Am J Prev Med

Abstract

BackgroundUnderinsurance has been a barrier to vaccination among children. Information on vaccination among adults 6518 years by insurance status is limited.PurposeTo assess vaccination coverage among adults 6518 years in the United States in 2012 by health insurance status and access to care characteristics.MethodsThe 2012 NHIS data were analyzed in 2014 to estimate vaccination coverage among adults 6518 years by health insurance status for 7 vaccines routinely recommended for use. For the non-influenza vaccination coverage estimates among adults 6518 years, regular descriptive analysis was used. To better assess influenza vaccination coverage for the 2011\u201312 influenza season, coverage was reported by restricting to individuals interviewed during September 2011 through June 2012, and vaccinated during August 2011 through May 2012, using the Kaplan-Meier survival analysis procedure.ResultsOverall, for all age groups, vaccination coverage was lower among those without health insurance compared with those with health insurance for all except HepA vaccination. Influenza vaccination coverage among adults 6518 years without or with health insurance was 14.4% versus 44.3%, respectively, pneumococcal vaccination coverage among adults 18\u201364 years with high-risk conditions was 9.8% versus 23.0%, Td coverage ( 6518 years) was 53.2% versus 64.5%, Tdap coverage ( 6518 years) was 8.4% versus 15.7%, HepA coverage (18\u201349 years) was 16.6% versus 19.8%, HepB coverage (18\u201349 years) was 27.5% versus 38.0%, shingles coverage ( 6560 years) was 6.1% versus 20.8%, and HPV coverage (female 18\u201326 years) was 20.9% versus 39.8%. In addition, vaccination coverage differed by type of insurance, whether or not respondents had a regular physician, or number of physician contacts. Persons without health insurance were less likely than those with health insurance to be vaccinated for influenza ( 6518 years), pneumococcal (18\u201364 years with high-risk conditions), tetanus ( 6518 years), Tdap ( 6518 years), and HPV (women 18\u201326 years) after adjusting for confounders.ConclusionsOverall, vaccination coverage among adults 6518 years was lower among uninsured populations. Implementing effective strategies are needed to help improve vaccination coverage among adults 6518 years, especially those without health insurance.20152018-02-26T00:00:00ZCC999999/Intramural CDC HHS/United States25890684PMC5826635868