Funding shortages, fear lead to vaccine gaps for kids

Washington -- Although 95% of the nation's school-age children have received their recommended vaccinations, 20% of preschoolers, or 2.1 million very young children, have not, according to a new report released at a Sept. 27 Capitol Hill briefing.

Underfunded immunization programs, underutilized vaccine registries and public misperception about the importance and safety of vaccines contribute to this shortfall, according to "Closing the Vaccination Gap: A Shot in the Arm for Childhood Immunization Programs."

The report was written by the Trust for America's Health, an advocacy group, and Every Child By Two, a campaign to promote early immunization begun by former first lady Rosalynn Carter and Betty Bumpers, wife of former Sen. Dale Bumpers (D, Ark.).

Vaccines are a public health success story, but the infrastructure that has supported their development and production for more than 50 years is crumbling, said Paul Offit, MD, who spoke at the briefing. Dr. Offit is director of the Vaccine Education Center at Children's Hospital in Pennsylvania.

In the 1950s, 26 companies developed and manufactured vaccines; today there are only four, he said. Dependence on so few manufacturers has meant that a production problem for even one can result in a severe shortage of a vaccine. Since 1998, nine vaccines have been in short supply at various times, resulting in numerous children missing shots, and physicians scrambling to maintain accurate callback records when supplies return to normal.

Firms are forsaking vaccines for more profitable drugs, said Dr. Offit, and liability concerns loom large for the companies that continue vaccine production. The National Vaccine Injury Compensation Program has done a good job during the past 20 years of protecting companies from large damage claims while allowing payment to those injured by vaccines, he said, but the program's "tread is starting to wear thin."

Now lawsuits filed beyond the scope of the program are beginning to amass, said Dr. Offit, particularly those claiming damages from the preservative thimerosal. The program also doesn't cover unborn children, and the fear of lawsuits claiming birth anomalies has stopped companies from developing promising vaccines that could be administered to pregnant women to prevent disease during an infant's first weeks of life.

"We need to value preventive medicine," said Dr. Offit. "We are far more willing to spend money on treatment than prevention."