Child Vaccination Program Is Pushed : Health: Clinton, denouncing drug companies for ‘shocking’ prices, earmarks $300 million for expanded immunizations. He’ll seek a law mandating free vaccines.

President Clinton announced plans Friday to spend an additional $300 million in federal funds this year to expand the government’s lagging immunization effort for children, and blasted drug companies for charging “shocking” prices for vaccines.

Clinton said he will seek legislation to make free vaccines available for all children. In addition, he said, the government will immediately try to open negotiations with drug companies to lower the prices the government is charged for vaccines, and to guarantee that any state can buy the vaccines at the reduced rate.

The additional $300 million will bring about the immunization of 1 million more infants and children, budget officials predicted.

“Our nation is the only industrialized nation in the world that does not guarantee childhood vaccination for all children,” Clinton said. “It ought to be like clean water and clean air. It ought to be a part of the fabric of our life.”

A day after his wife, Hillary Rodham Clinton, said that both care providers and consumers must prepare to make sacrifices for the sake of health, the President unleashed a harsh attack on the pharmaceutical industry.

He charged that while the nation’s immunization rate for children has been falling to 59%--only Bolivia and Haiti have lower rates in the Western Hemisphere--drug companies have been raising their prices.

The companies have increased their charges for a complete set of immunizations for one child from an average $23 a decade ago to an average of $200 today, he said, even while drug company profits have been rising at four times the rate of other Fortune 500 companies.

He denounced the drug industry for negotiating special deals to sell vaccines to 10 states, then balking at cutting similar deals with other states.

“Today we must tell the drug companies to change those priorities,” he said. “We cannot have profits at the expense of our children. These practices have got to stop.”

Clinton’s plans were in keeping with pledges made often during the campaign. The White House seemed also to be betting that they would make good politics at a moment when--five days before Clinton unveils his economic program--he is trying to foster broad popular support.

Some vaccine makers said Clinton’s statistics about costs were misleading because the number and type of vaccines have changed, along with other factors. They warned that if Clinton in effect nationalizes the drug industry, by eliminating private sales and regulating drug profits, he would also end the research and development that have spurred development of new vaccines.

The industry argues that there is more than enough free vaccine available from public sources, and argues that the government should direct its efforts at ensuring that the vaccine reaches children.

“We’re a convenient target,” said Craig Engesser, spokesman for Lederle Praxis Biologicals, of New Jersey, the largest vaccine maker.

The federal government buys a huge amount of vaccines, and distributes them through the states.

The $300 million in added funds for fiscal 1993 would be part of Clinton’s short-term economic stimulus package. The money would go to improve the government’s efforts to reach poor children, through such steps as opening new clinics, hiring more nurses, allowing longer hours at health facilities and starting a record-keeping system that would enable the government to keep track of children’s vaccine history.

The money would be considered part of the fiscal stimulus because of the jobs it would create. The federal government was already spending $343 million this fiscal year on the vaccine program. Of that money, $187 million is spent for the purchase of vaccines, and the rest for the facilities and personnel to deliver them to children.

Officials say the nation’s immunization rate has lagged particularly in inner-city and isolated rural areas. It has fallen because of parental complacency, because of the growth of immigrant groups not as attuned to the need for preventive medical attention, and because of a weakening of efforts to bring vaccines to children.

The White House has leverage over the drug companies in a number of ways. The President can embarrass them, as he tried to do Friday. He has influence over them through the Food and Drug Administration, and could also urge Congress to revoke their favorable tax treatment.

Separately on Friday, it was announced that the President has asked the acting director of the Office of Personnel Management for a “complete review” of the tens of thousands of dollars in bonuses that officials in the George Bush Administration issued in the final days of Bush’s presidency.

“He thinks it smells fishy and wants to get to the bottom of it,” said George Stephanopoulos, Clinton’s communications director.

A least five Cabinet secretaries authorized bonuses for senior employees in the closing months of the Bush Administration. Five minutes before Clinton took office, Interior Secretary Manuel Lujan Jr. authorized cash bonuses for 12 senior employees; former Labor Secretary Lynn Martin authorized eight bonuses totaling $22,000.

Stephanopoulos said that the federal office would review the bonuses to see if they complied with current “criteria and procedures.”

The President’s Remedy

Here are the main points of the plan President Clinton presented on inoculations:

Clinton will ask Congress to approve an additional $300 million for childhood immunizations for the fiscal year ending Sept. 30.

The President directed Donna Shalala, secretary of health and human services, to negotiate with drug manufacturers to develop agreements assuring that any state can purchase any necessary vaccines at reasonable prices.

In cooperation with Congress, the President will prepare an initiative to guarantee vaccination coverage for all children, regardless of whether they use public, nonprofit or private health providers.

FACT SHEET

Only about half or less of 2-year-olds are fully vaccinated.

In some inner-city areas, the rate is as low as 10%.

The resurgence of measles in 1989-1991 was a danger signal indicating that the immunization system is not working as it should.

Only about half of employer-based health insurance plans cover child immunization, so many parents must pay for both vaccine and administration costs themselves.

Source: U.S. Department of Health and Human Services

The Price of Prevention

President Clinton sharply criticized U.S. drug companies for their prices. Here are some of the costs, according to the Department of Health and Human Services: Complete Set of Inoculations: Private: 1982: $23 1992: $200

Public: 1982: $7 1992: $90

Individual Inoculations: Private: Diphtheria, tetanus and per tussis: $50 Oral polio vaccine: $40 Measles, mumps and rubella: $50 Hepatitis B: $60

Public: Diphtheria, tetanus and per tussis: $30 Oral polio vaccine: $8 Measles, mumps and rubella: $31 Hepatitis B: $21