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October 2007 NVAC Meeting Minutes - page 37 / 40





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October 2007 NVAC Meeting Minutes

starts, approximately a year and a half from now.

Dr. Jeanne Santoli reflected on Dr. Young’s comments by explaining that Working Groups work well because they are given a specific topic and told to run with it. She explained that the same process could work for Subcommittees as well. Dr. Birkhead agreed that Subcommittees needed to be focused toward a specific goal, such as adult immunization coverage.

Dr. Lovell suggested the Subcommittee take on the task of framing or outlining the scope of the problem, which is how to achieve higher immunization rates for adults. He explained that once the Subcommittee had created an outline, they could assign specific questions or challenges to smaller groups to solve. He also explained that the Subcommittee may be able to draw on the successes in pediatric immunization.

Dr. Almquist concluded the discussion by suggesting that this group—be it in the form of a Working Group or Subcommittee—take on the task of modeling adult immunizations and working to identify strategies to solve some of the problems experienced with adult immunizations. Dr. Birkhead agreed and stated that the Subcommittee should identify the issues that the group will address 2 to 3 years down the road. He also suggested if there were no other immunization coverage issues that needed to be addressed by this Subcommittee, that the Subcommittee possibly change its name.

Highlights of Recent Results from the New Health Insurance Modules of the National Immunization Survey—Dr. Philip J. Smith, NCIRD/CDC

Dr. Philip J. Smith provided the Subcommittee with a presentation highlighting insurance results from the National Immunization Survey (NIS). The purpose of his presentation was to share recent results from the 2006 Health Insurance Module (HIM) of the NIS. During his presentation, Dr. Smith also discussed the history of the 2001–02 HIM and the history of the 2006 HIM and past and present uses of HIM data.

Dr. Smith began by talking about the history of collecting insurance data for the NIS. Insurance data were collected on 24,514 children, and their providers reported their vaccination history. Dr. Smith explained that these data allowed CDC to learn about the use of “medical homes” and whether children had public insurance or private insurance or they were uninsured.

One research topic CDC investigated using the NIS data was the association between having a medical home and vaccination coverage among children eligible for the Vaccines for Children (VFC) program. Results from that investigation showed that VFC-eligible children who have a medical home and use it consistently to receive all vaccine doses can have vaccination coverage rates that are comparable to non-VFC children living in more affluent households.

Another research topic CDC investigated was the association between childhood vaccination coverage, insurance types, and breaks in health insurance coverage. Results from that study confirmed that children who were insured with public insurance or who were uninsured were significantly less well vaccinated than children covered by private insurance. Results also showed that children who were covered by health insurance at the time of the NIS interview and who had no breaks in health insurance coverage were significantly better vaccinated than children who were currently insured but who had breaks in coverage, than children who were currently uninsured but previously insured, and than children who were never insured.

Dr. Smith explained that the data from the 2001 to 2002 NIS HIM were used to estimate the percentage of children who were VFC eligible by State. The drawbacks to this survey revolved around confusion about deductibles or copayments.

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