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Pediatric vaccines have been much in the news recently, with new FDA approvals and the release of data on immunization coverage as of 2002 by the National Immunization Program (NIP) of the CDC. The new statistics show that the number of children being immunized is at an all-time high, with a particularly significant increase in coverage for varicella, to 80.6%, and three or more doses of pneumococcal conjugate vaccine, up to 40.9%. Coverage for the 4:3:1:3:3:1 series (four doses of diphtheria-tetanus-acellular pertussis [DTaP] vaccine, three of polio, one of measles-mumps-rubella [MMR], three of Haemophilus influenzae type b, three of hepatitis B, and one of varicella) increased from 61.3% in 2001 to 65.5% in 2002.
Is this good news? Yes and no: If roughly two thirds of children in the US have been covered for the 4:3:1:3:3:1 series (that's good), then one third are still not fully immunized (bad). Furthermore, level of coverage varies considerably state to state and by urban area. The highest estimated coverage for the recommended series was 79.3%, in Santa Clara County, Calif.; the lowest, 57.5%, in Newark, N.J.
Deficiencies in coverage are the result of a number of variables, including lack of insurance, interruption in supply, and growing indifference or outright opposition to childhood immunization in some regions:
Given these constraints on full immunization coverage, the release in August of a report from the Institute of Medicine (IOM) Committee on Evaluation of Vaccine Purchase Financing was particularly timely. In "Financing Vaccines in the 21st Century: Assuring Access and Availability," the committee advocates revolutionary changes in the way vaccines are produced, distributed, and paid for, including:
The members of the committee envision a major national debate on these extraordinary proposals. The full text of the report can be read at www.nap.edu .