Turnout Is Low for Immunizations : Health: County offers free vaccinations for preschoolers in effort to prevent another measles epidemic, but few parents bring their children.

Haunted by memories of a recent measles epidemic that took 40 young lives, public and private health workers in Los Angeles County are in the midst of another drive to vaccinate preschool children for measles, whooping cough and other preventable childhood diseases. Once again, they are reporting disappointing results.

Sponsors of the immunization drive, part of National Pre-School Immunization Week, were hoping to put a dent in the estimated one-half to two-thirds of children 4 and younger in high-risk Latino, African-American and immigrant communities who have not been adequately immunized.

But after the first six days of the drive, officials said they were well below their goal of 3,000 immunizations for the week. They would not release specific figures.

Dr. Shirley Fannin, director of the county’s public disease control programs, said that unless many more children are immunized, the county will face the possibility of another epidemic.

Health workers say the low rates come despite the widespread availability of free vaccines. Los Angeles County offers free vaccines at more than 40 county clinics on an ongoing basis. “We give free shots to all who come,” Fannin said.

The number of places where free immunizations were available greatly expanded during National Pre-School Immunization Week. The Los Angeles Immunization Coalition is sponsoring the local activities. It kicked off the weeklong program last weekend at 23 sites around the county, using churches, clinics, community centers and housing developments to offer free immunizations.

Opportunities for free immunizations will continue through the year. May has been dubbed Toddler Immunization Month in California. The Immunization Coalition will remain active and has more drives in the works.

An illustration of the disappointing turnout could be found at a mobile clinic offering free immunizations that was set up in the parking lot of the Crenshaw district Lucky store one day this week.

The site had been picked because it was in an area hit hard by the measles epidemic that peaked in 1990 and took 40 lives by 1992.

For days, Lucky store management had stuffed grocery bags with flyers announcing the immunization effort. Spanish-language radio stations carried public service announcements. The Watts Health Foundation, a well-established player in the local health delivery system, supplied the mobile clinic for a day.

Still, only one mother showed up during the first two hours the clinic was open, bringing her 11-month old son in for a measles shot. Attendance was spotty after that. By the day’s end, Dr. Frederick N. Thomas, who was in charge of the mobile unit, said his team did about 20 immunizations, a number he considered “reasonable.”

Officials said similar scenes were found at other locations sponsored by the Immunization Coalition, representing about 20 service groups and public and private health organizations. The largest number of immunizations was reported at the San Fernando Gardens Housing Development, which provided 200 immunizations Sunday.

The local efforts come at a time when President Clinton is struggling to push through Congress a plan to provide $1.1 billion to immunize all children. Critics of the plan in Washington question spending so much money when there are many parents who are not taking on the responsibility of immunizing their children.

Local health workers argue that free vaccines should not be viewed as another government “giveaway” program because immunizations are a cost-effective way of avoiding public health costs later. They estimate that every $1 spent on immunizations is expected to save $10 to $14 in future health costs.

Among possible reasons for the low immunization rates, health officials say, are the many barriers that stand in the way of poor parents. They point out that although the county offers free immunizations, it limits the hours its clinics provide the shots, making it difficult for working parents to bring in their children.

Health workers also say language can be a barrier in educating parents about the need to immunize.

Adding to the problem are personal attitudes. Health workers say some parents cannot bear seeing their infants cry or do not want to put up with the discomfort that is the temporary aftereffect of some shots. Some parents also heed a myth, debunked by health workers, that even if a child is vaccinated, he can contract riskier versions of some diseases later in life; therefore, they reason, it is better for a youngster to have some diseases, such as measles, at an early age.

But health workers say the problem is not entirely the parents. During a demonstration project in 1991 and 1992 financed by the Centers for Disease Control, Dr. Suzanne Westman set out to see what would happen if the some barriers were removed at two county clinics. Her team gave free shots, did not require appointments or much paperwork and stayed open long hours, six days a week.

Within two years, the team had vaccinated 35,375 children at the two clinics, more than any other county clinic. In contrast, the Immunization Coalition, pulling together the support of 20 organizations and utilizing a major public relations campaign, has set a goal of immunizing 15,000 children this year. The county has just taken over the two-clinic program from Westman and hopes to continue its success.

Dr. Wilbert Mason, a physician at Childrens Hospital Los Angeles, said that during 1990, when hospitals were inundated with measles cases, many parents were so poor and had to work so hard that they could not afford to leave work to have their children vaccinated. “It’s easy to blame the parents, but in many situations, parents are forced to choose between getting their kids immunized and putting bread on the table,” he said.

Mason said that during the first six months of 1990, Childrens Hospital treated 440 children with measles, and 195 of them had to be admitted for extended hospitalization at a cost of $1.7 million.