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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Tuesday, August 7, 2007
Underinsured children fall into vaccine gap
By Elizabeth Cooney, Globe Correspondent
Children whose private health insurance does not pay for new recommended vaccines may not be eligible to receive them in public programs, leaving them more vulnerable than if they had no insurance, according to a Harvard study.
These gaps are occurring as the number and cost of new vaccines have escalated. New vaccines recommended for children have doubled in the past five years and the cost to fully vaccinate a child -- about $1,170 -- is 7.5 times higher in 2007 than it was in 1995, Dr. Grace M. Lee of Harvard Medical School and colleagues write in tomorrow’s Journal of the American Medical Association. They surveyed state immunization program managers in 48 states from January to June 2006.
Those children were referred to public health clinics, but they were still unable to receive vaccine because funding to pay for it was not available, the researchers found. The work was funded by the US Centers for Disease Control and Prevention.
"To us that was alarming because we had always seen the public sector as a safety net for vulnerable children," said Lee, also of Children’s Hospital Boston and Harvard Pilgrim Health Care. "Now we find that with the newer, more expensive vaccines, a lot of states are unable to provide these vaccines to kids who can’t afford them."
The JAMA study did not attempt to find out how many families might pay out of pocket for vaccines. The HPV vaccine costs about $120 for each of three doses, the meningitis vaccine costs about $80, and the rotavirus vaccine costs about $60.
"I imagine that if a family can’t afford health insurance that covers vaccines, they probably wouldn’t be able to afford to pay for that," Lee said.
In an accompanying editorial, Dr. Matthew M. Davis of the University of Michigan suggests a tiered approach to financing newly recommended vaccines for underinsured children where funding is not available.
"Vaccines that benefit more of the population per individual immunized would receive higher priority," he writes.
Lee and her co-authors suggest working with insurance plans to include coverage.
"Until those enhancements can be made to health insurance plans, I think we need to support our public sector safety net," she said. "We need to come up with funding for these kids who are falling through the cracks to bridge the gap until we can have all health insurance plans covering vaccines."