Insurance Coverage and Household Income Contribute to Disparity in MMR Vaccination Rates

Sub-optimal vaccination rates across the country are not just a consequence of anti-vaxxer crusades — though anti-vaxxer communities have certainly made lots of noise and have elicited the most outrage from science-loving members of the public. A piece published this week by NPR highlighted the quiet ways that poverty and access to health care factor into inadequate vaccination rates across the country, which unsurprisingly gets overlooked for the juicer vaccination headlines.

As with other aspects of health care, there is a significant disparity in care that correlates to insurance status. “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. The greatest disparity is among the uninsured compared to those with private insurance,” a CDC epidemiologist told the new organization. According to CDC data, only 75 percent of children between the ages of 19 and 35 months had received at least one dose of the MMR vaccine; comparatively, children of low-income families with Medicaid had a 90 percent vaccination rate, while 94 percent of children covered by private insurance have been vaccinated. Household income was also a factor in whether children were adequately vaccinated, with children living below the poverty line having inadequate rates of vaccination. A single dose of the MMR vaccine is approximately 93 percent effective in preventing illness, while two doses increases the effectiveness to 97 percent.

Health insurance status, though, should not dictate whether young children get the vaccinations that are recommended by health experts. A federally-funded initiative called Vaccines For Children, launched 25 years ago, guarantees all manner of free vaccines to children of families who are unable to afford them. In the first couple of years of its implementation, the program successfully boosted MMR vaccination rates from 90 to 92 percent.

After sifting through years of data following the VFC program, a 2016 study concluded that while free vaccines helped boost vaccination rates, the cost of them clearly was only one prohibitive factor in whether children would ultimately receive them. “Providing free vaccinations does not guarantee optimal uptake and some children, such as low-income black children, still have lower vaccination rates than their richer peers,” explained one of the study’s authors. “Other potential barriers to vaccinations include travel costs, time costs, access to vaccination providers and lack of knowledge and fears about vaccinations.” For now, physicians are being encouraged to offer vaccinations to any child who walks into a doctor’s office, regardless of the reason for the visit, as a way to increase vaccination rates among the most vulnerable communities.