Some children shut out from vaccines

[almaty 19]

CHICAGO - For children whose health insurance doesn't cover newly recommended shots, it's better to have no insurance at all, a new study suggests.

Free vaccines are available to children who are uninsured or qualify for public insurance.

But many states can't afford to help children with inadequate private insurance that doesn't cover new, expensive shots and even some older shots, the study found. That puts more than a million children at risk, researchers said.

Illinois, for example, doesn't provide vaccines against chickenpox, pneumonia, hepatitis A, human papillomavirus and rotavirus to children with insufficient private insurance. Parents would have to pay $400 out of pocket for those vaccines.

"Health insurance plans are not necessarily keeping up with the new vaccines, posing significant ethical dilemmas to public health clinics," said the study's lead author Dr. Grace Lee of Harvard Medical School.

The study of the nation's patchwork system of paying for immunizations appears in Wednesday's Journal of the American Medical Association.

Childhood shots have become a $1 billion-a-year endeavor for government since the discovery of polio vaccine 55 years ago. The per-child cost grew more than sevenfold from $155 in 1995 to $900 for boys and $1,200 for girls this year. Costs in the private sector are higher.

Lee and her colleagues surveyed states to find out which shots they provide and to whom. Program managers from 48 states responded. Lee wouldn't say which states participated because researchers promised anonymity.

Sixteen of the states require health insurers to cover all recommended vaccines.

About 55 million employees and their dependents get coverage through self-insured companies that are exempt from state mandates. Those people are the most likely to be underinsured for vaccines, said vaccine policy expert Dr. Matthew Davis of the University of Michigan.

According to the research, 17 states reported they were unable to give a vaccine for meningitis to children with inadequate private insurance, even if they were seen in public health clinics. And eight states don't give pneumococcal shots to underinsured infants and toddlers.

A handful of states don't provide shots for chickenpox and hepatitis A to the underinsured. Two states don't provide Tdap, the combined booster shot for tetanus, diphtheria and pertussis (whooping cough) for 11- to 12-year-olds.

More than 1 million insured children are unable to get the meningococcal vaccine leaving them vulnerable to potentially deadly infection, the researchers estimated.

The survey did not ask about two vaccines recommended last year: an oral vaccine for infants against rotavirus, a common cause of childhood diarrhea and vomiting, and a vaccine for girls against human papillomavirus, which can cause cervical cancer.

Workers covered by plans marketed by Aetna and other insurance companies generally are covered for childhood vaccines, although they may have to pay co-payments or satisfy deductibles, said Mohit Ghose, a spokesman for America's Health Insurance Plans.

As costs rise, it may be necessary to decide at a national level which vaccines are most important, Davis said. He was not involved in the new study, but wrote an accompanying editorial in the journal.

Officials at the U.S. Centers for Disease Control and Prevention oppose prioritizing vaccines and instead favor better coverage by insurers and more government funding as a safety net, said CDC immunizations director Dr. Lance Rodewald.

[MaRob 0]

I work at a pediatrician's office in Texas, and if the parent's insurance doesn't cover a particular vaccine, they are considered "underinsured" and get State vaccines... but thats another reason why Texas is just a great state to live in!

[GeordieWife 1]

I'm a nurse for a high school in Texas, and about five times a year an organization called 'Agape' and one called 'Carevan' holds clinics at Chick fil A for free shots regardless of your status...AND you get a coupon for a free ice cream too. They are not advertised very much, so the school districts health services department often knows so ask them!

Edited August 8, 2007 by GeordieLover

[almaty 19]

I work at a pediatrician's office in Texas, and if the parent's insurance doesn't cover a particular vaccine, they are considered "underinsured" and get State vaccines... but thats another reason why Texas is just a great state to live in!

no workman's comp in texas

[L_n_O 3]

free icecream!>??

[almaty 19]

free icecream!>??

i get a shot in the azz for that..

[GeordieWife 1]

free icecream!>??

i get a shot in the azz for that..

Yup...ain't Texas great! Well..it's part of the campaign here to immunize. It's required by schools now..no shots, no school. Parents can opt out but they have to get a waiver from the state and have it notarized that they object for reasons of conscience (this also now includes religious or medical exemptions).

[L_n_O 3]

no shots, no school, no ice-cream

now that's harsh..

[GeordieWife 1]

no shots, no school, no ice-cream

now that's harsh..

yeah and I'm the 'bad guy' that has to kick them out of school for immunization delinquencies. But...most parents are very understanding and take care of it right away ( I keep stickers in my office..yes even for high schoolers...for those who get no ice cream. I'm a cool nurse that way).

[Cantankerous 0]

I work at a pediatrician's office in Texas, and if the parent's insurance doesn't cover a particular vaccine, they are considered "underinsured" and get State vaccines... but thats another reason why Texas is just a great state to live in!

no workman's comp in texas

Texas has had a Workers' Compensation Act since 1913.