PROGRESS ON THE CHILDHOOD IMMUNIZATION INITIATIVE

President Clinton submitted the Comprehensive Childhood Immunization I nitiative Act to Congress in April 1993. The objective of the legislat ion is to protect all children in the United States by their second bi rthday against nine vaccine-preventable infectious diseases. As origin ally introduced in the Congress the initiative called for (a) Federal purchase and distribution of recommended childhood vaccines for all ch ildren, (b) improving the public health capacity to deliver vaccine, ( c) establishing a State-based national immunization information and tr acking system, and (d) expanding immunization education and mobilizati on efforts directed to health care providers and parents. The authors review the progress and current status of the initiative, updating a p revious progress report. The President's legislative proposal, modifie d 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. T herefore, 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 men tioned in the original title of the legislation, this is a ''comprehen sive'' effort to address the problem of under-immunization in U.S. pre school children.