Patchwork system means kids don't get shots
1 million may not have enough insurance for necessary vaccines, study says
Updated: 6:35 p.m. ET Aug 7, 2007
CHICAGO - For children whose health insurance doesnt cover newly recommended shots, its 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 cant afford to help children with inadequate private insurance that doesnt 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, doesnt 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 studys lead author Dr. Grace Lee of Harvard Medical School.
The study of the nations patchwork system of paying for immunizations appears in Wednesdays 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 wouldnt say which states participated because researchers promised anonymity.
Sixteen of the states require health insurers to cover all recommended vaccines.
55 million and their families may be underinsured
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 dont give pneumococcal shots to underinsured infants and toddlers.
A handful of states dont provide shots for chickenpox and hepatitis A to the underinsured. Two states dont 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 Americas Health Insurance Plans.
Tough decisions
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.
(for the original:
http://www.msnbc.msn.com/id/20164131/wid/11915773?GT1=10252)
******timely and interesting*****
this country has far more to worry about than those of us who choose not to vaccinate or who vaccinate selectively...
when/if this country clears this mess up, then and only then can they blame people like us for the lack of "herd immunity"...(which is a fallacy for so many reasons ....I won't get into them here!!!!)...or worse yet suggests we be forced to vaccinate our children against our will!!!!