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Study reveals gaps in vaccine financing for underinsured children

r vaccines given in the private sector, 46 percent of states did not provide publicly purchased varicella (chickenpox) vaccine to underinsured children and 70 percent of states did not provide publicly purchased meningococcal conjugate vaccine to the underinsured. For vaccines given in the public sector, 17 percent of states were unable to provide publicly purchased pneumococcal conjugate vaccine to underinsured children and 40 percent were unable to provide publicly purchased meningococcal conjugate vaccine. This meant that underinsured children were not able to receive state-purchased vaccine in either the private or public sectors in these states. None of the vaccines we studied was covered for all underinsured children in the United States, the authors write.

Due to limited financing for new vaccines, 10 states changed their policies for provision of publicly purchased vaccines between 2004 and early 2006 to restrict access to selected new vaccines for underinsured children. The most commonly cited barriers to implementation in underinsured children were lack of sufficient federal and state funding to purchase vaccines.

Assuming 14 percent of children are underinsured in the United States, we estimate that 2.3 million children are unable to receive state-purchased meningococcal conjugate vaccine in the private sector, and 1.2 million children are unable to receive this vaccine even if they are referred to the public sector, they write. Current trends in health insurance products, including enrollment in high-deductible health plans that may or may not provide immunizations or other preventive benefits before a high deductible has been met, are likely to increase the magnitude of this gap and must be carefully monitored.

(JAMA. 2007;298(6):638-643. Available pre-embargo to the media at www.jamamedia.org)

Editors Note: Please see the article for additional information, including other author
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Contact: Judith Montminy
617-432-0442
JAMA and Archives Journals
7-Aug-2007


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