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Challenge for Immunization Programs: Protect Preschool, Postschool Generations

Charles Marwick
JAMA. 1988;260(12):1675-1676. doi:10.1001/jama.1988.03410120023006.
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THE NATIONAL Immunization Program in effect for the past quarter century has resulted in record-high levels of vaccine coverage and a record-low incidence of disease among school-age children in this country. But a new task looms. It is to immunize the populations that are either younger or older than general school age—infants, preschool children, and adults—against vaccine-preventable diseases.

Reaching those at either end of this age spectrum is several orders of magnitude more complex than programs directed at those entering school, says Walter A. Orenstein, MD. He is the new director, Immunization Division, Centers for Disease Control (CDC), Atlanta.

Officials estimate that 97% of children entering school are adequately immunized against diphtheria, tetanus, pertussis, poliomyelitis, mumps, rubeola, and rubella. But as Orenstein reported at the CDC's 22nd annual Immunization Conference in San Antonio, Tex, there are indications—although unfortunately no hard figures—that substantial numbers of preschool children are not vaccinated at


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