藏精阁

By Rosalynn Carter

This article originally appeared in the The Atlanta Journal and Constitution, Oct. 11, 1991.

Former first lady Rosalynn Carter has worked to support causes of women; and children throughout her public-service career.children; disease; deaths; public; health; care; medicine; regulations; costs; reform; opinion

Childhood diseases that largely disappeared during the 1970s - measles, whooping cough, rubella - are staging a comeback.

Last year, the United States experienced the largest outbreak of measles in two decades. Eighty-nine of the 27,786 reported cases resulted in needless deaths. From 1987 to 1989, the number of reported cases of whooping cough increased 47 percent, and last year some babies were born with congenital rubella syndrome.

We Americans today enjoy significantly longer, healthier life spans than our ancestors partly due to dramatic advances in vaccine technology during the past 40 years. The recent measles epidemic resulted not from the failure of the vaccine to protect, but from the failure of the health- care system to deliver the vaccine to susceptible children at the recommended age.

Betty Bumpers, wife of Arkansas Sen. Dale Bumpers, and I have launched a new immunization program, which we are calling "Every Child By Two." We hope to enlist the leadership of governors' spouses in all 50 states to put in place state and community programs to guarantee that all our children will be vaccinated against preventable diseases by age 2.

The disease (measles) has come back for various reasons, but particularly due to a relaxed emphasis on immunizations. It recently reached epidemic proportions in nine major U.S. cities.

At the Centers for Disease Control (CDC) in Atlanta, we learned the good news that we have vaccines that can prevent eight potentially crippling and killing childhood diseases. The bad news is that we are not immunizing our children early enough. Only about 50 percent of children aged 2 and younger are immunized, and this is the age at which measles cases are now occurring.

Because so many babies are dying, CDC scientists thought this might be a new strain of measles. What they learned is that babies in the inner cities, where measles epidemics are occurring, are so malnourished that their bodies are too weak to withstand the disease.

This is a tragic and sad commentary on the state of health care in our country. Surely we can do better.

Certain routine practices of the health-care bureaucracy - requiring advance appointments, physical exams, physician referrals or enrollment in well-baby clinics prior to vaccination - act as barriers to immunization.

Other obstacles include the lack of flexible hours necessary for working mothers, the lack of transportation to and from centers that are centrally located and the sky-rocketing cost of vaccines.

Insurance providers exacerbate the problem. Despite the greater expense of treating childhood diseases than of preventing them, almost half of all private insurance plans do not cover basic immunization. All medical-insurance carriers should cover routine childhood immunizations, and Medicaid providers should be adequately reimbursed for vaccines and vaccine administration and should receive these vaccines at the lowest possible prices.

It is most important that parents keep their children healthy by staying informed. Medical guidelines for the frequency and ages at which children should be vaccinated have changed over the years. The CDC now recommends that children receive a series of vaccinations beginning at two months of age and continuing until they are 2 years old. Booster shots at age 5 and again at age 15 will provide most children with adequate protection into their adult years.

"Every Child By Two" needs grass-roots support. If all children are to have equal access to immunization, we must each take responsibility for our own communities. Civic clubs, places of worship, women's groups and community organizations can and, I hope will, put immunizing children on their agendas.

In addition, we must urge politicians to enact regulations that would require insurance providers to cover immunization costs, set standards for immunization practices at clinics and require immunization for enrollment in day-care centers.

In 1979, the U.S. Public Health Service predicted we could reduce the number of measles cases to 500 by 1990. Clearly, we have lost ground. It is imperative that we move quickly to vaccinate children at risk for measles and other vaccine-preventable diseases that could resurge.

We are the stewards of our children's future. Without our intervention now, many will never have the opportunity for a fulfilling and productive life nor grow to develop the talents that can make the world a better place.