Influenza Vaccination Among Children With Asthma in Medicaid Managed Care

Harvard University, Cambridge, Massachusetts, United States
Ambulatory Pediatrics (Impact Factor: 2.49). 01/2006; 6(1):1-7. DOI: 10.1016/j.ambp.2005.08.004
Source: PubMed


To describe influenza vaccination rates and identify risk factors for missing vaccination among children with asthma in managed Medicaid.
As part of a longitudinal study of asthma care quality, parents of children aged 2-16 years with asthma enrolled in Medicaid managed care organizations in Massachusetts, Washington, and California were surveyed by telephone at baseline and 1 year. We evaluated influenza vaccination rates during the follow-up year.
The study population included 1058 children with asthma. The influenza vaccination rate was 16% among all children with asthma and 21% among those with persistent asthma. Children with persistent asthma (odds ratio [OR] 0.53, 95% confidence interval [CI] 0.36-0.79) and those who had been hospitalized during the follow-up year (OR 0.29, 95% CI 0.11-0.76) were less likely to miss vaccination. Children older than 9 years (OR 1.66, 95% CI 1.13-2.46) and children of parents with less than a high school education (OR 2.29, 95% CI 1.05-5.03), compared with a college degree, were at risk for missing vaccination. Among children with persistent asthma, older children (OR 1.65, 95% CI 1.01-2.69) and children of parents with less than a high school education (OR 4.13, 95% CI 1.43-11.90) were more likely to miss influenza vaccination.
Our findings suggest that interventions directed toward older children and families with lower educational levels may help improve influenza vaccination rates among this high-risk group. The low overall vaccination rate highlights the need for improvement in this important component of asthma care quality for all children with asthma.

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    • "ble to complications of influ - enza infection than other children , and that these complications also may be more severe . This perception of greater risk should result in greater influenza vaccine uptake among children with asthma compared with children who do not have asthma . Previous research has supported this theory in children and adults . Gnanasekaran et al . ( 2006 ) found that asthma severity and prior hospitalization for asthma was associated with more frequent influenza vaccination among children in a Medicaid sample . Data from the National Health Interview Survey and National Immunization Survey for the years 2006 – 2009 show that persons at all age groups are more likely to report receiving "
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    ABSTRACT: Data from the Behavioral Risk Factor Surveillance System was used to determine if parents' decisions to vaccinate children against seasonal influenza conform to predictions made by theories of preventive health behavior that postulate increased preventive action with increased risk. Results indicated that parents of children with active asthma were more likely to report influenza vaccination than parents of children who never had asthma (OR = 3.5, 95% CI 2.4–5.1). There was no difference in vaccination frequency reported by parents of children without asthma and children whose asthma is in remission (OR = .8, 95% CI.4–1.4). Parents of children whose asthma is in remission will require additional education and prompting to encourage needed influenza vaccination.
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