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Association of health insurance status and vaccination coverage among adolescents 13-17 years
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  • Alternative Title:
    J Pediatr
  • 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.
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