title: Impact of state vaccine financing policy on uptake of heptavalent pneumococcal conjugate vaccine.
abstract: OBJECTIVE
  We examined heptavalent pneumococcal conjugate vaccine (PCV7) uptake among children aged 19 to 35 months in the United States and determined how uptake rates differed by state vaccine financing policy.
  
  
  METHODS
  We analyzed data from the 2001-2003 National Immunization Survey. States that changed their vaccine financing policy between 2001 and 2003 (n=17) were excluded from analysis. Logistic regression was performed to identify the association between state vaccine financing policy and receipt of 3 or more doses of PCV7 after control for demographic characteristics.
  
  
  RESULTS
  The proportion of children receiving 3 or more doses increased from 6.7% in 2001 to 69.0% in 2003. After controlling for demographic characteristics, children residing in states that provided all vaccines except PCV7 to all children had lower odds of receiving 3 or more doses compared to children residing in states that provided PCV7 only to children eligible for the Vaccines for Children program (odds ratio=0.58; 95% confidence interval=0.51, 0.66).
  
  
  CONCLUSIONS
  It is essential that we continue to monitor the effect that state vaccine financing policy has on the delivery of PCV7 and future vaccines, which are likely to be increasingly expensive.
authors.affiliation: National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga 30333, USA. sstokley@cdc.gov
authors.forename: Shannon
authors.initials: S
authors.lastname: Stokley
authors.forename: Kate M
authors.initials: KM
authors.lastname: Shaw
authors.forename: Lawrence
authors.initials: L
authors.lastname: Barker
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Santoli
authors.forename: Abigail
authors.initials: A
authors.lastname: Shefer
mesh_terms: D002662:Child Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004608:Eligibility Determination; D005380:Financing, Government / Q000145:classification / Q000331:legislation & jurisprudence*; D019538:Health Care Surveys; D006291:Health Policy / Q000331:legislation & jurisprudence*; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D017589:Immunization Programs / Q000191:economics* / Q000706:statistics & numerical data*; D007115:Immunization Schedule; D007223:Infant; D008585:Meningitis, Meningococcal / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000191:economics* / Q000600:supply & distribution; D015999:Multivariate Analysis; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics* / Q000600:supply & distribution; D011635:Public Health Administration / Q000191:economics*; D013219:State Government; D014481:United States; D019472:Universal Health Insurance; D018074:Vaccines, Conjugate / Q000191:economics*
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate