Breaking the barriers to childhood immunization.

Although about 98 percent of children have received their basic series of immunizations at the time of school entry, only 67 percent of two-year-old children are appropriately immunized. Parental, provider, economic and system barriers to immunization must be overcome if the United States is to achieve the objective that 90 percent of two-year-old children receive the basic vaccination series against the major preventable childhood diseases by 1996. Parents must be educated about the importance of vaccines and the hazards of the diseases they prevent, and they must be given proper information about vaccine side effects and contraindications. Physicians should take advantage of all appropriate patient contacts, including acute office visits for minor illnesses, to keep children's immunizations current. Audits of office records, as well as tracking or reminder systems, improve vaccination rates. The Vaccines for Children Program is intended to remove cost as a barrier to the immunization of some children. The single immunization schedule endorsed by the American Academy of Family Physicians, the American Academy of Pediatrics and the Advisory Committee on Immunization Practices may alleviate confusion about the appropriate time to administer different vaccines.