KEYWORD1:
vaccination coverage, Medicaid, NIS

BACKGROUND:
In 1998 the Centers for Medicare and Medicaid Services (CMS) adopted as one of their Government Performance & Results Act (GPRA) goals, the goal of increasing the percent of two year old children enrolled in Medicaid who are fully immunized. A fundamental challenge to the Medicaid GPRA immunization initiative has been to develop a means of measuring coverage of the 2-year old Medicaid population. In July of 2001, the National Immunization Survey (NIS), fielded a topical module addressing health insurance coverage of children surveyed. This module contained an item regarding current enrollment in Medicaid.

OBJECTIVE:
To evaluate the capabilities and limitations of using the Medicaid enrollment question on the NIS health insurance module (NIS/HIM) to estimate vaccination coverage of children enrolled in Medicaid.

METHOD:
A preliminary weighted analysis using data from only the first available quarter of the NIS/HIM (2001 Q3), was conducted. National, state and urban area coverage estimates for 4DTP/3Polio/1MMR/3HIB/3HepB (4/3/1/3/3) were calculated for children enrolled in Medicaid versus children not enrolled in public programs (Medicaid, WIC, or VFC).

RESULT:
Nationally, 4/3/1/3/3 coverage for non-program children was 74.9% (± 3.1) compared to 68.3 (±4.0) for current Medicaid enrollees. State and urban area coverage estimates for Medicaid had large confidence intervals, ranging from ±10 to 37 percentage points.

CONCLUSION:
The NIS/HIM is a potential source for estimating vaccination coverage of Medicaid enrolled children. Usable state and local area estimates can be determined when data are available from a full year.
LEARNINGOBJECTIVES:
Attendees will learn the capabilities and limitations of the NIS health insurance module as a source for estimating vaccination coverage of Medicaid enrolled children.