Effectiveness of a community coalition for improving child vaccination rates in New York City.

We used a retrospective, matching, birth cohort design to evaluate a comprehensive, coalition-led childhood immunization program of outreach, education, and reminders in a Latino, urban community. After we controlled for Latino ethnicity and Medicaid, we found that children enrolled in the program were 53% more likely to be up-to-date (adjusted odds ratio = 1.53; 95% confidence interval = 1.33, 1.75) and to receive timely immunizations than were children in the control group (t = 3.91). The coalition-led, community-based immunization program was effective in improving on-time childhood immunization coverage.

Challenges and opportunities in biotechnology.

The biotechnology industry is thriving, and many predicted accomplishments have actually occurred during the last decade. Cloning and expression of genetic information is now simple and routine. Initial commercial products have been realized, but there is much yet to be accomplished in evaluating the clinical significance of many other gene products made available by biotechnology resources. During the next decade, human health care and the pharmaceutical industry should be affected substantially by first- and second-generation recombinant DNA products. Recombinant vaccines, blood coagulation factors, and known biological modulators produced by rDNA technologies should be widely used. Further opportunities will be realized with increasing discoveries of new bioactive molecules and identification of NANB hepatitis and AIDS infectious agents. Full exploitation of health care products will depend on innovative new delivery systems or the ability to reconstruct mammalian and plant genes, providing for in-situ delivery of the necessary gene products.