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Newer and more expensive vaccines are recommended for American children all the time. But many children aren't getting them even when they have private health insurance. States aren't always picking up the cost either.

NPR's Patty Neighmond reports on a study just released in this week's Journal of the American Medical Association.

PATTY NEIGHMOND: The new vaccines are impressive. They guard against significant illness. Take for example the rotavirus vaccine. Harvard Medical School pediatrician Grace Lee says that by age 5, most children in the U.S. have been infected by the virus, which causes diarrhea and vomiting.

Dr. GRACE LEE (Pediatrician, Harvard Medical School): It's responsible for hundreds of thousands of doctors visit and ER visits. And it's also responsible for anywhere between fifty-five and seventy thousand hospitalizations each year from this - that diarrhea illness.

NEIGHMOND: The rotavirus vaccine was approved last year. Then, there's the new hepatitis A vaccine, a tetanus, diphtheria and whooping cough booster; a vaccine against chicken pox and one against bacterial meningitis. And unlike older vaccines like polio, measles, mumps and rubella, some of these newer vaccines can be quite costly.

Dr. Lee.

Dr. LEE: The meningitis vaccine costs nearly $80 per dose. The human papillomavirus vaccine costs approximately $120 per dose, and three doses are given. So that would be $360 for a series. The rotavirus vaccine is $67 per dose. And the three dose series is recommended.

NEIGHMOND: If all the vaccines recommended by the Centers for Disease Control and Prevention were given, it will cost about $1,000 - that's seven and a half times more than what recommended vaccines cost of 10 years ago. And ironically, it's kids with private health insurance who are losing out. Federal programs pay for vaccines for uninsured kids. But more and more health plans, says Lee, just don't pay for all the newly recommended vaccines.

Dr. LEE: Some high deductible health plans will cover preventive care, like immunizations. But there are a portion of high deductible health plans that don't cover it.

NEIGHMOND: In the past, Dr. Lee says, the public health clinics provided a safety net for people who couldn't afford to pay for vaccines. But state and federal funding for these clinics has not kept up with the increasing cost of vaccines. In her study, Lee interviewed immunization program directors in 48 states. Thirty of them didn't have the money to provide all the recommended vaccines.

Dr. LEE: Now, in Massachusetts, with the increased cost of these vaccines, we are now unable to provide three of the newer vaccines, including rotavirus, meningococcal and human papillomavirus vaccines to underinsured children because there just isn't enough federal and state funding available for this.

NEIGHMOND: The vaccine most commonly not provided was the vaccine against meningitis, a potentially deadly infection. More than one million children did not get this vaccine.

University of Michigan pediatrician Dr. Matthew Davis studies vaccination policy.

Dr. MATTHEW DAVIS (Pediatrician, University of Michigan): We're talking here about vaccinations for teenagers against meningococcal meningitis, which is a disease that, although it doesn't occur frequently, when it does occur, has a very high mortality rate, especially for teenagers. So this is the type of meningitis that you've read about in the newspaper or heard about on the news affecting high school communities and college communities, where it spreads quickly and can have a very high rate of mortality and serious effects of illness.

NEIGHMOND: In the best-case scenario, Dr. Davis would like to see increased federal funding and comprehensive private coverage for all recommended vaccines. Boring that, he suggests prioritizing vaccines that are most beneficial to public health.

Patty Neighmond, NPR News.

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