Children who have health insurance will no longer be able to receive vaccinations from the Monroe County Health Department.

Increases in vaccine prices and shortages of certain shots have limited the number of inoculations available through the federal Vaccines for Children program (VFC), which was set up to reach children in low-income families.

"What it comes down to is that we do not have access to all the vaccines that we need and have to home in on those children least likely to get those vaccines through their insurance," said David Johnson, chief medical officer for the Michigan Department of Community Health.

The VFC was set up as a way to increase immunization rates by making them available at no cost to the underprivileged. Enforce- ment of who could receive these vaccines was broadly interpreted, and health departments functioned under the idea that it is best to get every child possible immunized.

They have not, until now, turned away any child that needed an immunization.

"If someone comes in between now and the end of the year, we'll give them the shots they need," said Patsy Bourgeois, clinic supervisor at the Monroe County Health Department.

"We have six months to educate people about this. Starting Jan. 1, 2003, we will have to turn people away."

Increasing cost of vaccine and limited availability have forced the federal government to require that health departments strictly adhere to the rules.

"Michigan needs to stretch its vaccine dollars as far as it can," Dr. Johnson said.

"If someone with insurance that covers vaccinations receives a vaccination at the health department, it will mean that a vaccination may not be available for another child who is eligible to receive vaccinations through these federally funded programs."

Children eligible for free vaccines fit at least one of the following criteria:

Are enrolled in Medicaid.

Are American Indian or Alaskan native.

Have no insurance.

Have insurance that does not cover vaccinations.

The changes do not take effect until Jan. 1. Children who go to the health department now will not be turned away for eligibility reasons, but their parents will be counseled regarding where they will get their shots in the future. Vaccines are available through pediatricians and primary care physicians.

Vaccine prices have risen nearly threefold in the last decade, due both to rising vaccine costs and an increasing number of required inoculations. In 1992, it cost $113 to deliver 19 necessary doses. This year, the cost is $414 for 24 doses. The Monroe County Health Department administers 18,000 shots to children every year.

The health department recommends that parents act early to get their children all necessary shots before the new school year starts in August.

Manufacturing and licensing problems at drug companies have led to a shortage of tetanus, diphtheria and pneumococcal conjugate vaccine.

If parents wait until the last minute, there may not be adequate supply.