Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Atlanta, GA 30333, USA.
Pediatrics. 2009 Dec;124 Suppl 5:S507-14. doi: 10.1542/peds.2009-1542J.
Underinsured children are covered by private health insurance that does not cover the cost of vaccines, are not entitled to receive publicly purchased vaccines at no cost through the Vaccines for Children (VFC) Program unless they receive doses at a Federally Qualified Health Center (FQHC) or a Rural Health Center (RHC), may be referred by their primary care providers to health department clinics (HDCs) for vaccinations, and may have lower vaccination coverage for new and more expensive vaccines.
To describe the estimated percentage of children in the U.S. who are underinsured, receive vaccine doses at HDCs, and are not VFC-entitled; and to evaluate the association between being underinsured, receiving vaccine doses at an HDC, and timely vaccination coverage.
Subjects were 16,621 19-35 month-old children sampled by the National Immunization Survey in 2007.
Of all 19-35 month-old children, an estimated 10.5% were underinsured; and an estimated 1.4% were underinsured, received doses at an HDC, and were not VFC-entitled. Compared to fully insured children, children who were underinsured and received doses at an HDC had significantly lower vaccination coverage for the varicella (81.5% vs. 87.7%, p < 0.05) and PCV7 (55.1% vs. 75.9%, p < 0.05) vaccines.
Children who were underinsured and received doses at HDCs were found to have lower estimated timely vaccination coverage for recently recommended vaccines and more expensive varicella and PCV7 vaccines. To adequately vaccinate these children at HDCs, states require stable funding to pay for vaccines as the number of new and more expensive vaccines grows.
未充分保险的儿童参加私人医疗保险，这些保险不支付疫苗费用，除非在合格的联邦健康中心 (FQHC) 或农村健康中心 (RHC) 接种疫苗，否则无权通过儿童疫苗计划 (VFC) 免费获得公共购买的疫苗，可能会被他们的初级保健提供者推荐到卫生部门诊所 (HDC) 接种疫苗，并且可能对新的和更昂贵的疫苗的接种率较低。
描述美国未充分保险、在 HDC 接种疫苗且不符合 VFC 资格的儿童的估计百分比；并评估未充分保险、在 HDC 接种疫苗和及时接种疫苗覆盖之间的关联。
研究对象为 2007 年全国免疫调查中抽样的 16621 名 19-35 月龄儿童。
在所有 19-35 月龄儿童中，估计有 10.5%未充分保险；估计有 1.4%未充分保险、在 HDC 接种疫苗且不符合 VFC 资格。与完全保险的儿童相比，未充分保险且在 HDC 接种疫苗的儿童，接种水痘（81.5%比 87.7%，p<0.05）和 PCV7（55.1%比 75.9%，p<0.05）疫苗的比例明显较低。
未充分保险且在 HDC 接种疫苗的儿童最近推荐的疫苗和更昂贵的水痘和 PCV7 疫苗的估计及时接种率较低。为了在 HDC 为这些儿童充分接种疫苗，各州需要稳定的资金来支付疫苗费用，因为新的和更昂贵的疫苗数量不断增加。
