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October 25, 2000

Effects and Ethics of Sanctions on Childhood Immunization Rates—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(16):2056-2057. doi:10.1001/jama.284.16.2053

In Reply: While we agree with Dr Minkovitz and colleagues that poor children face barriers in obtaining health care and that provider-based interventions might work, child-based interventions have proven effective. Our study demonstrated the success of sanctions. School laws (draconian in their sanctions, but almost universally accepted) achieve virtually 100% vaccine coverage. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) vouchers have been effective as incentives.1

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