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  • Title: Underinsurance and adolescent immunization delivery in the United States.
    Author: Smith PJ, Lindley MC, Shefer A, Rodewald LE.
    Journal: Pediatrics; 2009 Dec; 124 Suppl 5():S515-21. PubMed ID: 19948583.
    Abstract:
    OBJECTIVE: The goal was to explore the association of being underinsured and receiving doses at a health department clinic (HDC) with not receiving all recommended adolescent vaccine doses. METHODS: A total of 5657 adolescents, 13 to 17 years of age, were sampled in the National Immunization Survey-Teen in 2006-2007. RESULTS: A total of 63.9% of all adolescents were covered by private health insurance. Among privately insured adolescents, approximately 31.3% were underinsured. Compared with fully insured adolescents, underinsured adolescents were more likely to receive doses at an HDC for tetanus-diphtheria toxoids/tetanus toxoids-reduced diphtheria toxoids-acellular pertussis vaccine (25.1% vs 6.2%; P < .05), tetravalent meningococcal conjugate vaccine (11.5% vs 2.5%; P < .05), and quadrivalent human papillomavirus vaccine (16.2% vs 3.4%; P < .05). Also, compared with fully insured adolescents, underinsured adolescents who received doses at an HDC had lower estimated rates of vaccination coverage for tetanus-diphtheria toxoids/tetanus toxoids-reduced diphtheria toxoids-acellular pertussis vaccine (58.5% vs 70.9%; P < .05), tetravalent meningococcal conjugate vaccine (10.8% vs 25.8%; P < .05), and quadrivalent human papillomavirus vaccine (7.8% vs 14.3%; P < .05). CONCLUSION: Underinsured adolescents who receive doses at an HDC have lower rates of vaccination coverage than do fully insured adolescents.
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