Influenza Vaccinations Among Privately and Publicly Insured Children with Asthma
Author Department
Healthcare Quality; Medicine
Document Type
Article, Peer-reviewed
Publication Date
3-2023
Abstract
Objectives: Annual influenza vaccination rates for children remain well below the Healthy People 2030 target of 70%. We aimed to compare influenza vaccination rates for children with asthma by insurance type and to identify associated factors.
Methods: This cross-sectional study examined influenza vaccination rates for children with asthma by insurance type, age, year, and disease status using the Massachusetts All Payer Claims Database (2014-2018). We used multivariable logistic regression to estimate the probability of vaccination accounting for child and insurance characteristics.
Results: The sample included 310,099 child-year observations for children with asthma in 2015-2018. Fewer than half of children with asthma received influenza vaccinations; 51.2% among privately insured and 45.1% among Medicaid insured. Risk modeling reduced, but did not eliminate, this gap; privately insured children were 3.4 percentage points (pp) more likely to receive an influenza vaccination than Medicaid insured children (95% CI: 2.6pp to 4.2pp). Risk modeling also found persistent asthma was associated with more vaccinations (7.5pp higher; 95% CI: 7.0pp to 8.0pp), as was younger age. The regression-adjusted probability of influenza vaccination in a non-office setting was 3.2 pp higher in 2018 than 2015 (95% CI: 2.2p to 4.2pp), and significantly lower for children with persistent asthma and with Medicaid.
Conclusions: Despite clear recommendations for annual influenza vaccinations for children with asthma, low rates persist, particularly for children with Medicaid. Offering vaccines in non-office settings such as retail pharmacies may reduce barriers, but we did not observe increased vaccination rates in the first years after this policy change.
Keywords: Medicaid; asthma; vaccination.
Recommended Citation
Geissler KH, Shieh MS, Evans V, Lindenauer PK, Ash AS, Krishnan JA, Goff SL. Influenza Vaccinations Among Privately and Publicly Insured Children with Asthma. Acad Pediatr. 2023 Mar 2:S1876-2859(23)00055-4. doi: 10.1016/j.acap.2023.02.010. Epub ahead of print.
PMID
36870447