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Improving Preschool Immunization Levels Proving More Complex Than Simply Providing Vaccines

Charles Marwick
JAMA. 1993;269(12):1480-1481. doi:10.1001/jama.1993.03500120014003.
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MANY PHYSICIANS, other public health authorities, nurses, and third-party insurers apparently are in general agreement with the Clinton administration's proposal to purchase childhood vaccines. But there are increasing warnings that providing free vaccines will not alone ensure improved preschool immunization levels.

As has been widely publicized, the Clinton administration proposes to spend $300 million for the purchase of these vaccines. Administration officials suggest that making vaccines freely and universally available in this country will mean more preschool children would be vaccinated than is presently the case.

Third to Half Are Immunized  Their goal is to get at least 90% of children less than the age of 2 years immunized with the five recommended vaccines. These are diphtheria-tetanus-pertussis, measles-mumps-rubella, oral poliomyelitis, Haemophilus influenzae type B, and hepatitis type B.The Centers for Disease Control and Prevention, Atlanta, Ga, estimates that 37% to 56% of 2-year-old children in this country currently are


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