Posted on 12/22/2002 7:21:25 PM PST by Sparta
Mexico's paternalistic approach has led to a 96% vaccination rate for children ages 1 to 4, compared with 79% of American 2-year-olds.
MONTERREY, MEXICO – If parents here are late getting their child inoculated, a public-health nurse will come to their home, pull down the youngster's pants and give the vaccination right there in the living room.
If the parents are away at work, the nurse does not wait for them to come home and give permission. Shots are given anyway, and the paperwork is left with the baby sitter.
In Monterrey, like Houston, an industrial city of more than a million with large pockets of underclass, the government divides its poor neighborhoods into sections of about four square blocks each, then puts a nurse in charge of supervising parents in each area to ensure all of the children are vaccinated on time.
It is a paternalistic approach almost impossible to imagine in the United States - where privacy rights and other freedoms are highly valued and immunizations are increasingly feared - but it has proved remarkably effective: Mexico has a 96 percent vaccination rate for children ages 1 to 4, compared with an immunization rate of 79 percent for 2-year-olds in the United States.
The disparity is even greater between Monterrey and Houston, which has one of the most stubbornly low vaccination rates in the United States. In Monterrey, 98 percent of the children ages 1 to 4 are fully immunized, a higher percentage than reached by any U.S. city. In Houston, barely 71 percent of 2-year-olds are caught up on their shots.
Mexico's immunization success is something Americans - particularly Texans - can cheer. Epidemics of preventable disease used to go back and forth between the two countries. That no longer happens, thanks mostly to the remarkable but unheralded improvements in Mexico and other countries in the region.
"One of the main reasons there is no longer measles in the United States is because we no longer have measles in Latin America and the Caribbean," said Dr. Ciro de Quadros, the recently retired director of immunizations for the Pan American Health Organization. Mexico, he said, has done a "remarkable" job of vaccinating its children in the past decade.
Conventional wisdom says it is harder to develop a public-health system in a poor country. But Quadros notes that a wealthy country like the United States has problems of its own.
"In the United States, there are so many obstacles to vaccinations," said Quadros, a native of Brazil. "People have so many forms to fill out, and there are so many more lobbies - anti-vaccine, anti-technology, anti-everything."
The differences in culture and outlook between Mexico and the United States make it difficult to compare the two systems of administering vaccinations. But there are similarities, particularly between two cities that share so much trade and human traffic.
Both Houston and Monterrey suffered from a terrible resurgence of measles more than a decade ago, and leaders in both places promised to respond by bolstering vaccine programs to ensure such an epidemic never happened again. The goal - on both sides of the border - was a 100 percent vaccination rate.
But while Monterrey and Mexico as a whole have come close to keeping that promise, the improvement in Houston's vaccination program has not been so great. Vaccinations are clearly up from the winter of 1988-89, when 10 children died from measles in Houston and organizers of the Houston Livestock Show and Rodeo distributed letters warning that participants may have been exposed to the disease and risked taking it to other parts of the country.
Public and private groups responded by forming a number of programs, such as mobile health clinics, which are designed to better reach the most needy areas of Houston. But Houston still has no coordinated vaccine registry, which officials say is necessary to reach the people effectively.
And the effectiveness of the patchwork services now offered by so many different organizations is hampered by a lack of any central vision for running an immunization program, critics say.
"There's no real local leadership on the immunization issue," said Barbara Best, with the Children's Defense Fund.
While no one predicts another measles resurgence, officials in Houston and the rest of Texas have already started to worry about a return of pertussis, also known as whooping cough.
Mexico, by contrast, has a sharply focused vision. After the measles pandemic reached Mexico in 1990 and killed 5,899 babies, the Mexican government established a central authority to oversee the national vaccination campaign, known as the National Immunization Program.
Immunization campaigns are run three times a year, done with great fanfare. In addition, uniformed brigades of nurses keep careful watch over vaccination rates, neighborhood by neighborhood.
U.S. health officials, who have seen the unsparing force of a Mexican immunization campaign, tend to remember it with both awe and dread.
The public-health nurses of Monterrey begin tracking babies before they are born.
The nurse in charge of immunizations in a particular neighborhood keeps a census of the area, including maps detailing where women of child-bearing age live.
Babies are given their first immunizations - against polio and tuberculosis - in the hospital right after birth. They also receive a government-issued National Vaccination Record, on which the vaccines they receive throughout their lives will be tallied. The vaccine record must be presented in order to enter school, to get passports or other identification papers and even to get some jobs and loans. Losing the record is not usually a problem, because the same information is recorded with the federal government and can be replaced.
That's just what we need in America, and if Hillary ever gets herself elected, no doubt that's what will happen.
2. Even if there is, it is likley just that Mexicans, many of whom live in abject squalor, have more to fear from many of these diseases than we do.
Somehow I do not find this praiseworthy.
Can you imagine the lawsuits if Junior had so much as a bruise if they pulled that in the US? Not to mention the charges of sexual abuse that would be filed.
Perhaps Mexico has already passed tort reform...
Other descriptions in the article (public nurse overseers, etc.) make me think that the Mexican exodus to the U.S. has more than just poverty as a cause.
Yep, they send them to the US to be immunized for free.
America, Mexico's free health care program.
Believe it.
There are many consequences, intended and unintended, in a totalitarian state. High immuniztion compliance and in some cases, higher literacy rates are among those consequences.
As an example I was amazed to learn 30 years ago when I worked in Brasil that Brasil had a higher basic literacy rate than the US. In Brasil if your children didn't attend school the federal troops simply came for the parents of minor children and the children themselves if they were older than 13. Attendance in primary schools through a GED equivalency was almost 100%.
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