{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:29:31Z","timestamp":1770812971745,"version":"3.50.1"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"Supplement_5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,12,1]]},"abstract":"<jats:p>OBJECTIVE: The goal was to explore the association of being underinsured and receiving doses at a health department clinic (HDC) with not receiving all recommended adolescent vaccine doses.<\/jats:p>\n               <jats:p>METHODS: A total of 5657 adolescents, 13 to 17 years of age, were sampled in the National Immunization Survey-Teen in 2006\u20132007.<\/jats:p>\n               <jats:p>RESULTS: A total of 63.9% of all adolescents were covered by private health insurance. Among privately insured adolescents, \u223c31.3% were underinsured. Compared with fully insured adolescents, underinsured adolescents were more likely to receive doses at an HDC for tetanus-diphtheria toxoids\/tetanus toxoids-reduced diphtheria toxoids-acellular pertussis vaccine (25.1% vs 6.2%; P &amp;lt; .05), tetravalent meningococcal conjugate vaccine (11.5% vs 2.5%; P &amp;lt; .05), and quadrivalent human papillomavirus vaccine (16.2% vs 3.4%; P &amp;lt; .05). Also, compared with fully insured adolescents, underinsured adolescents who received doses at an HDC had lower estimated rates of vaccination coverage for tetanus-diphtheria toxoids\/tetanus toxoids-reduced diphtheria toxoids-acellular pertussis vaccine (58.5% vs 70.9%; P &amp;lt; .05), tetravalent meningococcal conjugate vaccine (10.8% vs 25.8%; P &amp;lt; .05), and quadrivalent human papillomavirus vaccine (7.8% vs 14.3%; P &amp;lt; .05).<\/jats:p>\n               <jats:p>CONCLUSION: Underinsured adolescents who receive doses at an HDC have lower rates of vaccination coverage than do fully insured adolescents.<\/jats:p>","DOI":"10.1542\/peds.2009-1542k","type":"journal-article","created":{"date-parts":[[2009,11,30]],"date-time":"2009-11-30T18:08:00Z","timestamp":1259604480000},"page":"S515-S521","source":"Crossref","is-referenced-by-count":14,"title":["Underinsurance and Adolescent Immunization Delivery in the United States"],"prefix":"10.1542","volume":"124","author":[{"given":"Philip J.","family":"Smith","sequence":"first","affiliation":[{"name":"Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan C.","family":"Lindley","sequence":"additional","affiliation":[{"name":"Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abby","family":"Shefer","sequence":"additional","affiliation":[{"name":"Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lance E.","family":"Rodewald","sequence":"additional","affiliation":[{"name":"Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2009,12,1]]},"reference":[{"key":"2021120821240041100_R1","unstructured":"Social Security Online. Compilation of the Social Security laws: program for distribution of pediatric vaccines. Available at: www.ssa.gov\/OP_Home\/ssact\/title19\/1928.htm. Accessed November 3, 2009"},{"key":"2021120821240041100_R2","unstructured":"Centers for Disease Control and Prevention. Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Recomm Rep.\u20081991;40(RR-10):1\u201328"},{"key":"2021120821240041100_R3","doi-asserted-by":"crossref","unstructured":"Broder KR, Cortese MM, Iskander JK, et al. Preventing tetanus, diphtheria, and pertussis among adolescents: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep.\u20082006;55(RR-3):1\u201334","DOI":"10.1037\/e506922006-001"},{"key":"2021120821240041100_R4","unstructured":"Centers for Disease Control and Prevention. Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep.\u20082005;54(RR-7):1\u201321"},{"key":"2021120821240041100_R5","doi-asserted-by":"crossref","unstructured":"Markowitz LE, Dunne EF, Saraiya M, et al. Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep.\u20082007;56(Early release):1\u201324","DOI":"10.1037\/e601292007-001"},{"key":"2021120821240041100_R6","unstructured":"Centers for Disease Control and Prevention. CDC vaccine price list. Available at: www.cdc.gov\/vaccines\/programs\/VFC\/cdc-vac-price-list.htm. Accessed January 29, 2009"},{"key":"2021120821240041100_R7","unstructured":"US Department of Health and Human Services, Health Resources and Services Administration. The Health Center Program: Section 330 of the Public Health Service Act (42 USCS \u00a7 254b): authorizing legislation for the Health Center Program. Available at: http:\/\/bphc.hrsa.gov\/about\/legislation\/section330.htm. Accessed December 23, 2008"},{"key":"2021120821240041100_R8","doi-asserted-by":"crossref","unstructured":"Jain N, Singleton JA, Montgomery M, Skalland B. Determining accurate vaccination coverage rates for adolescents: an overview of the methodology used in the National Immunization Survey-Teen. Public Health Rep.\u20082009;124(5):642\u2013651","DOI":"10.1177\/003335490912400506"},{"key":"2021120821240041100_R9","unstructured":"Smith PJ, Hoaglin DC, Battaglia MP, et al. Statistical methodology of the National Immunization Survey: 1994\u20132002. Vital Health Stat 2. 2005;(138):1\u201355"},{"key":"2021120821240041100_R10","unstructured":"American Association for Public Opinion Research. Standard definitions. Available at: www.aapor.org\/Standard_Definitions1.htm. Accessed November 3, 2009"},{"key":"2021120821240041100_R11","doi-asserted-by":"crossref","unstructured":"Lumley T. Analysis of complex survey samples. J Stat Softw. 2004;9(8). Available at: www.jstatsoft.org\/v09\/i08. Accessed November 29, 2008","DOI":"10.18637\/jss.v009.i08"},{"key":"2021120821240041100_R12","unstructured":"Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0\u201318 years: United States, 2008. MMWR Morb Mortal Wkly Rep.\u20082008;57(1):Q-1\u2013Q-4"},{"key":"2021120821240041100_R13","unstructured":"Minnesota Department of Health, Health Economics Program. Trends in Private Health Insurance Premiums and Cost Drivers, 2004. St Paul, MN: Minnesota Department of Health; 2005. Issue Brief 2005-02. Available at: www.health.state.mn.us\/divs\/hpsc\/hep\/publications\/privatemarkets\/2005-02.pdf. Accessed November 3, 2009"},{"key":"2021120821240041100_R14","doi-asserted-by":"crossref","unstructured":"Robinson JC. MPH reinvention of health insurance in the consumer era. JAMA.\u20082004;291(15):1880\u20131886","DOI":"10.1001\/jama.291.15.1880"},{"key":"2021120821240041100_R15","doi-asserted-by":"crossref","unstructured":"Schoen C, Doty MM, Collins SR, Holmgren AL. Insured but not protected: how many adults are underinsured?Health Aff (Millwood).\u20082005;W5:289\u2013302","DOI":"10.1377\/hlthaff.W5.289"},{"key":"2021120821240041100_R16","unstructured":"Kaiser Commission on Medicaid and the Uninsured. Underinsured in America: Is Health Coverage Adequate? Washington, DC: Kaiser Family Foundation; 2002. Available at: www.kff.org\/uninsured\/loader.cfm?url=\/commonspot\/security\/getfile.cfm&PageID=14136. Accessed November 3, 2009"},{"key":"2021120821240041100_R17","doi-asserted-by":"crossref","unstructured":"Smith PJ, Santoli JM, Chu SY, Ochoa DQ, Rodewald LE. The association between having a medical home and vaccination coverage among children eligible for the Vaccines for Children program. Pediatrics.\u20082005;116(1):130\u2013139","DOI":"10.1542\/peds.2004-1058"},{"key":"2021120821240041100_R18","unstructured":"Centers for Disease Control and Prevention. Program in Brief: Immunization Grant Program (Section 317). Available at: www.cdc.gov\/ncird\/progbriefs\/downloads\/grant-317.pdf. Accessed December 23, 2008"},{"key":"2021120821240041100_R19","doi-asserted-by":"crossref","unstructured":"Hinman AR, Orenstein WA, Rodewald LE. Financing immunizations in the United States. Clin Infect Dis.\u20082004;38(10):1440\u20131446","DOI":"10.1086\/420748"},{"key":"2021120821240041100_R20","doi-asserted-by":"crossref","unstructured":"Lee GM, Santoli JJ, Hannan C, et al. Gaps in vaccine financing for underinsured children in the Unites States. JAMA.\u20082007;298(6):638\u2013643","DOI":"10.1001\/jama.298.6.638"},{"key":"2021120821240041100_R21","doi-asserted-by":"crossref","unstructured":"Lindley MC, Shen AK, Orenstein WA, Rodewald LE, Birkhead GS. Financing the delivery of vaccines to children and adolescents: challenges to the current system. Pediatrics.\u20082009;124(suppl 5):S548\u2013S557","DOI":"10.1542\/peds.2009-1542O"},{"key":"2021120821240041100_R22","unstructured":"Ezzati-Rice TM, Zell ER, Massey JT, Nixon MG. Improving the assessment of vaccination coverage rates with the use of both household and medical provider data. In: Proceedings of the Survey Research Methods Section, American Statistical Association. Alexandria, VA: American Statistical Association; 1996:335\u2013340"},{"key":"2021120821240041100_R23","doi-asserted-by":"crossref","unstructured":"Frankel MR, Srinath KP, Hoaglin DC, et al. Adjustments for non-telephone bias in random-digit-dialing surveys. Stat Med.\u20082003;22(9):1611\u20131626","DOI":"10.1002\/sim.1515"},{"key":"2021120821240041100_R24","unstructured":"Blumberg SJ, Luke JV. Wireless substitution: early release of estimates from the National Health Interview Survey, July\u2013December 2007. Available at: www.cdc.gov\/nchs\/data\/nhis\/earlyrelease\/wireless200705.pdf. Accessed June 5, 2008"},{"key":"2021120821240041100_R25","unstructured":"Cochran WG. Sampling Techniques. 2nd ed. New York, NY: Wiley; 1963"},{"key":"2021120821240041100_R26","unstructured":"Little RJA, Rubin DB. Statistical Analysis With Missing Data. New York, NY: Wiley; 1987"},{"key":"2021120821240041100_R27","unstructured":"Khare M, Singleton JA, Wouhib A, Jain N. Assessment of potential bias in the National Immunization Survey (NIS) from the increasing noncoverage of non-landline telephone households. Presented at the 42nd National Immunization Conference; March 20, 2008; Atlanta, GA. Available at: http:\/\/cdc.confex.com\/cdc\/nic2008\/webprogram\/Paper15584.html. Accessed March 5, 2009"},{"key":"2021120821240041100_R28","doi-asserted-by":"crossref","unstructured":"Bates B. Plethora of shots burdens providers. Pediatr News.\u20082008;42(6). Available at: www.pediatricnews.com\/article\/S0031-398X(08)70240-6\/preview. Accessed November 3, 2009","DOI":"10.1016\/S0031-398X(08)70240-6"},{"key":"2021120821240041100_R29","doi-asserted-by":"crossref","unstructured":"Freed GL, Cowan AE, Clark SJ. Primary care physician perspectives on reimbursement for childhood immunizations. Pediatrics.\u20082008;122(6):1319\u20131324","DOI":"10.1542\/peds.2008-2033"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/124\/Supplement_5\/S515\/892005\/zpe3120900s515.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/124\/Supplement_5\/S515\/892005\/zpe3120900s515.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T01:34:56Z","timestamp":1639013696000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/124\/Supplement_5\/S515\/29819\/Underinsurance-and-Adolescent-Immunization"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,12,1]]},"references-count":29,"journal-issue":{"issue":"Supplement_5","published-online":{"date-parts":[[2009,12,1]]},"published-print":{"date-parts":[[2009,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2009-1542k","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,12,1]]}}}