Budget Cuts May Mean 8,000 Miss Measles Shots

More than 8,000 children in San Diego County may not get measles vaccinations next year despite a fivefold increase in measles cases over the past year, county health officials say.

“If we haven’t got the vaccine, we’re obviously not going to immunize,” said Donald Ramras, county health officer. “If things don’t change, my prediction is that some people won’t get it.”

The problem is a money crunch in the state Department of Health Services. Officials of that office expecting a shortage for next year of vaccines against measles, polio and mumps, among other diseases, because of a 25% to 30% cut in funding and a rise in vaccine prices.

The state health department’s shortfall affects the counties, to which it distributes the vaccines.

“It’s been kind of a desperate situation for the last part of the year,” said Loring Dales, chief of the immunization unit of the state health department.

Dales estimated that about 35,000 children in the state will not receive any measles vaccine. Up to now, about 150,000 children in California had been inoculated at public facilities every year.

Public clinics in several counties this year have on occasion had to turn away children needing any of a variety of vaccines, Dales said. If the public clinics do not receive more money, more children will be turned away in the second half of next year, he said.

“This is the first time that it has ever been this bad,” Dales said.

State and federal funds buy the vaccines; the state bears 25% of the cost.

San Diego County administered nearly 33,000 measles vaccinations in 1989. Officials expects the lack of funds to mean that 8,000 fewer children will be vaccinated. Ramras said the shortage will be felt by July or August next year.

“Our bottom-line projection is that the county will need about $350,000” more to be able to vaccinate the children who need it, Ramras said.

The county has had 182 cases of measles this year, contrasted with 34 cases last year, he said.

Compounding the problem is a recommendation to be published Friday by the Centers for Disease Control in Atlanta. The centers recommend that children receive two doses of measles vaccine--the first at 12 to 15 months of age and the second around 4 to 6 years of age. The centers also recommend a third dose for college students and health workers.

The county would need $835,000 more to comply with that recommendation, Ramras said.

Despite the cost of added inoculations, the recommendation has been long overdue, said James Connor, professor of pediatrics at the UC San Diego School of Medicine. The American Academy of Pediatrics issued a statement in July recommending that children also be inoculated for measles when they enter junior high school.

The CDC recommendation was prompted by concern about vaccine failure, a problem that has become apparent in the past two to three years, said Dr. William Atkinson, a medical epidemiologist at the centers’ immunology division.

Atkinson said that about 40% of measles cases in the United States involve patients who have been vaccinated. Atkinson explained that the vaccine will not work if it is left in the light or at room temperature too long. He also said that it will not work if given to a child younger than 1 year.

He said, however, that the measles vaccine itself is “one of the better ones we have,” with an effectiveness rate of 95%.

But he says that people should be vaccinated more than once to be on the safe side. “We believe that about 75% of individuals who do not respond to the first dose will respond to a second dose,” he said.