In 1977, approximately 20 million of the 50 million persons in
the
United States who were 15 years old were estimated to need at least
1
dose of 1 vaccine in order to be considered fully protected against
the 7 diseases for which vaccines are routinely administered in
childhood--i.e., diphtheria, measles, mumps, pertussis,
poliomyelitis,
rubella, and tetanus. To remedy this situation, the Department of
Health, Education, and Welfare (now Department of Health and Human
Services) announced, on April 6, 1977, a nationwide Childhood
Immunization Initiative. The Initiative had 2 stated objectives:
1)
To attain immunization levels in the nation's children of at least
90%
by October 1979. 2) To establish mechanisms to maintain high
immunization levels by ensuring that children received vaccinations
at
the proper times.
The Initiative mobilized the public as well as the private
sectors
with extensive involvement by volunteers and voluntary
organizations,
including a major public information and education campaign. More
than 28 million individual immunization records of school children
were reviewed to identify children in need of vaccinations and to
refer them for these vaccinations. School immunization
requirements
were enacted and enforced by state and local governments.
Government
agencies that had not formerly been involved in immunization
activities established standards for immunization levels among
their
constituents. A major increase in federal support for immunization
grant programs helped to eliminate the backlog of unimmunized and
incompletely immunized children and to create systems to maintain
high
levels of immunization.
The results of the Childhood Immunization Initiative are
reflected
in the following: 1) Immunization levels of children entering
school
for the first time in the fall of 1980 were 96% for measles,
rubella,
and diphtheria-tetanus-pertussis (DTP); 95% for poliomyelitis; and
92%
for mumps. Immunization levels of children entering school for the
first time in 1981 are not yet available. 2) Disease incidences
are
at or near record low levels. In 1981, provisional data indicate
that
measles, mumps, paralytic poliomyelitis, rubella, and tetanus all
reached record low levels, with diphtheria and pertussis being at
near
record low levels (Table 1). 3) All 50 states now have laws
requiring
documentation of immunity as a condition of first entry to school.
For measles, in 40 states these laws extend from kindergarten
through
12th grade. 4) In all 50 states, a standard immunization record
has
been developed and distributed for use in both the public and
private
sector to ease problems of documention of immunizations. 5) In 35
states, systems have been instituted in public clinics throughout
the
state to ensure that children actually receive needed vaccinations.
This involves scheduling visits for immunizations and recalling
children who fail to come in for these visits. 6) In 15 states,
hospital-based maternal education programs have been implemented to
provide new mothers in over 90% of targeted hospitals with
information
about vaccinations before they are discharged with their infants.
7)
The initial success in the Childhood Immunization Initiative was so
encouraging that a new target was enunciated--i.e., the elimination
of
indigenous measles from the United States by fall of 1982. As
documented in numerous previous articles, this program is
proceeding
on schedule. 8) Since 1978 approximately 120,000,000 doses of
childhood vaccines have been administered by the public sector.
Reported by Immunization Div, Center for Prevention Svcs, CDC.
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