Association of health insurance status and vaccination coverage among adolescents 13-17 years

Details

• Alternative Title:
  J Pediatr
• Personal Author:
  Lu, Peng-jun ; Yankey, David ; Jeyarajah, Jenny ; O’Halloran, Alissa ; Fredua, Benjamin ; Elam-Evans, Laurie D. ; Reagan-Steiner, Sarah
• Description:
  Objective:
  
  To assess selected vaccination coverage among adolescents by health insurance status and other access-to-care characteristics.
  
  Study Design:
  
  The 2015 National Immunization Survey-Teen data were used to assess vaccination coverage disparities among adolescents by health insurance status and other access-to-care variables. Multivariable logistic regression analysis and a predictive marginal modeling were conducted to evaluate associations between health insurance status and vaccination coverage.
  
  Results:
  
  Overall, vaccination coverage was significantly lower among uninsured compared with insured adolescents for all vaccines assessed except HPV vaccination (≥3 doses) among males. Among adolescents 13-17 years, Tdap vaccination coverage (≥1 dose) was 77.4% versus 86.8% among uninsured compared with insured adolescents, respectively. MenACWY vaccination coverage (≥1 dose) was 72.9% versus 81.7%. HPV vaccination coverage (≥1 dose) was 38.8% versus 50.2% among males and 42.9% versus 63.8% among females. HPV vaccination coverage (≥3 doses) was 24.9% versus 42.8% among females. In addition, vaccination coverage differed by the following: type of insurance among insured adolescents, having a well-child visit at 11-12 years of age, and number of healthcare provider contacts in the past year. Uninsured were less likely than insured adolescents to be vaccinated for HPV (females: ≥1 dose and ≥3 doses; and males: ≥1 doses) after adjusting for confounders.
  
  Conclusions:
  
  Overall, vaccination coverage was lower among uninsured adolescents. HPV vaccination coverage was lower than coverage for Tdap and MenACWY vaccines in both insured and uninsured adolescents. Wider implementation of effective evidence-based strategies is needed to help improve vaccination coverage among adolescents, particularly for those who are uninsured.
  
  
• Subjects:
  Adolescent Female Healthcare Disparities Health Care Surveys Health Services Accessibility Humans Insurance, Health Insurance Coverage Logistic Models Male Medically Uninsured United States Vaccination Coverage

  More +
• Keywords:
  Adolescent Vaccination Health Insurance Status Type Of Health Insurance Vaccination Coverage
• Source:
  J Pediatr. 195:256-262.e1
• Pubmed ID:
  29398056
• Pubmed Central ID:
  PMC6201297
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  195
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5ec7bd39c8eea69e93505ef1e03a44ec969921cf456538ba8dfae0abfc1a51fe
• Download URL:
  https://stacks.cdc.gov/view/cdc/60045/cdc_60045_DS1.pdf
• File Type:
  [PDF - 378.40 KB ]