Unmet healthcare need limits receipt of influenza vaccinations among children and adolescents in the US

The importance of childhood preventive care, including vaccinations, is well known; however, less than half of all children and adolescents in the US receive the preventive care recommended by professional guidelines. We sought to determine if unmet healthcare need was associated with receipt of influenza vaccinations among children and adolescents in the US, using a nationally representative, population-based sample. We examined data on 61,572 children from the 2005-2010 National Health Interview Survey. Unmet healthcare need was defined as delayed or forgone healthcare during the past 12 months due to cost, for the child and for any other family member. Child's receipt of flu shot or spray was examined during the 12 months prior to the survey. Multivariable logistic regression was used to determine if children who experienced unmet healthcare need were less likely to receive a seasonal influenza vaccination, controlling for a multitude of relevant covariates (including: age, gender, race/ethnicity, parental education, parental employment, family size and composition, family income, child health insurance, activity limitation status, usual source of care, past year healthcare utilization, past year expenditures, and chronologic time). Overall, 28.6% of children received a flu vaccine, and 4.9% of children experienced unmet healthcare need while an additional 15.5% of children had a family member who experienced unmet healthcare need. Multivariate regression results indicated that children who directly experienced unmet healthcare need were 14% less likely to receive a flu vaccine (OR: 0.86, 95% CI: 0.78-0.95) and children who did not directly experience unmet need but who had a family member who did experience unmet need were 10% less likely to receive a flu vaccine (OR: 0.90, 95% CI: 0.85-0.95) compared to children in families with no unmet need. Additionally, significant disparities exist in children's receipt of an influenza vaccination. As the flu vaccine is often offered at little to no cost, it may be unlikely that many families would delay or forgo a flu vaccine for their child due to cost. However, delaying or forgoing any type of care may have spillover effects on receipt of preventive services, including influenza vaccinations, such as reducing knowledge about preventive services and decreasing general access to health services. Reducing any type of unmet healthcare need for children and their family members may improve both short and long-term health outcomes for children by increasing their opportunity to receive timely and preventive care.