    [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.