Washington. In 1983 only 1,497 cases of measles were reported in the United States. Last year, there were more than 25,000, with at least 60 deaths. Outbreaks occurred in dozens of cities.
This is an inexcusable step backward, for measles is a disease that can easily be prevented. It is also yet another warning that something is tragically wrong with America's health system, especially as it serves the disadvantaged.
According to a report from the federal National Vaccine Advisory Committee, half of the measles cases last year occurred among unvaccinated pre-schoolers, most of them inner-city blacks and Hispanics. The principal cause of the epidemic, said the panel, was "failure to deliver vaccine to vulnerable children on schedule."
The report said some parents had to schedule visits to medical clinics months in advance, had to wait for hours in crowded clinics and had to pay for children's vaccinations that used to be free. In addition, some clinics were closed evenings and weekends.
Another problem is that many health-insurance policies do not cover vaccinations. And some parents simply are not aware of the importance of early-childhood vaccinations.
Given the low immunization levels for measles, the panel said it is reasonable to suspect that there also are "substantial numbers" of children now susceptible to pertussis (whooping cough), poliomyelitis, mumps and rubella (German measles).
The federal Centers for Disease Control says only 50 to 60 percent of all children under age 2 have completed the recommended infant immunizations, including four DTP shots (for diphtheria, tetanus and pertussis) plus a booster before entering school; three doses of oral polio vaccine; one shot for measles, mumps and rubella, plus another shot before school, and one shot for haemophilus influenza type b.
The side effects of these diseases include pneumonia, encephalitis, meningitis, deafness, learning disabilities, paralysis -- and death.
What's especially disturbing is that immunization is one of the simplest and most cost-effective medical procedures. But try convincing the Scrooges in the White House of this.
Rep. Henry Waxman, D. Calif., chairman of the House Health and Environment Subcommittee, points out that the Reagan administration proposed in 1981 to cut the immunization program effectively in half and in 1985 began to cut payments for monitoring immunization rates. Last year the Bush administration said it didn't want to pay for poor children's second measles shots, which had been recommended by pediatricians and the Centers for Disease Control.
The vaccine advisory panel made several recommendations:
* Increase federal aid by $50 million year to state and local immunization programs.
* Require medical insurance to cover childhood immunizations.
* Require children to be immunized before they enter day-care programs.
* Allow people to be vaccinated on request, without having to make appointments or undergo physical examinations.
Another idea came up at a recent meeting of health officials. It would link welfare benefits to vaccinations by making parents show that their children are fully immunized in order to get welfare and Medicaid.
This proposal has an obvious danger. It might set up new hurdles that keep the needy from getting welfare, and leave them without benefits and vaccinations.
But if, as part of the strategy, the government made vaccinations easily and freely available to the poor and educated them about the need, then this might be an effective mechanism. For example, nurses could be available at welfare offices to vaccinate children, and information about immunization could be included with correspondence to welfare and Medicaid recipients.
We have it within our power to virtually wipe out many of the diseases that cripple and kill our children. Don't we owe that to them?
Carl Rowan is a syndicated columnist.