European Stars and Stripes (Newspaper) - May 18, 1993, Darmstadt, Hesse                                L. A / vat j . Only 50 percent of inner City american children Are vaccinated by age 2 by Michael Wood National geographic he world s richest country the United states lags behind the world s poorest countries in an Effort to immunize nil children under age 2. It s a Paradox born out of the nearly total immunization of american kindergarten age children in the 1970s. The Paradox is that we ended up so successful that today Many developing countries have higher vaccination Levels than we do says or. William h. Foege executive director of the task Force for child survival and development at the Carter presidential Center in Atlanta. When global vaccination began in 1971 barely 5 percent of 2-year-Olds in poor countries were being vaccinated against childhood diseases. By 1991 the percentage had risen to 80. Leaders of the United nations immunization program Are now eyeing a goal of 90 percent by 2000. In contrast,.an average of Only about 50 percent of american inner City 2-year-Olds Are vaccinated and the National rate for 2-year-Olds is about 70 percent according to the . Centers for disease control. In new York City Only about 40 percent of preschool children received All their recommended immunizations by age 2 in 1991. That compared with 89 percent of children under 1 in Algeria 77 percent in Uganda 76 percent in Al Salvador and 70 percent in Mexico. The Gap lies Between Ages 2 and 5. State Laws in the United states require children to be completely immunized before they enter kindergarten. More than 99 third world childhood killers sir major pm Hood diseases that cause enormous amounts of  death among to Laird world children under age 5, 1. Measles 2, diphtheria 3. Pertussis whooping cough 4. Tatanus 5. Polio 6. Tuberculosis vaccinations save lives. 77 world health or any ution expanded program on immune Taian Epi is making Progress but has More work to do. Them Mem mry for by swin poor not Myrto 3.2 million 1.8 million  Cut medical costs every Foliar spent on childhood i saves $10 in Mure ? 1993 National  society d Bill a tzar / National geographic now . National geographic Public health nurse Iris Vazquez inoculated a baby at a free immunization clinic run by Arlington county a. The clinic is part of a Federal state Effort to vaccinate All . Children before age 2. Currently Only about 70 percent Are vaccinated. Percent of american 5-year-Olds Are fully vaccinated. But immunization of younger children in the United states is required Only by Nursery schools and licensed Day care centers. No other Law requires immunization of preschool children. You can t Stop All transmissions unless you get the injections in children by the age of 2," Foege said. If you can t deliver immunization to your kids what can you do right president Glinton wants the nation to do better. In february he proposed spending $300 million beginning this summer to immunize1 1 million More american infants and children. In his address to Congress feb. 17, Clinton said we know now that we will save $10 later for every $1 we spend by eliminating preventable childhood diseases. That s a Good investment no matter How you measure  or. Robert Kim Farley the american physician who directs the world health organization s expanded program on immunization Epi agrees. He Calls his Little heralded Effort to prevent childhood diseases an incredible bargain at about $1.5 billion a year. Geneva based Epi immunized children in developing countries against six diseases that cause an enormous amount of . Death among third world youngsters under age 5 Measle diphtheria pertussis whooping cough tetanus polio and tuberculosis. A similar program eradicated smallpox in 1980 and is on the verge of eliminating polio from the americas. Both forge and or. Walter r. Dowel be cd Deputy director say that the Clinton proposal May have to go further to achieve its goals. A new system is needed to keep track of youngsters Between Ages 2 and 5, Foege says. One has to motivate some of the mothers in the inner City to get their children vaccinated Dowdle says. That s sort of been the reason Why we Haven t been Able to eliminate measles in this  first he says we be got to find out if we can make Access More available and opportunities for vaccination  if that does t raise immunization Levels sufficiently he adds reluctantly a Law requiring vaccination might be necessary. The last thing we want is to have the Law create additional burdens on inner City families Foege takes a different approach. Access is a meaningless term he says. We should be measuring. Outcome rather than  he cites a plan in great Britain where child immunization Levels were Low a few years ago despite 100 percent Access. Then the government offered physicians a Bonus if they achieved 70 percent immunization. Later the percentage was raised to 90 percent. Like magic Foege says their immunization figures have gone ahead of the United states.". In extremely poor countries the savings is More often in lives . Contracting a disease such As measles can be a virtual death warrant for an infant already weakened by malnutrition and diarrhoea a major killer of third world children. Although . Vaccination Levels fall Short . Disease Levels remain Low. If you use that As your criteria we do better than most places Foege says. Who estimates that vaccination saves the lives of 3.2 million third world children each year at a Cost of about $13achild. Despite Epi s Progress an estimated 1.8 million children in poor countries die can year from vaccine preventable illness. The toll includes 876,000 deaths from measles 565,000 from tetanus in newborns 363,000 from pertussis and 119,000 from polio. For every child who Dies another becomes permanently disabled by complications from the diseases. Because these diseases Are so common in developing. Countries children tend to contract them earlier. Thus Epi tries to get children fully immunized by age 1. _ Progress is being made toward other goals worldwide elimination of tetanus among newborns by 1995 global eradication of polio by 2000 a 95 percent reduction of deaths from measles by 1995. The program is also moving in new directions. Two additional vaccines for yellow fever and hepatitis a were added to its Arsenal in 1992. Others on the horizon protect against rot virus which causes 800,000 annual deaths from acute diarrhoea and another against respiratory sync tial virus an infection that kills 300,000 annually. In 1990 who and other . Agencies announced a major research Effort to develop a one shot super vaccine to be injected soon after birth protecting infants against All childhood diseases. But experts Don t expect it to be available for several years. Battery of vaccines to protect children recommended schedule of immunizations for infants and children. .af.ll. 2 mos. 4 mos. 6 mos. 12-1 5 mos. 15 mos. 15-1 8 mos. 4-6 . 11-12 . 14-16 . Pm a. I Vav v Vav v v Vav v y a a. V v y v \ \ \ \ a so. " 9 or  the a a vaccine introduced viruses t cell the macrophage chemically signal other White blood cells called lymphocytes to Start reproducing. The 6 cell produce antibodies specifically targeted for the invading virus. The antibodies attack the virus and also Serveas beacons for More macrophages to attack. As Theattle is won special t cells signal Jor the attack to end. Memory cell vaccination Ivow Omni pfc in int 9 a pm Boc Auw $0 vac cirt it Educ a virus to weakened or inactive theban the & Short lived. 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