SUPPLEMENT ARTICLE |
Insurance Status and Vaccination Coverage Among US Preschool Children
,
,¶
* National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
UCLA Center for Healthier Children, Families and Communities, Los Angeles, California
UCLA School of Public Health, Los Angeles, California
|| Department of Practice and Research, American Academy of Pediatrics, Elk Grove Village, Illinois
¶ UCLA Schools of Medicine, Public Health, Public Policy, and Social Research, Los Angeles, California
Background. Insurance status has been shown to have an impact on children’s use of preventive and acute health services. The objective of this study was to determine the relationship between insurance status and vaccination coverage among US preschool children aged 19 to 35 months.
Methods. We linked data from 2 national telephone surveys, the National Immunization Survey and the National Survey of Early Childhood Health, conducted during the first half of 2000. Children were considered up to date (UTD) when they had received at least 4 diphtheria-tetanus-acellular pertussis/diphtheria-tetanus-pertussis vaccines, 3 poliovirus vaccines, 1 MMR vaccine, 3 Haemophilus influenza vaccines, and 3 hepatitis B vaccines at the time the interview was conducted.
Results. Among the 735 children in our study sample, 72% were UTD. The vast majority (94%) reported some type of health insurance at the time of the survey. Children with private insurance were more likely to be UTD (80%) than those with public insurance (56%) or no insurance (64%). In a multivariate analysis that controlled for child’s race/ethnicity; household income; maternal age/marital status/educational level; location of usual care; and Special Supplemental Nutrition Program for Women, Infants, and Children participation, insurance was no longer an independent predictor of vaccination.
Conclusions. The disparity in vaccination coverage among publicly, privately, and uninsured children is dramatic, underscoring its importance as a marker for underimmunization, despite the multivariate findings. The Vaccines for Children Program, a partnership between public health and vaccination providers who serve uninsured children and those enrolled in Medicaid, is well suited to target and improve vaccination coverage among these vulnerable children.
Key Words: children • insurance status • vaccination • vaccination coverage
Abbreviations: SCHIP, State Children’s Health Insurance Program • NIS, National Immunization Survey • NSECH, National Survey of Early Childhood Health • CDC, Centers for Disease Control and Prevention • UTD, up to date • WIC, Special Supplemental Nutrition Program for Women, Infants, and Children • VFC, Vaccines for Children Program
Received for publication Oct 20, 2003; Accepted Jan 13, 2004.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  S. J. Hambidge, S. L. Phibbs, V. Chandramouli, D. Fairclough, and J. F. Steiner A Stepped Intervention Increases Well-Child Care and Immunization Rates in a Disadvantaged Population Pediatrics, August 1, 2009; 124(2): 455 - 464. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Borras, A. Dominguez, M. Oviedo, J. Batalla, and L. Salleras The influence of public or private paediatric health care on vaccination coverages in children in Catalonia (Spain) Eur J Public Health, January 1, 2009; 19(1): 69 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Daskalaki, C. V. Spain, S. S. Long, and B. Watson Implementation of Rotavirus Immunization in Philadelphia, Pennsylvania: High Levels of Vaccine Ineligibility and Off-Label Use Pediatrics, July 1, 2008; 122(1): e33 - e38. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. S. O'Connor and M. D. Bramlett Vaccination Coverage by Special Health Care Needs Status in Young Children Pediatrics, April 1, 2008; 121(4): e768 - e774. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Rand, P. G. Szilagyi, C. Albertin, and P. Auinger Additional Health Care Visits Needed Among Adolescents for Human Papillomavirus Vaccine Delivery Within Medical Homes: A National Study Pediatrics, September 1, 2007; 120(3): 461 - 466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. J. Allred, K. G. Wooten, and Y. Kong The Association of Health Insurance and Continuous Primary Care in the Medical Home on Vaccination Coverage for 19- to 35-Month-Old Children Pediatrics, February 1, 2007; 119(Supplement_1): S4 - S11. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. Schempf, C. S. Minkovitz, D. M. Strobino, and B. Guyer Parental Satisfaction With Early Pediatric Care and Immunization of Young Children: The Mediating Role of Age-Appropriate Well-Child Care Utilization Arch Pediatr Adolesc Med, January 1, 2007; 161(1): 50 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. O'Connor, B. S. Matthews, and D. Gao Effect of open access scheduling on missed appointments, immunizations, and continuity of care for infant well-child care visits. Arch Pediatr Adolesc Med, September 1, 2006; 160(9): 889 - 893. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Coleman, M. L. Washington, W. A. Orenstein, J. A. Gazmararian, and M. M. Prill Interdisciplinary Epidemiologic and Economic Research Needed to Support a Universal Childhood Influenza Vaccination Policy Epidemiol. Rev., August 1, 2006; 28(1): 41 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Lieu, T. G. McGuire, and A. R. Hinman Overcoming Economic Barriers To The Optimal Use Of Vaccines Health Aff., May 1, 2005; 24(3): 666 - 679. [Abstract] [Full Text] [PDF]
|
|
