PEDIATRICS Vol. 93 No. 5 May 1994, pp. 777
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THE VACCINE SCAPEGOAT

J. F. L. MD

Cynics argue that the reason Bill and Hillary Clinton pistol-whipped the drug industry over vaccine prices just days before the State of the Union was to intimidate the rest of U.S. industry into silence oven the tax-laden economic proposal. And the reason cynicism like this is coming back into vogue is that the Clintons, as elsewhere, had so transparently demagogued the vaccine issue, leaving huge and obvious parts of the immunization problem unmentioned ...

A more honest explanation of the problem at least would have mentioned both the famous liability suits that pushed up the cost of vaccines and the government bureaucracy's own failed efforts to immunize the poor.

That brings us to the second widely known reason that so many children don't receive the proper immunizations: The bureaucracy can't figure out how to get the job done. Any child in any state can receive free vaccines at a public-health clinic paid for by state and federal money. So why don't more parents respond? One large reason is that the public system is very inconvenient.

Before they will administer a vaccination, many public-health clinics require a physician's referral or a complete physical. They don't phone with a reminder that it's time again for the shots. And, like the department of motor vehicles, their hours often aren't convenient for working parents ....

So yes, there's a problem, but clearly it's about something more complicated than just price. The President's answer is to spend $300 million to "improve outreach efforts" and hire more staff for the public clinics.