Preexisting chronic health conditions and health insurance status associated with vaccine receipt among adolescents

Katherine Seib, Natasha L. Underwood, Lisa M. Gargano, Jessica M. Sales, Christopher Morfaw, Paul Weiss, Dennis Murray, Tara M. Vogt, Ralph J. DiClemente, James M. Hughes

Research output: Contribution to journalArticlepeer-review


Purpose: Four vaccines are routinely recommended for adolescents: tetanus, diphtheria, and acellular pertussis (Tdap); human papillomavirus (HPV); meningococcal-conjugate (MCV4); and a yearly seasonal influenza vaccine. Vaccination promotion and outreach approaches may need to be tailored to certain populations, such as those with chronic health conditions or without health insurance. Methods: In a controlled trial among middle and high school students in Georgia, 11 schools were randomized to one of three arms: no intervention, parent education brochure, or parent education brochure plus a student curriculum on the four recommended vaccines. Parents in all arms were surveyed regarding their adolescent's vaccine receipt, chronic health conditions, and health insurance status. Results: Of the 686 parents, most (91%) reported their adolescent had received at least one of the four vaccines: Tdap (82%), MCV4 (59%), current influenza vaccine (53%) and HPV (48%). Twenty three percent of parents reported that their adolescent had asthma. Most parents reported that their adolescent's insurance was Medicaid (60%) or private insurance (34%), and 6% reported no insurance. More adolescents with a chronic health condition received any adolescent vaccine than adolescents without a chronic health condition (p < .0001). Among those with no insurance, fewer had received any adolescent vaccine than those with Medicaid or private insurance (p < .0001). Conclusions: The federal Vaccines for Children program offers recommended vaccines free to eligible children (including those without health insurance). Our findings suggest that parents may not be aware of this program or eligibility for it, thus revealing a need for education or other fixes.

Original languageEnglish (US)
Pages (from-to)148-153
Number of pages6
JournalJournal of Adolescent Health
Issue number2
StatePublished - Feb 2016


  • Adolescent immunization
  • Chronic disease
  • HPV vaccine
  • Influenza vaccine
  • Insurance
  • MCV4 vaccine
  • Tdap vaccine
  • Vaccines for Children

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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