Impact of health insurance status on vaccination coverage among adult populations

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Lu, Peng-jun ; O'Halloran, Alissa ; Williams, Walter W.
• Description:
  Background ; Underinsurance has been a barrier to vaccination among children. Information on vaccination among adults ≥18 years by insurance status is limited. ; Purpose ; To assess vaccination coverage among adults ≥18 years in the United States in 2012 by health insurance status and access to care characteristics. ; Methods ; The 2012 NHIS data were analyzed in 2014 to estimate vaccination coverage among adults ≥18 years by health insurance status for 7 vaccines routinely recommended for use. For the non-influenza vaccination coverage estimates among adults ≥18 years, regular descriptive analysis was used. To better assess influenza vaccination coverage for the 2011-12 influenza season, coverage was reported by restricting to individuals interviewed during September 2011 through June 2012, and vaccinated during August 2011 through May 2012, using the Kaplan-Meier survival analysis procedure. ; Results ; Overall, for all age groups, vaccination coverage was lower among those without health insurance compared with those with health insurance for all except HepA vaccination. Influenza vaccination coverage among adults ≥18 years without or with health insurance was 14.4% versus 44.3%, respectively, pneumococcal vaccination coverage among adults 18-64 years with high-risk conditions was 9.8% versus 23.0%, Td coverage (≥18 years) was 53.2% versus 64.5%, Tdap coverage (≥18 years) was 8.4% versus 15.7%, HepA coverage (18-49 years) was 16.6% versus 19.8%, HepB coverage (18-49 years) was 27.5% versus 38.0%, shingles coverage (≥60 years) was 6.1% versus 20.8%, and HPV coverage (female 18-26 years) was 20.9% versus 39.8%. In addition, vaccination coverage differed by type of insurance, whether or not respondents had a regular physician, or number of physician contacts. Persons without health insurance were less likely than those with health insurance to be vaccinated for influenza (≥18 years), pneumococcal (18-64 years with high-risk conditions), tetanus (≥18 years), Tdap (≥18 years), and HPV (women 18-26 years) after adjusting for confounders. ; Conclusions ; Overall, vaccination coverage among adults ≥18 years was lower among uninsured populations. Implementing effective strategies are needed to help improve vaccination coverage among adults ≥18 years, especially those without health insurance.
• Subjects:
  • Adolescent
  • Adult
  • Aged
  • Humans
  • Insurance, Health
  • Medically Uninsured
  • Middle Aged
  • Vaccination
  • Vaccines
  • Young Adult
• Keywords:
  • Adult vaccination
  • vaccination coverage
  • health insurance status
  • type of health insurances
  • National Health Interview Survey (NHIS)
• Source:
  Am J Prev Med. 48(6):647-661
• Pubmed ID:
  25890684
• Pubmed Central ID:
  PMC5826635
• Document Type:
  Text
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Volume:
  48
• Issue:
  6
• Download URL:
  https://stacks.cdc.gov/view/cdc/52136/cdc_52136_DS1.pdf
• File Type:
  [PDF - 183.02 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:974bac5495b86e3215d6cb6af850c29f790f920f994a37bf127b019dce8eab94a3d3706e71caed9f122a7c2b4ac6788e1588b88e6faa335b7f8756cf01c14b8d