Health Officials Well Shy of Goal in Vaccination Drive

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

And, 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 two-thirds to one-half of all children 4 years old and younger in high-risk Latino, African-American and immigrant communities who haven’t 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.

There was a poor turnout, for example, last week at a Salvation Army clinic in Van Nuys, where workers left an hour early because only 10 parents brought children in for shots, said Eileen Halverson, a volunteer.

“People just didn’t show up--probably because the word didn’t get out soon enough,” Halverson said.

The largest number of immunizations was reported at the San Fernando Gardens in Pacoima, which gave 255 immunizations last Sunday.

“About 100 of those shots were of children 5 and under, who are the high-risk kids,” said Bob Frangenberg, director for county clinics in the San Fernando, Santa Clarita and Antelope valleys. He credited advertising and flyers handed out among local groups for the large turnout.

Dr. Shirley Fannin, director of the county’s public disease control programs and part of the effort, said more children must be vaccinated to end what she called the real danger of another epidemic.

Health workers say the low rates come despite the widespread availability of free vaccines. Los Angeles County offers free vaccinations at more than 40 county clinics.

The number of places where free immunizations were available greatly expanded during National Pre-School Immunization Week. The Los Angeles Immunization Coalition, sponsoring the activities locally, kicked off the campaign last weekend by offering free immunizations at 23 sites around the county, including churches, clinics, community centers and housing developments.

Although the week ended Saturday, opportunities for free immunizations will continue. May has been dubbed Toddler Immunization Month throughout California, and the Immunization Coalition will remain active and is planning future drives.

As for the causes for the disappointment, consider the scene at a mobile immunization clinic 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. Neighborhoods nearby are largely populated by African-American, Latino and immigrant parents of children born in the last two years.

For days, Lucky store management had stuffed grocery bags with flyers announcing the immunizations. Spanish-language radio stations had 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, and attendance was spotty after that. By day’s end, Dr. Frederick N. Thomas, in charge of the mobile unit, said his team did about 20 immunizations, a number he considered “reasonable.”

The experience was much the same at other locations sponsored by the Immunization Coalition, which represents about 20 service groups and public and private health organizations.

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 American children. Critics of the plan in Washington question spending so much more money when there are obviously so 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 since immunizations are such a cost-effective way of avoiding future public health costs. 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 get their children in.

Health workers also say language can be a barrier in educating parents about the need to immunize. They also point to the large numbers of county residents who have no health insurance.

At a cost of between $200 and $300, a series of shots can be prohibitive for many. Few agencies other than the county health clinics can afford to give away the shots. Even some of those with insurance are forced to pay because immunizations are considered preventive medications and are not covered by all insurance plans.

Adding to the problem are attitudes. Health workers say some parents simply can’t bear seeing their infants cry or don’t want to put up with the temporary discomfort that some children suffer after shots. Feeding the problem is at least one old myth, discounted by health workers, that it is better to expose toddlers to some diseases, such as measles, rather than risk complicated problems later in life.

But health workers say the problem is not just parents. During a demonstration project in 1991 and 1992 financed by the U.S. Centers for Disease Control, Dr. Suzanne Westman set out to see what would happen if the some of the barriers were removed at two county clinics. Her team gave free shots, no questions asked, did not require appointments and stayed open long hours, six days a week.

Within two years, the team had vaccinated 35,375 children at the two clinics, putting it above all of the other more than 40 county clinics. 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. Westman has turned the program over to the county, which is trying to continue its success.

Wilbert Mason, a physician at Childrens Hospital Los Angeles, said that during 1990, when his hospital along with others in central Los Angeles County was inundated with measles cases, many of the parents were so poor, and had to work so hard, that they simply could not afford to take time off 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.

“To me, that’s a rather a cost-ineffective way to deal with a disease like measles,” he said.

Clinic Locations

Free immunization clinics will be held in the San Fernando and Antelope valleys as part of National Pre-School Immunization Week. Organizers hope to reach at-risk children who are 4 years old and younger.

* Tuesday, 12:30 to 3 p.m. at Palmdale Cultural Center, 38300 N. Sierra Highway, Palmdale.

* Saturday, 10 a.m. to 2 p.m. at Delano Recreation Center, 15100 Erwin St., Van Nuys.

* Saturday, 10 a.m. to 2 p.m. at Blythe Street Park, Blythe Street and Willis Avenue, North Hills.