The impact of gaps in health insurance coverage on immunization status for young children.
OBJECTIVE
To examine the impact of full-year versus intermittent public and private health insurance coverage on the immunization status of children aged 19-35 months.


METHODS
2001 State and Local Area Integrated Telephone Survey's National Survey of Children with Special Health Care Needs (NS-CSHCN) and the 2000-2002 National Immunization Survey (NIS).


METHODS
Linked health insurance data from 2001 NS-CSHCN with verified immunization status from the 2000-2002 NIS for a nationally representative sample of 8,861 nonspecial health care needs children. Estimated adjusted rates of up-to-date (UTD) immunization status using multivariate logistic regressions for seven recommended immunizations and three series.


RESULTS
Children with public full-year coverage were significantly more likely to be UTD for two series of recommended vaccines, (4:3:1:3) and (4:3:1:3:3), compared with children with private full-year coverage. For three out of 10 immunizations and series tested, children with private part-year coverage were significantly less likely to be UTD than children with private full-year coverage.


CONCLUSIONS
Our findings raise concerns about access to needed immunizations for children with gaps in private health insurance coverage and challenge the prevailing belief that private health insurance represents the gold standard with regard to UTD status for young children.
Division of Health Policy and Management, University of Minnesota, School of Public Health, 420 Delaware Street S.E., MMC 729, Minneapolis, MN 55455-0392, USA.
Lynn A
LA
Blewett
Gestur
G
Davidson
Matthew D
MD
Bramlett
Holly
H
Rodin
Mark L
ML
Messonnier
D002675:Child, Preschool; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D017149:Private Sector / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data*