Impact of health insurance status on vaccination coverage among adult populations

Am J Prev Med. 2015 Jun;48(6):647-61. doi: 10.1016/j.amepre.2014.12.008. Epub 2015 Apr 15.

Abstract

Introduction: Underinsurance is a barrier to vaccination among children. Information on vaccination among adults aged ≥18 years by insurance status is limited. This study assesses vaccination coverage among adults aged ≥18 years in the U.S. in 2012 by health insurance status and access to care characteristics.

Methods: The 2012 National Health Interview Survey data were analyzed in 2014 to estimate vaccination coverage among adults aged ≥18 years by health insurance status for seven routinely recommended vaccines.

Results: Influenza vaccination coverage among adults aged ≥18 years without or with health insurance was 14.4% versus 44.3%, respectively; pneumococcal vaccination coverage among adults aged 18-64 years with high-risk conditions was 9.8% versus 23.0%; tetanus and diphtheria toxoid (Td) coverage (age ≥18 years) was 53.2% versus 64.5%; tetanus, diphtheria, and acellular pertussis (Tdap) coverage (age ≥18 years) was 8.4% versus 15.7%; hepatitis A (HepA) coverage (age 18-49 years) was 16.6% versus 19.8%; hepatitis B (HepB) coverage (age 18-49 years) was 27.5% versus 38.0%; shingles coverage (age ≥60 years) was 6.1% versus 20.8%; and human papillomavirus (HPV) coverage (women aged 18-26 years) was 20.9% versus 39.8%. In addition, vaccination coverage differed by insurance type, whether respondents had a regular physician, and number of physician contacts.

Conclusions: Overall, vaccination coverage among adults aged ≥18 years is lower among uninsured populations. Implementation of effective strategies is needed to help improve vaccination coverage among adults aged ≥18 years, especially those without health insurance.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Humans
  • Insurance, Health*
  • Medically Uninsured / statistics & numerical data*
  • Middle Aged
  • United States
  • Vaccination / statistics & numerical data*
  • Vaccines
  • Young Adult

Substances

  • Vaccines