who take a positive health action, for whatever reason, should receive credit for protecting their children against serious illness.

EDUCATING FAMILIES AND THE COMMUNITY

Workshop participants agreed on the need across the country for more and better efforts to educate families about the importance and safety of immunization and to encourage them to have their children immunized appropriately. The messages need to be delivered to individual families and to the community as a whole, and the messengers need to include individual providers, office and clinic staff, community groups, and public health officials.

The committee emphasized that this national public education campaign must be sustainable and sustained, in contrast to many of the valuable but short-term and highly focused efforts that developed in response to the measles epidemic. Immunization education for families and the community must become a continuing activity to reach a steady succession of families with newborn children and to reinforce the message that families must take repeated actions to have their children fully immunized.

Education and outreach programs must emphasize the value of immunizations and the importance of having very young children receive all the recommended immunizations at the recommended times. Families need to understand that their unimmunized infant or toddler is at risk of catching serious but preventable diseases. The community as a whole needs to be aware that its unimmunized preschool children increase the risk that children and adults who are not fully immune to these diseases will become ill. The emphasis in years past on up-to-date immunization for school entry seems to have overwhelmed the newer message that children need to receive most of their immunizations by the time they are 2 years old. For example, a study in Puerto Rico found that most of the immunization posters displayed in health clinics emphasized immunization requirements for school entry and identified special clinics providing those immunizations (Gindler et al., 1993).

Resources for Public Education

David Salisbury stressed how valuable the United Kingdom had found professional market research in guiding the public information elements of its immunization program. “Selling” immunization to the public is given the same thorough analysis and development given to selling commercial products. Salisbury showed three 30-second television spots to illustrate the messages and the recurring elements that tie all immunization program advertisements together. The British also have used the introduction of new vaccines as an opportunity



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