IMMUNIZATIONS GETTING A BIG BOOST : SHOTS FOR KIDS TOO IMPORTANT TO BE MISSED.

Byline: Lori Moody Daily News Staff Writer

Deziree Mendez has had lots of milestones in her short life.

She smiled for the first time at about a month old. She walked 12 months later. And when she was 15 months old, she said her first word.

Just as notable was getting most of her immunizations completed by the time she was 2. Now, all the toddler will need are booster shots in a few years.

``I don't want her to get sick,'' said her mother, Paula Kitonis, 20, of Granada Hills. ``I don't know what measles, rubella and mumps look like. I don't want to see what measles, rubella and mumps look like.''

Deziree's up-to-date immunization record makes her a standout among many of California's children, where only a little more than half actually get the proper shots by the prescribed schedules to guard them from preventable diseases.

It's a shabby record that health officials are working to change.

With National Infant Immunization Week this week and Toddler Immunization Month in California in May, health experts are warning parents not to delay inoculations for their children.

Unfortunately, many do.

And the price of waiting can be high. Not just in medical expenses but in deaths that might have been prevented.

A shot for safety

``Our goal is to have 90 percent of 2-year-olds fully immunized with all the appropriate vaccines by 2000,'' said Dr. Luis Montes, medical director for the county's immunization program. ``Dollar for dollar, (immunizations) are the best investment we've made. Without immunization, we would have rampant disease, crisis after crisis.''

A 1996 check of Los Angeles County children shows the medical community has a lot of educating to do to reach that 90-percent goal. That survey of kindergarten students' immunization records showed only 56 percent of them received the necessary immunizations by the time they were 2 years old, health officials say.

And across the state, only 57 percent of children were up-to-date on their immunizations as 2-year-olds. California ranks 5 percent below the national average, which is 76 percent, according to the state Department of Health Services.

``The problem is parents wait until the child is ready to go to school, when it is required by law to have immunizations done,'' said Nina Vassilian, supervisor for health education for Los Angeles County. ``Children are very vulnerable to vaccine-preventable diseases way before they start school. If they are not protected, and parents wait until the child goes to kindergarten, that's too late.''

That means starting inoculations in infancy. By the age of 2, children should have received most of their immunizations to protect them against 10 childhood diseases: measles, mumps, polio, tetanus, diphtheria, rubella, chickenpox, whooping cough, hepatitis B and Hib meningitis.

``Our problem is educating the public and young parents that immunizations must be started as soon as baby is 2 months of age and also followed through so the entire immunization is completed,'' Vassilian said. ``With some vaccines, more than one dose of the vaccine is required or needed in order for the child to be fully protected.''

The immunization campaign is focusing on an easy way for parents to remember when their child needs inoculations - at 2, 4, 6, 12 and 15 months. Boosters are given about the time the children are ready to enter kindergarten.

``With all the changes and the complexity of the schedules, it's hard for parents to keep track of which immunizations their children need,'' said Joan McCandless, a spokeswoman for the California Coalition for Childhood Immunization. ``It's easier to keep track of by time. If they take children in at those intervals, by and large they can be sure their children will get immunized.''

Getting the word out

McCandless' coalition, a partnership of more than 80 public and private groups, sponsored a mock measles outbreak last week at Charles Drew University Head Start in Compton and other sites in the state, kicking off National Infant Immunization Week.

Hope for Kids, a 5-year-old Los Angeles-based group involved with the South Los Angeles Immunization Coalition, planned to spend Saturday canvassing neighborhoods in Los Angeles and five other counties that health officials consider high-risk, going door-to-door to give residents information about free immunizations. The organization has made a similar effort in the past but on a smaller scale.

``We have much lower rates of immunization among Latinos and more so among African-Americans,'' according to the county's Vassilian.

According to the 1996 retrospective survey of Los Angeles County kindergarteners: 68 percent of white children were up-to-date with immunizations by the age of 2; 75 percent of Asian children had all their immunizations; 54 percent of Latino children were current; and 39 percent of African-American children were up-to-date.

To increase Latino and African-American parents' awareness of the need for earlier immunizations, the Los Angeles County Immunization Program plans to use English/Spanish language billboards, bus and catering-truck posters, and radio, TV and newspaper advertising targeting those groups.

What's the problem?

There are a variety of reasons given for low immunization rates. Doctors, for example, sometimes miss opportunities to see if a child's immunizations are current, McCandless said.

``When a child goes in for a medical appointment, say a runny nose or a slight fever, that is not a contraindication for giving an immunization,'' she said.

``Health-care providers are learning that that is an opportunity to immunize.''

The coalition cites other risk factors: low education levels and socioeconomic status, young parents, lack of prenatal care, lack of knowledge about clinics where free immunizations are available, transportation problems and cultural barriers.

Another problem is that, unless there is an epidemic, the threat of disease is ``out of sight, out of mind,'' health experts say.

Such beliefs can have dire consequences.

Consider that there were 724 cases of whooping cough in 1996, resulting in the death of one baby, according to state health officials. Forty-one babies have been born with congenital rubella syndrome since 1990 in California. And about 2,381 cases of Hib meningitis have been reported among all age groups since March 1989.

It is the measles epidemic of 1988-91 in California that health officials continue to point to as a perfect example of what happens when children aren't adequately immunized. During that period, there were more than 17,000 reported cases of the disease. Of the 70 people who died, 50 were children under the age of 5. Medical care and control of the outbreak cost $31 million.

Yet that measles outbreak could have been prevented, if only so many people had not neglected immunizations early in life.

``If we don't correct that, there could be another measles epidemic,'' said McCandless, who also is national program director of the American Red Cross Kids Care Fair program. ``As the analysis of that epidemic was published, people realized not just the cost of human misery and pain, but the medical cost of that epidemic was huge. Every $1 of immunization saves us $10 to $14 in medical care.''

The coalition, a project of the state Department of Health Services immunization branch, formed two years ago in response to the measles outbreak. Health officials say their efforts to get the word out may be paying off. In Los Angeles County, the 1996 survey that showed 55 percent of kindergarteners had been properly immunized was an increase from 52 percent the previous school year.

``We have to see what the next survey will show us,'' said Montes, of the county's immunization program. ``Hopefully, with all our efforts, we can convince people immunizations are important.''

Searching for shots?

The Los Angeles County Department of Health Services Immunization Program offers free immunizations at a number of clinics. Proof of income or citizenship is not required. Some clinics require appointments to see a pediatrician.

Local clinics and their schedules are:

Antelope Valley Health Center, 335 E. Avenue K-6, Lancaster. [phone]. From 8 a.m. to noon and 1 to 4 p.m. Monday and Tuesday and from 8 to 11 a.m. and 1 to 4 p.m. Wednesday, Thursday and Friday.

Burbank Health Center, 1101 W. Magnolia Blvd., Burbank. [phone]. From 8 to 11 a.m. and 12:30 to 4:30 p.m. Monday through Friday.

Glendale Health Center, 501 N. Glendale Ave., Glendale. [phone]. From 8 to 11 a.m. and 12:30 to 3:30 p.m. Monday through Friday.

Mid-Valley Health Center, 7515 Van Nuys Blvd., Van Nuys. [phone]. From 8 to 10:30 a.m. and 12:30 to 4 p.m. Monday through Friday.

North Hollywood Health Center, 5300 Tujunga Blvd., North Hollywood. [phone]. From 8 to 11 a.m. and 12:30 to 4 p.m. Monday through Friday.

Pacoima Health Center, 13300 Van Nuys Blvd., Pacoima. [phone]. From 8 to 11 a.m. and 12:30 to 4 p.m. Monday through Friday.

San Fernando Health Center, 300 N. Brand Blvd., San Fernando. [phone]. From 8 a.m. to 4 p.m. Monday through Friday.

Tujunga Health Center, 7747 Foothill Blvd., Tujunga. [phone]. From 8 to 11 a.m. and 12:30 to 4 p.m. Monday through Friday.

CAPTION(S):

2 Photos, 2 Boxes

Photo: (1--Cover--Color) On the cover: Victoria Sims, right, 4, examines Danielle Collins, 3, during the recent Mock Measles Campaign Kickoff.

(2) Preschoolers at Laurel Street Center in Compton play patients during a mock measles outbreak last week.

Phil McCarten/Daily News

Box: (1) Searching for shots? (See Text)

(2) RECOMMENDED SCHEDULE FOR CHILDHOOD VACCINES

Daily News