[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 
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 

                                                      William J. Clinton

The White House,
April 1, 1993.