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Lower vaccination rates occur among U.S. military dependent children
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Despite universal coverage of all recommended childhood vaccinations among U.S. military dependent children, rates were lowest in this population of children when compared with all other insured and uninsured U.S. children, according to recent study findings.
“The reasons for this association are not clear and likely range from children being truly undervaccinated to lack of accurate and complete vaccination documentation,” Angela C. Dunn, MD, MPH, of the department of Family and Preventive Medicine at the University of California San Diego, and colleagues wrote. “If the actual reason is the former, then a systemic process to identify individuals who are not up to date on vaccinations may be needed. If the latter is the cause, a more robust method of documenting vaccinations may be needed.”
Researchers pooled data from the National Immunization Survey on vaccination coverage rates among 103,807 U.S. children aged 19 months to 35 months between 2007 and 2012. Coverage rates were compared between U.S. military dependent children (n = 3,421) and all other U.S. children.
Results indicated that when compared with 21.1% of all other children not up to date with the 4:3:1:3:3:1 series, excluding the Haemophilus influenzae type B vaccine, 28% of military dependent children were not up to date (OR = 1.4; 95% CI, 1.2-1.6).
Moreover, military dependent children were more likely to be incompletely vaccinated after controlling for sociodemographic characteristics (OR = 1.3; 95% CI, 1.1-1.5).
Compared with children who were not military dependent, military dependent children were more likely to be white, have mothers aged between 20 and 29 years with more than 12 years education and were married. Additionally, military dependent children were more likely to have moved state residences since birth and/or had two or more health care providers and lived in a household at or above the poverty line.
When specifically looking at the types of vaccines, military dependent children had lower rates of coverage for individual vaccines. Rates were significantly lower for the DTaP (77.9% vs. 84.3%; P < .01) and inactivated polio vaccine (88.5% vs. 93.3%; P < .01).
In addition, lower coverage rates for the 4:3:1:_:3:1 series were observed among military dependent children (72% vs. 77.9%; P < .01). Risk factors associated with the likelihood of having low coverage rates of this vaccine series were children who were black, aged younger than 30 months, had mothers with less than a college education, were not married and were between the ages of 20 and 29 years.
“As the United States seeks to reform its health care system, it is essential that we understand how policies will affect health indicators. The Affordable Care Act mandates that all new health insurance plans offer all childhood vaccinations recommended by the Advisory Committee on Immunization Practices at no cost to the patient, including eliminating all co-pays and cost-sharing arrangements,” Dunn and colleagues wrote. “All risk factors associated with incomplete vaccination, including financial barriers, should be clearly identified and addressed to ensure adequate vaccination coverage and to minimize the morbidity and mortality due to vaccine-preventable diseases.”
Disclosure: The researchers report no relevant financial disclosures.
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