Fwd: Hillary Clinton - The Thimerosal Queen & The Mother of the Autism Epidemic

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OK, here's my contribution to the discussion....forwarding this interesting article from another list. Thanks, It's Mrs. Clinton's shot at an inoculation cure -Hillary Rodham Clinton's effort to supply childhood vaccines toevery pre-school childInsight on the News, Feb 22, 1993 by Elena NeumanSummary: Bush poured money into getting more preschoolersvaccinated, but the effort was criticized as meager, and someexpertsquestion whether greater spending is even the right prescription.NowHillary Clinton will get her turn at a chronic national problem.In a little-publicized 1991 media event, Arkansas's first ladyblasted the Bush administration for its purported failure to pay foradequate supplies of childhood vaccines."That has always been one of the most

inexplicable positions takenbythe administration over the years," said Hillary Clinton from apodium she shared with Jocelyn Elders, who has been picked to becomethe new surgeon general. "Because if preventative health care is apositive thing, what better way than through immunization?" Sherevisited the subject at a Nov. 18 appearance before the Children'sDefense Fund, the advocacy group she once led. "We owe our childrenmore than we've been giving them," she declared. "What on earthcouldbe more important than making sure that every child has the chancetobe born healthy, to receive immunizations and health care as thatchild grows?"Now the nation's first lady, appointed by her husband to lead hisplanned overhaul of the nation's health care system, Mrs. Clinton isin a position to follow through on these complaints. And a plan tofederally fund all childhood vaccines will reportedly be

theadministration's first health care reform. If childhood immunizationis less than universal because of neglect by penny-pinchingRepublicans in the White House, as the Clinton campaign charged,thengiving children the medical attention they deserve is one campaignpromise that should be easy to fulfill.According to the most quoted statistics, compiled by UNICEF and theChildren's Defense Fund, the United States ranks 17th in the world -behind countries like Albania, Poland, Mexico and Pakistan - for thepercentage of 1-year-olds who have been vaccinated against polio.A Children's Defense Fund survey this past summer found that moststates report preschool vaccination coverage levels below 60percent;in cities such as Los Angeles, Houston, Cleveland and Chicago, fewerthan 50 percent of children under age 2 have received shots toprevent measles, mumps, rubella, diphtheria, pertussis (whoopingcough) and

other childhood diseases, the report said.Childhood immunization has been a hot issue since 1989, when itattracted national media attention because of an outbreak ofmeasles -a disease all but wiped out in 1983. Infections of whooping coughalso rose in the late eighties, primarily due to parents forgoingDTP(diphtheria, tetanus and pertussis) shots for their children aftermedia reports that the vaccine caused serious adverse reactions,evendeath.The Bush record on children's health was thus an open target forliberal criticism. In an opinion piece in the Washington Post lessthan a month before the election, commentator Kinsley saidthe issue was a touchstone distinguishing Bush voters from Clintonvoters. Describing the problem as an "aspect of the general declineof national wellbeing that snuck up on us while we were partying inthe 1980s," he laid the blame at the doorstep of "people with

nofaith in the power of government to do good." What made him aDemocrat, Kinsley offered, was his feeling that "as a citizen of therichest country in the world, this is a problem I shouldn't have toworry about. And I wish we had a president who would take whateveraction, and spend whatever money, is necessarry to solve it." Katz, a professor of pediatrics at Duke University MedicalCenter and the chairman of the Federal Advisory Committee onImmunization Practices, echoed this analysis in late December andurged Bill Clinton to be the president Kinsley had wished for. "Withthe de-emphasis on federal support originating during the Reaganyears and continuing through the Bush administration, problems haveundermined the nation's mandate to protect its children "he wrote ina Scripps column. "Childhood vaccination must be a sure bet.President Bush's health-care promises proved empty. They let

downtheinnocent children among us. Let's hope Bill Clinton's medical agendaputs the nation's future - its children - first and foremost."Even Hollywood has thrown its weight behind the call for greaterefforts at childhood immunization. In 1991, Spielberg, KateCapshaw, Henry Winkler, Bill Cosby and a host of entertainmentexecutives and producers formed the Children's Action Network, inassociation with the American Academy of Pediatrics, to launch afull-scale immunization awareness drive.Despite this seeming unanimity of liberal opinion, however, theClintons may have a tough time living up to expectations. Theindictment of the Bush administration for inaction on immunizationleft out two stubborn facts: Federal efforts have hardly beenlacking; and the problem is more complicated than it has beenportrayed.Advocates of a full federal offensive have emphasized the Bushadministration's

failure to propose spending as much as Congressappropriated. Left out is the fact that spending on childhoodpreventive medicine may have been the fastest growing federal budgetline in the Bush years - increasing by 250 percent.Federal spending on immunization in fiscal 1988 was $98 million; infiscal 1992 it was $297 million; and for fiscal 1993, which beganOct. 1, Bush requested $349 million. During those years, funding fortwo new vaccines, hepatitis B and Haemophilus influenza type b, plusa booster shot for measles, mumps and rubella was added to thebudget.Nor were federal efforts limited to increased funding. In 1991, Bushdirected his top health officials to do a six-month study of sixmajor urban centers to determine how the national immunization ratecould be improved; upon receiving the panel's suggestions to makepublic clinics more user-friendly, he approved an additional $46million to support vaccine

distribution and education, quite apartfrom vaccine supply.Vaccine "one-stop shopping" centers and immunization "express lanes"were planned for inner cities; plans were drawn up to consolidategovernment aid centers with public clinics to make it easier forpoorparents to have their preschool children immunized at the same timeas and in the same office where they applied for food stamps orwelfare benefits.These policy moves were "innovative and unusual. An important firststep " says Talbott, executive director of Every Child by Two,an advocacy organization for children's immunization founded byformer first lady lynn and Betty Bumpers, wife ofArkansasSen. Dale Bumpers. It was the first time since a federalimmunizationgrant program was authorized in 1962 that money was allotted forfunctions other than the purchase of vaccines, and health careprofessionals applauded.Almost

without exception, Democrats on Capitol Hill criticized thepolicy, not on its merits but as too little, too late, or as a Band-Aid approach. "We don't need a six-city road show to study theproblem"' said Sen. Kennedy of Massachusetts. "We need ageneral federal commitment to see that every child is immunized"Katztold the Los Angeles Daily News that Bush had "finked out" onchildren.Now, former Bush health officials profess amazement at the way amassive budget increase, coupled with policy innovations, was turnedinto a political liability. "The notion that there haven't beenenormous increases in public health service funding, distributionandservices during the Bush administration simply belies the fact ofwhat's happened - during a time when there was a great deal ofconstraint over the general federal spending," says Moley,former deputy secretary of health and human services.Moley, like

other Bush officials, ridicules the notion that theinternational rankings of UNICEF are reliable - that statisticsfrom,say, Pakistan or Albania are reported accurately. "After all thistalk, are [the Clinton people] prepared to match the percentageincreases the Bush administration put through in such areas asimmunization for children, Head Start and AIDS? ... I don't knowwhere they're going to get the money to do this unless theydramatically increase taxes or the deficit." That may in fact be theplan. The Children's Defense Fund advocates tripling spending - to$1billion - for a universal immunization purchase program in which allvaccines, for both public clinics and private physicians, would befederally funded.Given Mrs. Clinton's close ties to the organization, it's notsurprising that the idea is being seriously considered. And althoughthe Clinton administration says it has not quite figured out how

topay for the expensive federal program, higher taxes would in fact beconsistent with a campaign speech that Clinton delivered to aconvention of the American Association of Retired Persons in June inSan , Texas. He said he planned to raise taxes on peoplemaking more than $200,000 to pay for specific programs - among themprenatal health care and immunization for all preschoolers.The problem is that with all the money that has been poured into theimmunization program in the past four years and with therestructuring of the program, there has not been a correspondingimprovement in rates at which preschoolers get their shots. Whilemeasles has been brought under control, some experts attribute itsdemise to the natural run of an epidemiological cycle rather thananyPublic Health Service action.Some immunization experts insist that to fully immunize the nation'schildren, particularly children in poverty,

the issue is less one ofhow much the federal government is willing to spend than of howwilling the government is to be paternalistic when parents areirresponsible.According to Walter Orenstein, director of the department ofimmunization at the federal Centers for Disease Control in Atlanta,the chief cause of the measles resurgence "was not a problem withvaccine supply, but a problem with delivery of services and parents'lack of knowledge about the vaccine schedule."But when Roper, the Bush-appointed director of the Centersfor Disease Control, suggested in 1991 that parents might share theblame for vaccination rates, he was denounced as being politicallyinsensitive. His suggestion was to make welfare checks to motherscontingent upon immunization of their preschoolers, just as publicschool admission has since the 1970s required full vaccination. (Itis for this reason that the immunization rate of

schoolage childrenis nearly 100 percent.)"We all know that spending money and having coverage is not the onlyproblem that we have to deal with, but we're not allowed to say it"'says Gail Wilensky, former special assistant to Bush for healthcare. "We need to get people to engage in more responsible behaviorwhen it comes to their children. We need to stop pretending thatthisis just a financing health care problem."Moley says, "You've got crack-addicted mothers trying to survive dayby day whose last thought in the world is getting their childrenproperly immunized. But God forbid anyone should suggest thatparental irresponsibility and bad behavior are a factor here."ph Liu, a senior associate and health care specialist at theChildren's Defense Fund, has been one of the most vocal opponents ofthis view. To him it's more a matter of parental ignorance (and alarge dose of Republican mishandling) than

of irresponsibility."You can go to almost any very concerned, very involved parent andask them what's the immunization schedule that their child needsfrombirth to age 4, and you won't find single parent out of a hundredthat has the ability to recite that schedule," he says.In the past, pediatricians kept track of immunizations and informedparents of when to bring their children in. Today, says Liu, manyfamilies don't have such a relationship with a pediatrician. Parentsjust don't know what they're supposed to be doing.In addition, points out Judith Shea of the National Association ofCommunity Health Centers, the system of public immunization is toodiffuse. "There isn't a coordinated system throughout the states,"she says. "The communication among all the entities administeringpublic vaccines is not as fluid as it should be." Public clinics areoften disorganized, require long waits and the scheduling

ofappointments weeks or months in advance, and aren't open at hoursthat working parents can manage.Recent studies also have found clinics to be burdened by an ever-increasing clientele. A 1991 survey of Dallas-area pediatricians andfamily practitioners published in Pediatrics magazine found thatmorethan 70 percent referred some of their patients to public clinicsrather than administer the vaccines themselves. And a Milwaukeestudyfound that children not covered by health insurance were far morelikely to be sent by their doctors to public clinics. (Only half ofprivate insurance plans cover the cost of immunization.) Althoughthere hasn't been a problem with vaccine supply in the clinics, theincreased use has led to longer waits for appointments and inwaitingrooms.The rectify these problems, a Bush-appointed group of federal,state,local and private organizations developed "Standards for

PediatricImmunization Practices" based on the recommendations of the PublicHealth Service's National Vaccine Advisory Committee.The standards suggest keeping clinics open during off-hours andweekends; vaccinating children on a walk-in basis, therebyeliminating the need for scheduling appointments; forgoing therequirement of comprehensive physical examinations beforeadministering vaccines; vaccinating children who come to a clinicforservices other than a vaccine or who accompany other family members;and administering in a single visit all vaccinations for which achild is eligible."We're trying to do a better job of making our clinical servicesuser-friendly," says Orenstein of the CDC."It's very clear that we have to work with the public and privatesector to do this. It isn't simply a matter of just education. It'san issue of trying to make the services as pleasant as possible, toreduce

clinic waits and to not require appointments all the time."Sen. Riegle, a Michigan Democrat, is introducing legislation -the Comprehensive Child Health Immunization Act - that seeks toimplement the standards as a matter of federal law.Optimism about the new standards is not unanimous, however. Jankson, executive director of the National Vaccine InformationCenter, says the elimination of comprehensive physicals and thesimultaneous inoculation of siblings would lead to an increase inadverse reactions to vaccines."There are a host of reasons that we shouldn't lessen therestrictions. We should, in fact, tighten them up," she says. "Theintent of the National Childhood Vaccine Injury Act was to makevaccines safer, so these standards really fly against Congress'sintent in passing that law, which still now should form the basis ofany federal policy about immunization campaigns."kson is

referring to a law passed in 1986 in response to anumberof serious neurological reactions and deaths from the whooping coughvaccine. A slew of lawsuits against the manufacturers of the vaccinethreatened to put them out of business and jeopardized the nation'svaccine supply. They also sent the prices of most vaccinesskyrocketing. The price of the DTP vaccine, for example, has risen5,147 percent from its low of 19 cents a dose in 1977 to $9.97 in1992. The 1986 law partially rectified the crisis by legislatingmedical precautions for administering vaccines as well as a publiclyfinanced vaccine injury compensation fund to eliminate the need foroutside litigation against the companies."The at-risk indicators for a vaccine adverse reaction are if therehas been a history in that family among siblings or very closerelatives of having had an adverse reaction," says kson. "So therecommendation of giving siblings

simultaneous vaccinations seemsmisguided. Having some sort of sequenced pattern to having siblingsreceive vaccinations makes a lot more sense. But really the mostriskis introduced by not having competent medical professionals do theexams, the screening and admininistering of the vaccinations.Doctorsare not well-trained enough to diagnose adverse reactions, and ifdoctors aren't well-trained enough, you can certainly imagine thatother persons without the professional training, what theirdeficiencies would be in recognizing adverse reactions,"The National Vaccine Information Center, an advocacy group forfamilies of children injured by vaccines, has tracked 360 deaths and17,221 other serious adverse reactions due to vaccinations in the 20months leading up to July 1992. This, they say, represents only afraction of the number of adverse reactions. (The CDC and manypediatricians and neurologists, on the other

hand, question whethervaccines are the true cause of all these injuries and deaths.)kson, Orenstein and other immunization professionals furtherquestion the universal vaccine purchase program promoted by theChildren's Defense Fund, the American Association of Pediatrics andother heath care organizations. While Orenstein concedes thatuniversal purchase would prevent fragmentation of care while alsostopping the overuse of public clinics by children who are normallytreated by private physicians, he says he wonders whether such anexpensive solution would solve the problem of low vaccination ratesin the inner cities."We still will need to improve our health care delivery capacitiesinthe inner cities," he says. "We shouldn't think that buying thevaccines will somehow get a kid in Harlem vaccinated. Moreover, willvaccine manufacturers drop out of the market as a result ofuniversalpurchase? That is a

potential threat. Will they invest the sameamount of money in research? That is not clear." Vaccinemanufacturers expressed just these concerns upon receiving word ofClinton's universal purchase plans, and the CDC is currently fundinga study to determine the benefits and risks of universal purchase.A recent study in the Journal of the American Medical Association,however, seems to suggest that universal purchase would not solvethenation's preschool immunization problem.The study found that in caring for the uninsured and underinsured,expanded free or subsidized health care for low-income pregnantwomenwas not associated with an improvement in access to prenatal care orin birth outcomes. Between 1984 and 1987, the study reported, therate of Massachusetts women who received prenatal care declined,evenas public care received increased funding."The Clinton people have a lot to learn on this issue, and

they'vejust been following a very knee-jerk kind of reaction"' sayskson."They think that universal immunization is a great thing to do forchildren, when in fact it really is a very poor effort at trying tosafeguard children's health."Immunization of preschoolers may prove to be one of those problemsthat everyone - Democrat and Republican alike - would like to solve,but that can't be solved by money alone.Bush tried his hand at it for four years. Now it's Clinton's turn.COPYRIGHT 1993 News World Communications, Inc.COPYRIGHT 2004 Gale Group--- End forwarded message ---