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Article |

A Chance to Live

Alan R. Hinman, MD, MPH
JAMA. 1992;267(1):158-159. doi:10.1001/jama.1992.03480010166043.
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June Goodfield has written an interesting book about the effort to immunize the world's children. Written as a companion to a television documentary, the book is geared to an educated lay audience.

In the first part, the author describes the impact of the vaccine-preventable diseases targeted by the World Health Organization's Expanded Programme on Immunization (EPI)—diphtheria, tetanus, pertussis, poliomyelitis, measles, tuberculosis—and the initiation in 1974 and early difficulties of the EPI. She also describes the complexities of vaccine manufacture, the problems in getting vaccine from the manufacturer to the child (including transportation issues and the necessity for a "cold chain" to prevent inactivation of vaccines by heat), and the inadequacies of the health care delivery system in developing countries. She then discusses the different agendas of agencies that work in immunization (particularly the World Health Organization [WHO] and the United Nations Children's Fund [UNICEF]) and the differences in personality and


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