[Journal of the House of Representatives, 1993]
[Thursday, April 1, 1993 (36), Para 36.26 Comprehensive Child Immunization]
[Page 310]
[From the U.S. Government Publishing Office, www.gpo.gov]

Para. 36.26  comprehensive child immunization

  The Clerk then read the message from the President, as follows:

To the Congress of the United States:
  I am pleased to transmit for your immediate consideration and 
enactment the ``Comprehensive Child Immunization Act of 1993''. Also 
transmitted is a section-by-section analysis.
  This legislation launches a new partnership among parents and 
guardians; health care providers; vaccine manufacturers; and Federal, 
State, and local governments to protect our Nation's children from the 
deadly onslaught of infectious diseases. The legislation is a 
comprehensive initiative to remove existing barriers to immunization. It 
will ensure that all children in the United States are immunized against 
vaccine-preventable diseases by their second birthday. Because of the 
importance of this initiative to the health of our children, I am 
transmitting this legislation in advance of my proposal for 
comprehensive reform of the Nation's health care system, which I expect 
to submit to the Congress in May.
  Beginning in fiscal year 1995, the bill would authorize the Secretary 
of Health and Human Services to purchase and provide childhood vaccines 
in quantities sufficient to meet the immunization needs of children in 
the United States. It would also institute a national immunization 
tracking system through grants to the States to establish State 
immunization registries. In addition, the bill contains provisions to 
ensure that the National Vaccine Injury Compensation Program, an 
essential link in our Nation's immunization system, remains operational. 
Funding for the program of vaccine purchase and distribution will be 
identified in my legislation for broad-based reform of the national 
health care system and made available beginning in fiscal year 1995 from 
the Comprehensive Child Immunization Account in the United States 
Treasury.
  Immunizations are cost-effective. For example, the measles vaccine 
saves over $10 in health care costs for every $1 invested in prevention. 
We know that children are most vulnerable before their second birthday 
and that approximately 80 percent of vaccine doses should be given 
before then. Many children, however, do not receive even their basic 
immunizations by that age. We must remove the financial barriers to 
immunization that impede children from being vaccinated on time, and 
facilitate development of a national tracking system to ensure children 
are immunized at the earliest appropriate age.

  The problem posed by soaring vaccine costs is exacerbated by a 
deteriorating immunization infrastructure. This legislation continues 
the rebuilding of our capacity to deliver vaccines and educate parents 
started in my economic stimulus package.
  This proposal would direct the Secretary to purchase and provide 
vaccine without charge to health care providers who serve children and 
are located in a State that participates in the State registry grant 
program. In nonparticipating States, free vaccine would be distributed 
to Federal health care centers and providers, including those serving 
Indian populations. Health care providers could not charge patients for 
the cost of the vaccine. They could, however, impose a fee for its 
administration, unless such a fee would result in the denial of vaccine 
to someone unable to pay. The authority of the Secretary established 
under this legislation, to purchase and provide vaccines, shall cease 
to be in effect beginning on such date as may be specified in a Federal 
law providing for immunization services for all children as part of a 
broad-based reform of the national health care system.
  In addition, the bill would provide for a collaborative Federal and 
State effort to track the immunization status of the Nation's children. 
It would authorize the Secretary to make grants to States to establish 
and operate State immunization registries containing specific 
information for each child in the State. Entering infant birth and 
immunization data into registries will enable identification of 
children who need vaccinations and will help parents and providers 
ensure that children are appropriately immunized.
  A keystone of the Nation's vaccine immunization effort is the 
National Vaccine Injury Compensation Program. This legislation would 
authorize payments from the Vaccine Injury Compensation Trust Fund for 
compensable injuries from vaccines administered on or after October 1, 
1992, and would reinstate and permanently extend the vaccine excise 
tax.
  I urge the Congress to take prompt and favorable action on this 
legislation.
                                                  William J. Clinton.  
  The White House, April 1, 1993.

  By unanimous consent, the message, together with the accompanying 
papers, was referred to the Committee on Energy and Commerce and the 
Committee on Ways and Means and ordered to be printed (H. Doc. 103-61).