Unvaccinated Kids

As millions of children go back to school this week, a distressingly high proportion of them will fail an important medical test. Though effective, safe and usually free vaccines are readily available, these children have no protection against at least four common, communicable and dangerous diseases.

In New York, for example, State Health Commissioner Robert P. Whalen reports that about 20% of the 300,000 children due to enter first grade have not been immunized against polio, measles or rubella. Most of them are not even protected against diphtheria, the vaccine for which is included in the three-way D.T.P. (diphtheria, tetanus, pertussis) shots that have long been standard treatment for all infants. In some areas, Whalen says, less than half of the entering class have been immunized. There have been similar or even greater drop-offs in vaccinations among preschool children in most other states.

Proved Protection. Whatever the cause--parental overconfidence, carelessness or ignorance--the situation may well lead to a comeback by diseases that had been almost conquered. In the 20 years since polio vaccines became available, the number of U.S. cases of that crippling and often fatal disease has fallen from a peak of 58,000 in 1952 to a mere seven in 1974. Common or "red" measles (rubeola) used to strike 4 million children a year, kill 400 and leave 800 with irreparable brain damage. By last year, the total number of cases was down to 22,000; only a handful had serious consequences. Much the same is true of German measles (rubella), the crippler of the fetus during pregnancy. From a high of 58,000 reported cases (far below the true total) in 1969, the number of rubella cases dropped to 12,000 last year, and only 45 infants were born with resulting deformities. Smallpox, dreaded and widespread as recently as 1930, is virtually nonexistent today; as a result, smallpox inoculations, once routine, are seldom given.

Massive vaccination programs are costly: immunizing 60 million children against common measles between 1963 and 1972 cost the Federal Government about $180 million. But the results were worth the price. The investment, say Dr. John J. Witte and Norman W. Axnick, both of the U.S. Center for Disease Control, has not only saved immeasurable suffering, mental crippling and death, but has also produced a saving of $1.3 billion over ten years. As they figure it, besides the 24 million cases of measles averted, 2,400 lives were saved, 7,900 cases of retardation prevented, 709,000 years of productive life made possible, and there were 78 million school days, 12 million physician visits and 1,352,000 hospital days saved.

One cause of the current parental apathy and neglect, New York's Commissioner Whalen suggests, is that many of today's preschoolers have mothers who are too young to have been aware of the great polio panics of the early 1950s, or of the fetus-crippling rubella epidemics of the early '60s. In ethnic ghettos, poverty, illiteracy and language barriers are also factors.

Forty states (plus the District of Columbia) require preschool immunization against polio, 41 against measles, 39 against diphtheria and 34 against rubella. Nine states have no requirements: Arizona, Idaho, Indiana, Iowa, Utah, Vermont, Washington, Wisconsin and Wyoming. Their citizens can reach adulthood without easily available protection against diseases that may disfigure, disable and even kill.

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