Many Kids With Private Insurance Missing Vaccinations

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The new or expanded recommendations for meningococcal conjugate, tetanus-diphtheria-acellular pertussis (Tdap), hepatitis A, influenza, rotavirus, and human papillomavirus vaccines (HPV) have resulted in a 7.5-fold increase in the cost to fully vaccinate a child in the public sector -- from $155 in 1995 to $1,170 in 2007.

"As one learns more about vaccines, there are more complexities in the timing, the age levels, can you give it with other vaccines," Sumaya said. "Thirty years ago, all the vaccine recommendations were on one sheet of paper. Now, it takes several sheets of paper, with a lot of individual notes and exceptions."

Children who are uninsured, Medicaid-eligible or of American Indian/Alaska Native origin can get all the vaccinations recommended by the ACIP through the federal Vaccines for Children (VFC) program.

On the other hand, children with private health insurance often have plans that don't cover all the recommended vaccines, or the vaccine may be covered but not its administration.

In 2000, an estimated 14 percent of children aged 0 to 17 were underinsured in the United States, according to background information in the study. These children may be referred to public health clinics, but now, it seems, those clinics are no longer able to provide the needed vaccines.

"We had been hearing reports from state policy makers and clinicians about a lack of adequate funding to give vaccines to all children who needed them," Lee explained.

In the 2006 study, her group interviewed the program managers for state immunization programs in 48 states.

For vaccines given in the private sector, 46 percent of states did not provide publicly purchased chicken pox vaccine, and 70 percent did not provide publicly purchased meningococcal conjugate vaccine to underinsured children.

For vaccines given in the public sector, 17 percent of states were unable to provide publicly purchased pneumococcal conjugate vaccine, and 40 percent were unable to provide publicly purchased meningococcal conjugate vaccine to underinsured children.