Tots' Shots Required for Welfare Georgia Plan Shown to Raise Vaccinations

Article excerpt

CHICAGO -- Threatening to withhold welfare payments to low-income families unless their children got regular vaccines significantly increased immunization rates in Georgia, a study found.

Several states implemented similar measures in the 1990s, when the federal government encouraged testing of innovative welfare programs, including those that improved the health of public aid recipients.

At the time, critics slammed the practice as unfair, and an editorial accompanying the study in today's Journal of the American Medical Association questions the ethics of the practice.

"The ethical stumbling block . . . rests in the fact that financial penalties for delayed immunization were threatened only to individuals already at high risk for economic deprivation," wrote Matthew Davis and John Lantos. Lantos is a medical ethicist at the University of Chicago. Davis, formerly of UC, is now at the University of Michigan.

But the study authors said poor children face a higher risk of "vaccine-preventable" diseases.

"It is both a public health obligation to encourage low-income parents to have their children immunized for these diseases and a benefit to these families and to the public as a whole," the authors said.

Several states implemented similar programs and were required to assess their impact, though only Georgia and Maryland have completed their evaluations, said co-author David Connell of Abt Associates, Inc. of Cambridge, Mass.

At Georgia's request, the social science research firm evaluated the program from its start in 1993 through 1996, when it, like many others, was revamped under President Clinton's welfare reform legislation. …

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