8

Conclusions

Vaccines are the most highly effective medical means for preventing serious illnesses and death, yet the personal health care system alone has not proven capable of delivering all the necessary immunizations, especially to young children. To meet the challenge of the President 's Childhood Immunization Initiative—to ensure that by 1996 at least 90 percent of 2-year-olds have received all recommended immunizations—the nation needs an enhanced, broad-based collaboration between the public health system and private medical practice.

The infusion of federal funds into immunization programs emphasizes the administration's commitment to improving immunization levels among the nation's preschool children. It also is giving states badly needed resources to improve immunization services. States, which have the unique Constitutional authority to act to protect the public 's health, must accept responsibility for determining the need for immunization and ensuring that services are available to meet those needs. In addition, local health departments, individual providers, and families must accept certain responsibilities for immunizing children. As with states, each of them must be able to identify specific unmet needs and must have the resources to respond to those needs. Some of what should be done is complex or costly, but many simple steps can be taken as well.

Initiatives are under way to increase access to primary care through reform of the national health care system and to reduce financial barriers to immunization through a broadened federal vaccine purchase program. These efforts will not, however, lead to higher immunization rates unless there is leadership for action on immunization, accountability and responsibility for providing immunizations, support for improved provider practices, and effective communication with families and the community. The advancement of each of



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OCR for page 68
Overcoming Barriers to Immunization: A Workshop Summary 8 Conclusions Vaccines are the most highly effective medical means for preventing serious illnesses and death, yet the personal health care system alone has not proven capable of delivering all the necessary immunizations, especially to young children. To meet the challenge of the President 's Childhood Immunization Initiative—to ensure that by 1996 at least 90 percent of 2-year-olds have received all recommended immunizations—the nation needs an enhanced, broad-based collaboration between the public health system and private medical practice. The infusion of federal funds into immunization programs emphasizes the administration's commitment to improving immunization levels among the nation's preschool children. It also is giving states badly needed resources to improve immunization services. States, which have the unique Constitutional authority to act to protect the public 's health, must accept responsibility for determining the need for immunization and ensuring that services are available to meet those needs. In addition, local health departments, individual providers, and families must accept certain responsibilities for immunizing children. As with states, each of them must be able to identify specific unmet needs and must have the resources to respond to those needs. Some of what should be done is complex or costly, but many simple steps can be taken as well. Initiatives are under way to increase access to primary care through reform of the national health care system and to reduce financial barriers to immunization through a broadened federal vaccine purchase program. These efforts will not, however, lead to higher immunization rates unless there is leadership for action on immunization, accountability and responsibility for providing immunizations, support for improved provider practices, and effective communication with families and the community. The advancement of each of

OCR for page 68
Overcoming Barriers to Immunization: A Workshop Summary these goals depends on developing better information and information tools that make it possible to identify the unmet needs for immunization and to evaluate the impact of steps taken to meet those needs. More fundamentally, improved immunization coverage of preschool children requires a population-based approach to the overall issue of primary care that combines the efforts of private health care providers and a public health system capable of assessing the health of communities, developing public health policy, and assuring that necessary services are provided. As the nation debates health care reform, the promise for preventing illness with vaccines contrasted with the poor immunization rates of preschool children offers an important lesson about the provision of preventive health services. As effective as preventive services such as immunizations are when they are administered, simply making them available through private providers and public health clinics does not guarantee that these services will be used or received by all who need them. The promising approaches to immunization discussed at the workshop indicate the importance of collaboration between the public health system and private medical practice. This population-based approach to improving the health of the public is likely to be successful for other preventive and primary care services as well.