Half of O.C.’s Preschoolers Lacking Shots

Three years after a measles outbreak killed two infants and infected 550 more children in Orange County, only half the county’s preschoolers are fully immunized against childhood diseases and a quarter of those under age 2 are not immunized at all, authorities say.

Requirements that children have up-to-date immunizations in order to enter kindergarten or licensed day care have resulted in a 95% immunization rate for school-age children. But preschoolers are still at “very high risk” for communicable diseases which can be prevented by vaccine, said Len Foster, Orange County deputy director of public health.

While the high cost of immunizations from private physicians has prevented some children from getting the precautionary shots, money isn’t always the issue, authorities say. “There are a lot of people who have all the resources in the world and still don’t get it done,” said Mary Wright, project coordinator for the county’s Immunization Assistance Program.

Some parents, who do not remember polio or diphtheria outbreaks, may not understand the importance of vaccinations, Wright said. Others get behind in the series of vaccines when infant doctor appointments, which are routinely scheduled in the first year, become sporadic.

Others say the low immunization rates also reflect the growing proportion of children who are uninsured. One UCLA study found that 26% of Orange County children are uninsured at some point in a given year. Even those who have insurance are not always covered for immunizations. Only 45% of conventional employment-based plans will pay for vaccinations.

Some parents may put it off when they learn that a full series of immunizations from a private physician can cost $300 and more per child, medical authorities say.

Officials said that in Orange County, more middle-class parents are taking advantage of immunizations that are free for all preschool children at a variety of county public health clinics.

But many more do not, said Dianna DeVane, director of community services for the March of Dimes. “They don’t know how the system works, they dread the wait, they’ve heard stories, which may or may not be true, about the people who hang out at the clinics. A lot of it is a lack of education.”

DeVane chairs a 3-month-old organization, the Orange County Immunization Coalition, which is part of a nationwide campaign to raise the immunization rate.

While measles cases have dwindled over the past three years to an all-time low in California, the coalition and a variety of other organizations are scheduling a spate of free clinics, hoping to snag parents into getting their children vaccinated and into regular health care.

“So many people can’t afford health care, these fairs are becoming a necessity,” said Diana Buckhantz, consultant for the Los Angeles-based Children Now, one sponsor of Kids Care Fair which will offer free immunizations and health screenings this weekend throughout Southern California, including two sites in Orange County.

The Kids Care Fair will be from 9 a.m. to 1 p.m. Saturday at Corbin Community Center, 2215 W. McFadden Ave. in Santa Ana. On Sunday, it will be from 9 a.m. to 1 p.m. at the Boys and Girls Club, 7758 Knott Ave. in Buena Park. Children up to 6 years old may receive free immunizations. Health screenings will be available for anyone up to 18 years old.

In addition, the Orange County Immunization Coalition, in conjunction with the Santa Ana Police, will offer free immunizations from 10 a.m. to 2 p.m. on Aug. 22, at Lucky Market, 724 S. Harbor Blvd. in Santa Ana.

In October, the coalition will hold free clinics at 24 sites in Orange County in conjunction with a nationwide Child Health Day. The sites will be open from 9 a.m. to 4 p.m. on Oct. 10 and will provide free vaccinations for children under 12. Records of previous immunizations are not required. Information about locations may be obtained by calling (714) 834-8560.

One drawback to immunization fairs is that they are only a day long and shots must be given in a four-part sequence, Foster said.

But spokesmen for the Kids Care Fair said they will focus attention on the importance of regular and preventive health care for children. Wright said the October clinics will be held at public health clinics to spotlight the sites where they can get further doses. In addition, follow-up notices or phone calls are being considered.

“If nothing else, they bring publicity for the need for immunizations,” Wright said.

Immunizations: How They Work, Where to Get Them

How Vaccines Fight Disease: The immune system is primed to make its own antibodies against disease-causing bacteria, viruses and toxins.

1. Person is injected with a dead or modified microorganism of the disease.

2. Immune system produces antibodies against the microorganism and “memorizes” the disease’s traits.

3. If the real microorganism enters the blood, antibodies are produced in large numbers to halt the infection.

Rates Around the State: A survey conducted earlier this year shows that about half of the 2-year-olds in Southern California, including Orange County, are fully immunized. The percentages of fully immunized throughout the state. Rural Northern California: 58% San Francisco Bay Area: 58% Central Valley: 31% Central Coast: 54% North Central Valley: 46% Los Angeles County: 42% Orange County, other parts of Southern California: 51%

Where to Get Free Shots

Buena Park 7212 Orangethorpe Ave. Costa Mesa 2845 Mesa Verde East San Juan Capistrano 27512 Calle Arroyo Santa Ana 1725 W. 17th St. Westminster 64462 Industrial Way

Buena Park Thursday, 8 a.m.-4 p.m. Costa Mesa First and third Wednesday of each month San Juan Capistrano Thursdays, 1-4 p.m. Santa Ana Monday-Friday, 8 a.m.-4 p.m.; Tuesdays until 6:30 Westminster Tuesday, 12:30-4 p.m.

Immunization Schedule Age: Shots Needed 2 months and 4 months: Polio, DTP (diphtheria, tetanus, pertussis), Hib (haemophilus influenza Type B), hepatitis B 6 months: DTP, Hib, hepatitis B 12 months: MMR (measles, mumps, rubella) 15 months: Polio, DTP, Hib 4-6 years: Polio, DTP, MMR 14-16 years: Tetanus Every 10 years: Tetanus

Measles and Age: Orange County’s youngest residents get measles much more often than older children and adults. Comparisons for 1990, the most recent year for which information is available, by age group per 100,000 population: Age: Rate 0-1: 312 2-5: 42 6-9: 17 10-14: 20 15-19: 55 20-29: 55 30-39: 20 40 and older: 1

Vital Statistics

* The U.S. ranks 17th in protecting all children against preventable diseases.

* The series of vaccinations that once cost the federal government $7 now costs $200. Private physicians now charge anywhere from $300 to $500 for a full series.

* Minority children living in urban areas are four to nine times more likely to contract measles than white children of the same age.

* Before the measles vaccine received approval in 1963, an average of half a million cases were reported each year in the U.S. Measles also killed 400 to 500 people annually.

Sources: AMA Encyclopedia of Medicine; Orange County Health Care Agency; California Department of Health Services Immunization Unit (based on the 1992 survey sample of 1,086 children); federal Centers for Disease Control

Researched by LYNN SMITH and JANICE L. JONES / Los Angeles Times