In my article that appeared in the May 1991 issue of the American Journal of Diseases of Children,1 I mentioned several factors responsible for the low levels of immunization in inner-city preschool children, including the lack of a uniform data system, missed opportunities, overinterpretation of contraindications, and administrative barriers. I recommended the development of an effective tracking system, parent education, removal of barriers and increased access to services, incentives (positive or negative), and provider education. At least 10 actions and initiatives that have occurred through the end of 1992 should help us achieve our goals. They include the following:
Direct involvement of the president. On June 13,1991, and again on May 11, 1992, President George Bush held Rose Garden ceremonies emphasizing White House concern about low immunization levels in preschool children. The first of these ceremonies led to visits to six cities by the highest-level federal health officials: the
Hinman AR. What Will It Take to Fully Protect All American Children With Vaccines? An Update. Am J Dis Child. 1993;147(5):536–537. doi:10.1001/archpedi.1993.02160290042020
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