ditional coverage for well-child care, which at present is limited to visits for immunizations.

Other workshop participants echoed Ms. Chriss’s concerns about the confusion created by distinctions between recommended and required immunizations. They also agreed that greater clarity is needed in implementing immunization recommendations from ACIP and other professional groups. Dr. Rodewald, of the National Immunization Program at CDC, noted that the epidemiology of disease risks during childhood helps explain why some immunizations are recommended for infants but are not required for school entry. The risk for pneumococcal disease and Haemophilus influenzae type b, for example, is high for infants and very young children but not for school-age children. Insurance plans should cover the schedule of vaccines recommended by health care organizations rather than restricting their benefits only to those vaccines that are required for school entry. Dr. Stanley, of the Texas Department of Health, proposed that the state as well as employers separate immunization coverage decisions from the mandates for school entry.



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