Monday, May 20, 2019

The Other Reasons Kids Aren't Getting Vaccinations: Poverty and Health Care Access

May 20, 20195:52 PM ET
Heard on All Things Considered
Selena Simmons-Duffin


The little girl is catching up on some vaccines she's behind on: missing doses of the DTaP and polio vaccines. She's over two years old — both of those shots are supposed to happen at a baby's six-month check up.

"It happens a lot," Siefman says. The Unity Health Care clinic, where Siefman practices, serves mostly low-income, mostly African-American patients. She says her patients often miss vaccinations because of struggles in their parents' lives. The reasons include: "transportation, couldn't get off work, didn't have insurance and didn't know that they could come in without insurance."


Data from the CDC shows the connection between poverty and vaccination rates bears out nationally.

"We see large coverage gaps among children who are living below the poverty line compared to those at or above poverty and among children who have no insurance," says Hill. "The highest disparity is among the uninsured compared to those with private insurance."

For instance, CDC data shows that in 2017 only 75% of uninsured children age 19 to 35 months had gotten at least one dose of MMR, the vaccine for measles. That compares to 94% of privately insured children, and 90% of those on Medicaid.


Hill co-authored a CDC study published online in 2016 that examined which specific factors related to poverty correlated to whether children were up-to-date on their vaccines or not. Up-to-date children "tended to live in households with fewer children, higher incomes and less mobility, compared to children who were not [up-to-date]."

When it comes to mobility, it can be challenging for doctors to piece together vaccination histories for children whose families move a lot, the paper concludes.


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