Not enough local children are being immunized in a timely manner, but Anne Arundel County is taking steps to change that, a Health Department administrator said yesterday.
Dr. Marilyn E. Crumpton, director of maternal and child health, said only 60 percent of the county's 2-year-olds are getting needed immunizations according to the schedule developed by the Advisory Committee of Immunization Practices.
The committee is affiliated with the Centers for Disease Control and Prevention in Atlanta.
Most children catch up on their shots by the time they start kindergarten, she said, because state law requires a minimum ++ level of immunization to enroll. But parents who wait until then leave youngsters exposed for three or four years.
"And what's wrong with that?" she asked. "Well, they can get very sick. They get measles, whooping cough, even tetanus. At 2 years old, 40 percent of our children don't even have minimum protection."
Anne Arundel County is not alone in this problem. Most Maryland counties have similar immunization rates or worse, she said.
"We simply don't do a good enough job immunizing our kids," said Edward Hirshorn, assistant chief of the immunization division of the state's health department. He agreed that statewide efforts are needed to boost immunization rates.
To increase rates among toddlers, the federal government has made money available for outreach workers, said Dr. Crumpton. Anne Arundel County got a grant for three workers who visit day-care centers, physicians' offices, health clinics -- "wherever they get invited" -- to explain the vaccination schedule and recruit children who have not gotten their shots.
The county has scheduled a series of clinics at area schools for families to bring school-aged children up to date, as well as their younger siblings. Parents can also have their children immunized at five county clinics. The shots are free, although the county asks for a $5 donation if families can afford it.
The Health Department hopes to increase the number of toddlers properly immunized by 20 percent by September 1995. The only way to check the progress, however, is to screen all incoming kindergartners and check back to see when they were immunized.
"It's not easy to track this," said Dr. Crumpton, adding that the "fragmentation" of health care is largely responsible. Families often move, change physicians or insurance companies, so they see a variety of health-care providers. It's difficult to keep track of children's shots if their records have been frequently forwarded from place to place, she said.
Parents should keep a copy of the immunization records themselves, she added, but many have lost them or have only partial records.
The Immunization Committee suggests a schedule that includes vaccinations at birth, 2, 4, 6 and 15 months, and again between the ages of 4 and 6 years. Public health departments follow this schedule.
The Committee on Infectious Diseases of the American Academy of Pediatrics recommends a slightly different schedule, said Dr. Crompton, though both are acceptable. Parents should ask their physicians which schedule is being followed.
Another issue for some parents is the safety of the vaccines, with some parents reacting to the occasional horror story of a child having a serious adverse reaction. Although Dr. Crumpton and Mr. Hirshorn agreed there are cases where children have negative reactions, the incidences are rare.
Overall, it is far more dangerous for children not to be immunized, they said.
"In all instances, the benefits far outweigh the risk," said Mr. Hirshorn. "On a whole, the vaccines are very safe and very effective."
Using polio as an example, Dr. Crumpton explained that in 1954, the year before the vaccine became widely available, more than 18,000 children nationwide contracted paralytic polio. In 1991, there were eight cases and in 1992, four cases.
"Those [four] cases were from the vaccine," she said. "But you can see what the vaccination program did was trade 18,000 cases of paralysis for four."
The Anne Arundel County Department of Health and the county school system will hold immunization clinics at county schools. The vaccinations are free at these clinics.
* Annapolis Middle School, 1399 Forest Drive, Annapolis; 3 p.m. to 7 p.m. Aug. 24 and Sept. 14.
* Van Bokkelen Elementary School, 1140 Reece Road, Severn; 3 p.m. to 6 p.m. Aug. 23 and Sept. 15.
* Southern Middle School, 5235 Solomons Island Road, Lothian; 4 p.m. to 7 p.m. Aug. 25 and Sept. 14.
* Chesapeake Bay Middle School, 4804 Mountain Road, Pasadena; 10 a.m. to 3 p.m. Aug. 26 and noon to 6 p.m. Sept. 9.
* Magothy River Middle School, 241 Peninsula Farm Road, Arnold; 3:30 p.m. to 7:30 p.m. Aug. 31 and Sept. 7.
* Marley Middle School, 7730 Baltimore-Annapolis Blvd., Glen Burnie; 3 p.m. to 6 p.m. Sept. 9.
Parents also can have their children immunized at any one of five county clinics. The Health Department asks that parents call for an appointment. The vaccines are free, though the department suggests a donation of $5.
The clinics, which are open from 8 a.m. to 4:30 p.m., are located at:
* 300 Hammonds Lane, Brooklyn Park; 222-6620.
* 416 A St. S.W., Glen Burnie; 222-6633.
* 1370 Odenton Road, Odenton; 222-6660.
* 1950 Drew St., Annapolis; 222-7247.
* 2501 Mountain Road, Pasadena; 222-6640.