It's Mrs. Clinton's shot at an inoculation cure - Hillary Rodham Clinton's effort to supply childhood vaccines to every pre-school child

0 Comments | Insight on the News, Feb 22, 1993 | by Elena Neuman

Summary: George Bush poured money into getting more preschoolers voccinated, but the effort was criticized as meager, and some experts question whether greater spending is even the right prescription. Now Hillary Clinton will get her turn at a chronic national problem.

In a little-publicized 1991 media event, Arkansas's first lady blasted the Bush administration for its purported failure to pay for adequate supplies of childhood vaccines.

"That has always been one of the most inexplicable positions taken by the administration over the years," said Hillary Clinton from a podium she shared with Jocelyn Elders, who has been picked to become the new surgeon general. "Because if preventative health care is a positive thing, what better way than through immunization?" She revisited the subject at a Nov. 18 appearance before the Children's Defense Fund, the advocacy group she once led. "We owe our children more than we've been giving them," she declared. "What on earth could be more important than making sure that every child has the chance to be born healthy, to receive immunizations and health care as that child grows?"

Now the nation's first lady, appointed by her husband to lead his planned overhaul of the nation's health care system, Mrs. Clinton is in a position to follow through on these complaints. And a plan to federally fund all childhood vaccines will reportedly be the administration's first health care reform. If childhood immunization is less than universal because of neglect by penny-pinching Republicans in the White House, as the Clinton campaign charged, then giving children the medical attention they deserve is one campaign promise that should be easy to fulfill.

According to the most quoted statistics, compiled by UNICEF and the Children's Defense Fund, the United States ranks 17th in the world - behind countries like Albania, Poland, Mexico and Pakistan - for the percentage of 1-year-olds who have been vaccinated against polio.

A Children's Defense Fund survey this past summer found that most states report preschool vaccination coverage levels below 60 percent; in cities such as Los Angeles, Houston, Cleveland and Chicago, fewer than 50 percent of children under age 2 have received shots to prevent measles, mumps, rubella, diphtheria, pertussis (whooping cough) and other childhood diseases, the report said.

Childhood immunization has been a hot issue since 1989, when it attracted national media attention because of an outbreak of measles - a disease all but wiped out in 1983. Infections of whooping cough also rose in the late eighties, primarily due to parents forgoing DTP (diphtheria, tetanus and pertussis) shots for their children after media reports that the vaccine caused serious adverse reactions, even death.

The Bush record on children's health was thus an open target for liberal criticism. In an opinion piece in the Washington Post less than a month before the election, commentator Michael Kinsley said the issue was a touchstone distinguishing Bush voters from Clinton voters. Describing the problem as an "aspect of the general decline of national wellbeing that snuck up on us while we were partying in the 1980s," he laid the blame at the doorstep of "people with no faith in the power of government to do good." What made him a Democrat, Kinsley offered, was his feeling that "as a citizen of the richest country in the world, this is a problem I shouldn't have to worry about. And I wish we had a president who would take whatever action, and spend whatever money, is necessarry to solve it."

Samuel Katz, a professor of pediatrics at Duke University Medical Center and the chairman of the Federal Advisory Committee on Immunization Practices, echoed this analysis in late December and urged Bill Clinton to be the president Kinsley had wished for. "With the de-emphasis on federal support originating during the Reagan years and continuing through the Bush administration, problems have undermined the nation's mandate to protect its children "he wrote in a Scripps Howard column. "Childhood vaccination must be a sure bet. President Bush's health-care promises proved empty. They let down the innocent children among us. Let's hope Bill Clinton's medical agenda puts the nation's future - its children - first and foremost."

Even Hollywood has thrown its weight behind the call for greater efforts at childhood immunization. In 1991, Steven Spielberg, Kate Capshaw, Henry Winkler, Bill Cosby and a host of entertainment executives and producers formed the Children's Action Network, in association with the American Academy of Pediatrics, to launch a full-scale immunization awareness drive.

Despite this seeming unanimity of liberal opinion, however, the Clintons may have a tough time living up to expectations. The indictment of the Bush administration for inaction on immunization left out two stubborn facts: Federal efforts have hardly been lacking; and the problem is more complicated than it has been portrayed.

Advocates of a full federal offensive have emphasized the Bush administration's failure to propose spending as much as Congress appropriated. Left out is the fact that spending on childhood preventive medicine may have been the fastest growing federal budget line in the Bush years - increasing by 250 percent.