Philip Smith1, Jeanne Santoli
2, Susan Y. Chu
3, Dianne Ochoa
1, and Lance Rodewald
1. (1) ISD, CDC, MS E 62, 1600 Clifton Road, NE, Atlanta, GA, USA, (2) National Immunization Program, CDC, (3) Centers for Disease Control and Prevention, National Immunization Program, 1600 Clifton Road, NE, MS E-52, Atlanta, USA
BACKGROUND:
A goal of the Vaccines for Children (VFC) program is to foster continuous and comprehensive medical care for vulnerable children by reducing the cost of vaccines at their medical home.
OBJECTIVE:
We describe the association between vaccination status and having a medical home among VFC-eligible children.
METHOD:
N=24,514 children 19-35 months sampled by the National Immunization Survey, 2002. VFC-eligible children were Medicaid-eligible, American Indian or Alaska Natives, uninsured, or underinsured and vaccinated at a Federally Qualified Health Center. A medical home was defined as a doctor, nurse, or physician’s assistant who provided ongoing routine well-child care, preventive, and sick care. Up-to-date (UTD) children had 4+ doses of diphtheria, tetanus toxoids, and acellular pertussis; 3+ doses of polio; 1+ doses of measles, mumps, and rubella; and 3+ Haemophilus influenzae type B vaccines.
RESULT:
Nationally, 54% of all children were VFC-eligible. Among VFC-eligible children, 92% received all doses from VFC-enrolled providers, and 83% had a medical home. Among VFC-eligible children with a medical home 75% were UTD vs. 65% among VFC-eligible children with no medical home (p<0.05). VFC-eligible children with no medical home were significantly more likely to be Hispanic (RR=2.5) or non-Hispanic Black (RR=1.5) than non-Hispanic white; to have a mother with no more than a high-school education (RR=1.7) than with a higher education; to have a mother <30 years old (RR=1.5) than an older mother; or to have received all of their vaccinations at a public clinic (RR=2.0) than all private clinics. After controlling for these differences, not having a medical home remained significantly associated with a lower UTD rate (RR=0.8).
CONCLUSION:
Although the percent of VFC-eligible children receiving vaccinations at VFC providers is high, the percent not having a medical home is substantial, and these children are less likely to be UTD.
LEARNING OBJECTIVES:
Not having a medical home impacts vaccine coverage among VFC-eligible children.