The Shots Not Heard Across the World

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Only a bunch of pediatricians and health officials could celebrate, albeit in a muted kind of way, that toddlers across the nation are shrieking their lungs out. On the one hand, theyíre chalking up the highest-ever rates of childhood immunizations, and on the other theyíre bemoaning the fact that so many kids still remain out of reach. According to numbers released Thursday by the Centers for Disease Control, in 1998, 80.6 percent of children 19 to 35 months had the complete series of recommended shots for the big three of childhood disease: measles, polio and tetanus/diphtheria. Thatís up from 76.2 percent only four years ago. The downside, of course, lies in the remaining 19.4 percent of toddlers who have thus far eluded authorities. Although Walter Orenstein, director of the CDCís National Immunization Program, is pleased with recent immunization efforts, he is worried about the kids who are falling through the cracks. "Between state and federal programs, the vaccines are out there, but there is a lot to be done in keeping track of kidsí vaccine schedules and just getting them in there," Orenstein told the Associated Press.

Whatís keeping the non-compliance rate so high? Itís not the cost of the shots. "Finances are not really an issue in the case of immunizations, although they certainly used to be," says TIME medical contributor Dr. Ian Smith. "Today, there are so many free clinics available, virtually every person has access to basic care." The major reasons that some children are not getting the inoculations they need are twofold, says Dr. Smith: "First, in spite of all the public programs available today, some parents still lack basic awareness about the importance of immunization, and may not understand the scheduling that each shot requires." The second reason, says Dr. Smith, is more worrisome. "There are people out there who harbor serious misconceptions about the effects of vaccinations. These folks are concerned that getting a measles shot, for example, will give you the measles." Such fears have done a lot, says Dr. Smith, to keep kids off the immunization rosters. Getting that last 19.4 percent of kids onto an immunization schedule will require collaboration between local governments and community programs ó and, most important, health care workers capable of breaking through layers of resistance and fear.