New York State Insurance Plan Helps Ensure Childhood Vaccinations

Private health care providers refer preschool children to public health clinics for immunization most often because the cost of vaccination services would be a burden for the children's parents. However, when a child's health care is divided between a private practice and a public clinic, the child's vaccination is often delayed.

A goal of the national Childhood Immunization Initiative is to reduce vaccine costs for lower-income and uninsured families, especially so that vaccines may be provided in private physican offices. In 1991, New York State introduced a health insurance plan called Child Health Plus (CHPlus) that provided coverage for ambulatory care, including the full costs of immunization services.

Children less than 13 years of age and not on Medicaid were eligible for CHPlus if their family's income was less than 222% of the poverty level. The study showed that CHPlus insurance coverage caused a large shift of immunization delivery away from public health clinics to private primary care provider offices. Public clinic use for children's vaccination was decreased by up to two thirds.

The decrease in the number of immunizations delivered in the public health clinics was more than compensated for by the increase in immunizations delivered by primary care providers, resulting in improved immunization coverage.

Results were presented last month at the Pediatric Academic Societies' Annual Meeting in Washington, DC.

Title: Health Insurance for Low-Income, Working Families: Impact on the Delivery of Immunizations to Preschool ChildrenAuthors: Lance E. Rodewald, MD; Peter G. Szilagyi, MD, MPH; Jane Holl, MD; Laura R. Shone, MSW; Jack Zwanziger, PhD; Richard F. Raubertas, PhDAffiliations: National Immunization Program, CDC

University of Rochester