PRESIDENT CLINTON TAKES STRONG NEW ACTION TO IMPROVE CHILDHOOD IMMUNIZATION RATES. Today, President Clinton will issue an executive memorandum that:

Directs the WIC program to conduct an immunization assessment on every child applying for services. WIC, run by USDA, provides access to food stamps, dairy and other food products, and nutritional counseling to low-income women, infants and children. Together with CDC, the WIC program will develop a standardized procedure to include in the WIC certification process in order to evaluate the immunization status of every child applying for WIC services using a documented immunization history. Children who are determined to be behind schedule on their immunizations, or who do not have their immunization record, will be referred to a local health care provider or public health clinic as appropriate. Children who are uninsured receive vaccinations at no cost under the Vaccines for Children program. Studies indicate that linking immunization services with WIC improves vaccination coverage by up to 40 percent within 12 months.

Ensures that WIC staff are able to conduct immunization assessments accurately and efficiently. The CDC will develop user-friendly immunization materials designed to ensure that information on appropriate immunization schedules is easily accessible and understandable for WIC staff conducting nutritional risk assessments. WIC staff should be trained to use these materials by state and local public health authorities.

Develops a blueprint for future action to improve the immunization rates of children at risk. The President will direct HHS and USDA to develop a national strategic plan to improve the immunization rates of children at risk, to be completed within 60 days. The plan should include steps to:

° Expand the availability of automated systems or computer software to provide WIC clinics with information on appropriate childhood immunization schedules, with the eventual goal of providing this service in every WIC clinic nationwide;

° Disseminate a range of best practices for increasing immunization rates for low-income children to WIC state and local agencies;

° Include information on the importance of immunizations and appropriate immunization schedules in standard WIC efforts to educate families about breastfeeding, anemia, lead poisoning, and other health-related topics.

Evaluate the role other Federal programs serving children can play in increasing immunization rates. The strategic plan will also evaluate whether other Federal programs serving children should require a standard question on immunizations as part of their enrollment processes, and if appropriate, develop a plan for implementing new requirements.

PRESIDENT CLINTON PRAISES THE AMERICAN ACADEMY OF PEDIATRICS' NEW ACTION TO IMPROVE IMMUNIZATION RATES. Today, the American Academy of Pediatrics will advise its 55,000 members to remind their WIC-eligible patients of the importance of timely immunizations and asking these patients to bring their immunization records with them when they visit the WIC clinic. Providing complete and documented immunization histories to WIC providers ensures that staff can efficiently and accurately evaluate a child's immunization status and refer them to a health care provider if appropriate.

BUILDS ON THE CLINTON-GORE ADMINISTRATION'S LONGSTANDING COMMITMENT TO IMPROVING CHILDHOOD IMMUNIZATION RATES. In 1992, fewer than 55 percent of children under the age of three had received the full course of vaccinations. In order to address the dangerously low level of immunizations nationwide, President Clinton launched the Childhood Immunization Initiative, which helped make vaccines affordable for families through the Vaccines for Children Program, eliminated barriers preventing children from being immunized by their primary care provider, and improved immunization outreach. As a result, childhood immunization rates have reached all-time highs, with 90 percent or more of America's toddlers receiving the most critical vaccines by age two. Vaccination levels are nearly the same for preschool children of all racial and ethnic groups, narrowing a gap estimated to be as wide as 26 percentage points a generation ago. In addition, the Clinton-Gore Administration recently took action to provide enhanced federal funding for those states wishing to develop immunization registries. During the Clinton-Gore Administration, funding for childhood immunization efforts has more than doubled since 1993.

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