Vaccines have disabled many childhood killers of the past and are poised to take out a number of less deadly diseases we have so far endured. But despite their availability, a new survey of states indicates that a million or more kids are not receiving new vaccines, because neither their insurance companies nor states will pick up the tab.

Researchers report that 10 states between 2004 and early 2006 changed their rules to limit public purchases of selected vaccines for residents whose insurance policies do not cover vaccines and often carry high deductibles. The shift forces the underinsured to pony up as much as $89 per dose for a surging array of new and costly vaccines—or simply skip the injections given to prevent potentially fatal childhood diseases including meningitis and pneumonia.

"It's like sending someone to the ER and them getting turned away—you can't imagine these kids not getting vaccine," says Grace M. Lee, assistant professor of pediatrics at Harvard Medical School and Children's Hospital Boston, lead author of the study published in JAMA The Journal of the American Medical Association. "This is really concerning to us because we see the public health sector as a safety net for…all underinsured kids."

Lee and colleagues from Harvard Medical School, the Centers for Disease Control and Prevention (CDC) and the Association of Immunization Managers conducted phone interviews and phone or written surveys of state immunization managers from November 2005 to June 2006 to determine their policies on administering the five vaccines—for the bacteria meningococcus and pneumococcus, the viruses hepatitis A and varicella (chicken pox) as well as a booster for adolescents against tetanus, diphtheria and acellular pertussis (whooping cough) called Tdap—most recently recommended by a CDC advisory panel when the study began.

The team discovered that public health departments in 17 states did not inoculate the underinsured against meningococcal bacteria, which can cause potentially fatal meningitis and meningococcemia (a blood infection). The CDC's Advisory Committee on Immunization Practices (ACIP) in February 2005 recommended adding the vaccine to the required cadre of childhood immunizations.

Eight states reported they did not have the funds to vaccinate underinsured kids against pneumococcus; five states said they lacked funds to provide hepatitis A vaccines and two states did not supply varicella vaccine or Tdap.

The ACIP has recommended seven new vaccines in the past dozen years, hiking the cost of completely immunizing a child or adolescent from $155 in 1995 to a hefty $1,170 in 2007, the group notes. Last year's additions were rotavirus, which causes severe but treatable diarrhea, and human papillomavirus, the source of 70 percent of cervical cancer.

The federal government offers free shots to the uninsured and underinsured through an entitlement program called Vaccines for Children, but there's a catch: some underinsured families may have to travel as much as 200 miles to such centers, Lee says, which makes them inaccessible to those who do not have the time, money or transportation to get there.

Section 317 of the Public Health Services Act for the past 30 years has provided federal funds to states for vaccines for the needy, but the funding has not risen with the introduction of new vaccines. Surveyed immunization managers cited a lack of 317 funding as a barrier to coverage in 81 to 100 percent of ineligible children, depending on the vaccine.

"Public health departments have faced substantial stress from what is really something great—new vaccines and new vaccine technologies," says Walter Orenstein, associate director of the Emory Vaccine Center in Atlanta.

Diseases that can be prevented by vaccines claim the lives of 300 U.S. children every year, according to the 317 Coalition, a group funded by the pharmaceutical industry that lobbies Congress for greater vaccine funding.

3 Comments

1. 1. n8rgrl 10:23 AM 4/25/09

   I really don't think the decline in vaccinations is due to lack of coverage. Parents-including myself are now better able to educate ourselves of the DANGERS of vaccines, not the benefits. Had I not educated myself and fought with my son's doctors (claiming he had a "virus" and not severe allergies at 4 months old) he would be DEAD from vaccines! We have to educate ourselves and others about the government's and big pharma's financial stake at the cost of our health. They are not interested in "preventing" or "treating" anything. They are concerned with the almighty dollar and how they can convince uneducated people that if they don't get "this vaccine" or take "this pill" they will suffer major health problems. The problem is, the stuff they are giving us "for our health" is actually ruining our health-and padding their pockets and providing job security for treating our upcoming health issues, to take another pill, get another shot etc... it's a vicious conspiracy circle that is costing people their health, their wealth, and their lives.

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2. 2. minivanjack 04:24 PM 4/27/09

   Vaccinations are apparently causing A.D.D., Autism and asthma. Hmm. Maybe we had better get some full disclosure on the contents of those vaccinations before we happily go down the road of allowing institutions to shove needles into children. If vaccinations were so great we wouldn't need laws forcing children to have them.

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3. 3. lamorpa in reply to minivanjack 08:52 AM 6/12/10

   Um, what? 'apparently causing...'? No. A totally discredited lunatic fringe of deluded parents are desperately trying, without a shred of scientific evidence, to blame vaccines for Autism. That's definitely not 'apparent'

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