In Connecticut, far fewer children will have to catch up on their vaccines because the state has the third-highest immunization track record in the country. It inoculates 87.8 percent of its toddler to preschool-age population on time.

Immunizations Needed Under Connecticut’s public health code, to be considered adequately immunized and permitted to attend public school, a child must have received the following vaccines:  two doses of the live-attenuated measles; rubella; three doses of poliomyelitis vaccine with at least one given on or after the fourth birthday; four doses of diphtheria and tenanus and pertussis (DPT); mumps;  a single dose of hemophilus influenzae Type b (Hib) before age 5; three doses of Hepatitus B with two of the doses given one month apart followed by a third one given four months later;  and varicella.

Only Massachusetts, at 89.1 percent, and Florida, at 88.5 percent, have a better record than Connecticut. These are the findings of the federal Centers of Disease Control and Prevention's current National Immunization Survey.

The bad news is Connecticut's three largest cities — Bridgeport, New Haven and Hartford — have among the lowest inoculation rates for youngsters born in 2001 with Bridgeport's being the worst at 63 percent. New Haven's is only slightly better at 64 percent, and Hartford's stands at 78 percent, according to the Connecticut Immunization Registry and Tracking System.

By contrast, both the Naugatuck Valley and Norwalk vaccinated 85 percent of its children born that year. Data from other Connecticut municipalities was not immediately available.

For children who come from low-income families or households where they are either underinsured or lack insurance completely, vaccines are free under the U.S. Health and Human Services Department's $1.1 billion Vaccines For Children program.

The federal VFC program was started in 1996 under the Clinton administration with an initial budget of $250 million, and has expanded every year since to its present $1.1 billion, CDC spokesman Curtis Allen said. "It's expanded because of all of the new vaccines, which have been approved that are now required for children to have." In addition to the federal VFC, the state allocates another $7 million through its Vaccines For Children program, which unlike the federal one has no income qualification for participation.

Eighty percent of the state's pediatricians participate in the state-administered VFC program, Mick Bolduc, an epidemiologist with the Connecticut Immunization Tracking Registry, said. Those doctors and clinics that accept the free vaccine sign an agreement that bars them from billing the patient or his or her family for the vaccine, Bolduc said. "At most, they can bill for the cost of administering the vaccine, which cannot exceed $21."

What this shows Dr. Conrado Bárzaga is that the low urban vaccination rate in Bridgeport, New Haven and Hartford is not a product of economics, but a failure of the health care network to "get the word out" about the free vaccines.

Bárzaga, who is associate director of the Southwestern Area Health Education Center in Bridgeport, said his agency is making it a point at church groups, health fairs and neighborhood meetings, to urge parents to be vigilant health care advocates for their children.

"When a parent brings their child to a doctor for a well-child visit or even for a sick visit, either way, it's a good idea to ask if their immunizations are up to date," Bárzaga said. "It's very easy to get behind with that. Sometimes, it's hard to make an appointment or you have to cancel because of scheduling or because a child is sick. My thinking is that doctors should not miss an opportunity to [inoculate] a child if the child is not seriously ill."

--MARIAN GAIL BROWN