Robinson C A, Evans W B, Mahanes J A, Sepe S J
National Vaccine Program Office, Rockville, MD 20857.
Public Health Rep. 1994 Sep-Oct;109(5):594-600.
President Clinton submitted the Comprehensive Childhood Immunization Initiative Act to Congress in April 1993. The objective of the legislation is to protect all children in the United States by their second birthday against nine vaccine-preventable infectious diseases. As originally introduced in the Congress the initiative called for (a) Federal purchase and distribution of recommended childhood vaccines for all children, (b) improving the public health capacity to deliver vaccine, (c) establishing a State-based national immunization information and tracking system, and (d) expanding immunization education and mobilization efforts directed to health care providers and parents. The authors review the progress and current status of the initiative, updating a previous progress report. The President's legislative proposal, modified by Congress, was enacted August 10, 1993. Several key provisions of the original legislation, deferred by Congress, may be incorporated in subsequent legislation or implemented through existing authorities. Therefore, the evolving framework for the initiative derives not from a single legislative mandate, but expands current immunization program activities and adds important new and complementary activities. As mentioned in the original title of the legislation, this is a "comprehensive" effort to address the problem of under-immunization in U.S. preschool children.
1993年4月，克林顿总统向国会提交了《儿童全面免疫倡议法案》。该立法的目标是到美国所有儿童满两周岁时，保护他们免受九种可通过疫苗预防的传染病侵害。该倡议最初在国会提出时要求：(a) 联邦政府为所有儿童购买和分发推荐的儿童疫苗；(b) 提高提供疫苗的公共卫生能力；(c) 建立一个基于州的全国免疫信息和跟踪系统；(d) 扩大针对医疗保健提供者和家长的免疫教育及动员工作。作者回顾了该倡议的进展和现状，更新了之前的进展报告。经国会修改后的总统立法提案于1993年8月10日颁布。原立法中被国会推迟的几项关键条款，可能会被纳入后续立法或通过现有权力机构实施。因此，该倡议不断演变的框架并非源于单一的立法授权，而是扩展了当前的免疫计划活动，并增加了重要的新的补充活动。正如该立法的原标题所述，这是一项解决美国学龄前儿童免疫不足问题的“全面”努力。
