title: Reducing financial barriers to vaccinating children and adolescents in the USA.
abstract: OBJECTIVE
  To increase awareness of the financial barriers to childhood and adolescent vaccination, recent steps taken to mitigate these barriers, and remaining gaps following passage of Federal healthcare reform legislation.
  
  
  RESULTS
  Financial barriers to vaccination remain, even with the safety net of the Vaccines for Children Program. Newly recommended vaccines have substantially increased the cost to fully vaccinate a child up to age 18 years, and the combination of these cost burdens and inadequate reimbursement, in both the private and public sectors, has led some physicians to seriously consider stopping vaccination services. Up to 20% of privately insured children or adolescents have coverage that does not fully cover all costs of immunization, potentially leading to fragmented and inadequate preventive care.
  
  
  CONCLUSIONS
  Federal healthcare reform legislation, as currently constituted, may not fully address all financing gaps, and the extent to which financial barriers to immunization services remain will need to be evaluated as the legislation is implemented. Recent National Vaccine Advisory Committee recommendations need to be considered to address financial barriers to immunization.
authors.affiliation: Office of Public Health, New York State Department of Health, Albany, New York, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bednarczyk
authors.forename: Guthrie S
authors.initials: GS
authors.lastname: Birkhead
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000191:economics; D002648:Child; D002662:Child Health Services / Q000191:economics; D018166:Health Care Reform / Q000191:economics*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D014481:United States; D014611:Vaccination / Q000191:economics*