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Insurance status and vaccination coverage among US preschool children

Jeanne M Santoli1, Natalie J Huet, Philip J Smith

  • 1National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. jsantoli@cdc.gov

Pediatrics
|June 3, 2004
PubMed

Insights

Childhood vaccination coverage varies significantly by insurance status, with privately insured children being more up-to-date. This highlights insurance as a key marker for underimmunization, despite multivariate analysis findings.

Area of Science:

  • Pediatric Health
  • Public Health Policy
  • Immunization Practices

Background:

  • Insurance status significantly impacts children's access to preventive and acute healthcare services.
  • Previous research indicates a link between insurance coverage and healthcare utilization in pediatric populations.
  • Understanding this relationship is crucial for improving public health outcomes.

Purpose of the Study:

  • To examine the association between health insurance status and vaccination coverage in US preschool children.
  • To identify disparities in immunization rates based on insurance type (private, public, uninsured).
  • To inform strategies for enhancing vaccination coverage among young children.

Main Methods:

  • Utilized linked data from the National Immunization Survey and National Survey of Early Childhood Health (2000).
  • Defined 'up to date' (UTD) vaccination status based on recommended DTaP, Polio, MMR, Hib, and Hep B doses for children aged 19-35 months.
  • Analyzed vaccination coverage across different insurance groups and performed multivariate analysis controlling for demographic and socioeconomic factors.

Main Results:

  • 72% of the 735 children studied were up to date with vaccinations.
  • Children with private insurance (80%) had higher UTD rates compared to those with public insurance (56%) or no insurance (64%).
  • Multivariate analysis indicated insurance was not an independent predictor after controlling for other factors.

Conclusions:

  • A significant disparity in vaccination coverage exists between publicly, privately, and uninsured children, marking insurance status as a critical indicator of underimmunization.
  • The Vaccines for Children Program is well-positioned to address and improve vaccination rates among vulnerable, uninsured, and Medicaid-enrolled children.
  • Targeted interventions are necessary to ensure equitable access to immunizations for all preschool children.
Abstract

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