Summer Sherburne Hawkins1, Krisztina Horvath2, Jessica Cohen3, Lydia E Pace4, Christopher F Baum5,2,6. 1. School of Social Work, Boston College, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA. summer.hawkins@bc.edu. 2. Department of Economics, Boston College, Chestnut Hill, MA, USA. 3. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 4. Brigham and Women's Hospital, Boston, MA, USA. 5. School of Social Work, Boston College, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA. 6. Department of Macroeconomics, German Institute for Economic Research (DIW Berlin), Berlin, Germany.
Abstract
PURPOSE: We examined associations between the 2010 Affordable Care Act (ACA) provisions, 2011 Advisory Committee on Immunization Practices (ACIP) recommendation, and 2014 ACA-related health insurance reforms with HPV vaccine initiation rates by sex and health insurance type. METHODS: Using 2009-2015 public and private health insurance claims for 551,764 males and females aged 9-26 years (referred to as youth) from Maine, New Hampshire, and Massachusetts, we conducted linear regression models to examine the associations between three policy changes and HPV vaccine initiation rates by sex and health insurance type. RESULTS: In 2009, HPV vaccine initiation rates for males and females were 0.003 and 0.604 per 100 enrollees, respectively. Among males, the 2010 ACA provisions and ACIP recommendation were associated with significant increases in HPV vaccine uptake among those with private plans (0.207 [0.137, 0.278] and 0.419 [0.353, 0.486], respectively) and Medicaid (0.157 [0.083, 0.230] and 0.322 [0.257, 0.386], respectively). Among females, the 2010 ACA provisions were associated with significant increases in HPV vaccine uptake among Medicaid enrollees only (0.123 [0.033, 0.214]). The ACA-related health insurance reforms were associated with significant increases in HPV vaccine uptake for male and female Medicaid enrollees (0.257 [0.137, 0.377] and 0.214 [0.102, 0.327], respectively), but no differences among privately insured youth. By 2015, there were no differences in HPV vaccine initiation rates between males (0.278) and females (0.305). CONCLUSIONS: Both ACA provisions and the ACIP recommendation were associated with significant increases in HPV vaccine initiation rates among privately and publicly insured males in three New England states, closing the gender gap. In contrast, females and youth with private insurance did not exhibit the same changes in HPV vaccine uptake over the study period.
PURPOSE: We examined associations between the 2010 Affordable Care Act (ACA) provisions, 2011 Advisory Committee on Immunization Practices (ACIP) recommendation, and 2014 ACA-related health insurance reforms with HPV vaccine initiation rates by sex and health insurance type. METHODS: Using 2009-2015 public and private health insurance claims for 551,764 males and females aged 9-26 years (referred to as youth) from Maine, New Hampshire, and Massachusetts, we conducted linear regression models to examine the associations between three policy changes and HPV vaccine initiation rates by sex and health insurance type. RESULTS: In 2009, HPV vaccine initiation rates for males and females were 0.003 and 0.604 per 100 enrollees, respectively. Among males, the 2010 ACA provisions and ACIP recommendation were associated with significant increases in HPV vaccine uptake among those with private plans (0.207 [0.137, 0.278] and 0.419 [0.353, 0.486], respectively) and Medicaid (0.157 [0.083, 0.230] and 0.322 [0.257, 0.386], respectively). Among females, the 2010 ACA provisions were associated with significant increases in HPV vaccine uptake among Medicaid enrollees only (0.123 [0.033, 0.214]). The ACA-related health insurance reforms were associated with significant increases in HPV vaccine uptake for male and female Medicaid enrollees (0.257 [0.137, 0.377] and 0.214 [0.102, 0.327], respectively), but no differences among privately insured youth. By 2015, there were no differences in HPV vaccine initiation rates between males (0.278) and females (0.305). CONCLUSIONS: Both ACA provisions and the ACIP recommendation were associated with significant increases in HPV vaccine initiation rates among privately and publicly insured males in three New England states, closing the gender gap. In contrast, females and youth with private insurance did not exhibit the same changes in HPV vaccine uptake over the study period.
Keywords:
Affordable care act; Health disparity; Human papillomavirus; Policy; Vaccine
Authors: Lauri E Markowitz; Eileen F Dunne; Mona Saraiya; Herschel W Lawson; Harrell Chesson; Elizabeth R Unger Journal: MMWR Recomm Rep Date: 2007-03-23
Authors: Lauri E Markowitz; Eileen F Dunne; Mona Saraiya; Harrell W Chesson; C Robinette Curtis; Julianne Gee; Joseph A Bocchini; Elizabeth R Unger Journal: MMWR Recomm Rep Date: 2014-08-29
Authors: Emiko Petrosky; Joseph A Bocchini; Susan Hariri; Harrell Chesson; C Robinette Curtis; Mona Saraiya; Elizabeth R Unger; Lauri E Markowitz Journal: MMWR Morb Mortal Wkly Rep Date: 2015-03-27 Impact factor: 17.586
Authors: Carmen H Logie; Ashley Lacombe-Duncan; Philip Baiden; Peter A Newman; Suchon Tepjan; Clara Rubincam; Nick Doukas; Farid Asey Journal: BMJ Open Date: 2018-04-20 Impact factor: 2.692