[Public Papers of the Presidents of the United States: William J. Clinton (1993, Book I)] [April 1, 1993] [Pages 383-384] [From the U.S. Government Publishing Office www.gpo.gov]Message to the Congress Transmitting Proposed Child Immunization Legislation April 1, 1993 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 [[Page 384]] 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.