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Shots in the dark


President Clinton took office determined to boost childhood immunization rates that had slumped so badly they ranked among the worst in the hemisphere. Unfortunately, in devising a way to vaccinate more young children against common childhood diseases, the administration targeted the wrong enemy.

Instead of focusing on simplifying a complicated vaccination process, it decided that cost was the primary barrier and set out to provide shots free of charge to as many children as possible. The result is a program that has drawn scathing audits from the General Accounting Office.

Last year, as the program was getting off the ground, the GAO said the system the administration was devising to help states buy and distribute vaccines was cumbersome, untested and potentially unsafe. Now, another critical report from the GAO charges that the administration was wrong in focusing on providing free vaccines and that it underestimated the complexity of setting up a system of delivering vaccines to doctors and clinics.

After reading the report, even an administration ally like Sen. Dale Bumpers, D.-Ark., described the program as an "unmitigated disaster." So it is hardly surprising that the Republican response is to seek to do away with the program altogether. What is surprising is that the administration got itself into this fix in the first place.

Childhood immunization should be an easy issue to champion. Yet somehow the administration jumped to the wrong conclusions and set about spending money in all the wrong places. Yes, cost is a problem for some families, but it's hardly the overriding cause of low immunization rates.

Some states pay for all children's vaccines, but while their immunization rates are better than other states, they still don't approach the levels in most other Western hemisphere countries. Access to clinics, the difficulty of keeping track of immunization schedules, lack of public education on the importance of vaccinations -- all these factors seem to play a more important role than cost.

Despite that evidence, the Clinton administration focused its efforts on a vaccine-purchasing approach that will cost $457 million this year -- a nice target for budget-cutting Republicans. And, no doubt, a prime candidate for a horror story about government's penchant for taking a good issue and producing a bureaucratic nightmare.

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