Many Kids With Private Insurance Missing Vaccinations

Plans may not cover a particular shot or its administration, study finds.

By Amanda Gardner
HealthDay Reporter
Tuesday, August 7, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

TUESDAY, Aug. 7 (HealthDay News) -- Thanks to an increasingly complex coverage system, many U.S. kids who are privately insured are actually having more trouble getting recommended vaccines than kids who have no insurance at all, experts say.

Gaps in coverage for an expanding repertoire of recommended shots are leaving many "underinsured" kids falling through the cracks, they said. Filling those gaps could remedy the situation, however.

"Until we can ensure that such enhancements are made, we need to be able to support the public sector safety net so these children have some place to go, because right now, they have nowhere to go," said lead researcher Dr. Grace M. Lee, assistant professor of ambulatory care and prevention and pediatrics at Harvard Medical School, Children's Hospital Boston and Harvard Pilgrim Health Care.

"Our study highlights the need to enhance immunization benefits among insured children, making sure the appropriate requirements or incentives for employers and insurers are in place to make sure vaccines are covered," said Lee, whose team published its findings in the Aug. 8 issue of the Journal of the American Medical Association.

"Vaccines are our strongest prevention tool, and they're not being utilized as well as they could be," added Dr. Ciro Sumaya, founding dean of the Texas A&M Health Science Center School of Rural Public Health. "This has implications for the individual as well as for the population as a whole," said Sumaya, who is also a member of the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP).

The problems reflect an impossibly complex system for patients, parents, practitioners, payers and policy makers, the experts said.

For one thing, the number of new vaccines recommended for children and adolescents has almost doubled over the past five years.

Then, there's the cost. "The HPV vaccine alone is $150 a dose at three doses," Lee said. "In the past, it was less than $100 to give all the vaccines" a child needed, Lee added.