Expanded SCHIP Eligibility and Influenza Vaccination Receipt among Near-Poor Children

Objective: The State Children's Health Insurance Program was designed to provide health insurance to near-poor children ineligible for Medicaid. We examined whether state variations in SCHIP income eligibility were associated with influenza vaccination receipt, particularly whether gaps exist among near-poor children during the 2005-2006 influenza season. We analyzed individual-level data from the National Immunization Survey (NIS) 2006 (N= 29,880) that were weighted to be nationally representative of children ages 19-35 months. We measured influenza vaccination receipt in two ways: (a) full vaccination and (b) receipt of at least one vaccination if previously unimmunized. SCHIP program extensiveness, the key explanatory variable, was based on state income eligibility: <=200% Federal Poverty Level (FPL), or >200%FPL. We hypothesized that near-poor children who resided in a state with more generous SCHIP income eligibility criteria would be more likely to be vaccinated than those residing in states with less extensive programs after adjustment for individual and state level factors. Results: Only 20.08% of all eligible children were fully vaccinated in 2006. In our multivariable analysis, near-poor children in the most generous SCHIP states (i.e. upper income criteria >200%FPL) were significantly more likely to be vaccinated than near-poor children in less generous SCHIP states (OR= 1.34; p= 0.043). Conclusion: Expanding SCHIP income eligibility levels may help to improve influenza vaccination among near-poor children and ultimately, to address current gaps in the Healthy People 2020 vaccination coverage goals.