Impact of Affordable Care Act on gender specific HPV Vaccine coverage: Analysis using NIS-Teen Data from 2008-2016 Open Access

Abstract

Impact of Affordable Care Act on gender-specific HPV Vaccine coverage: Analysis using NIS-Teen Data from 2008-2016.

 

By Palak Patel 

Background: The Affordable Care Act (ACA) was one of the biggest health reforms in American history. The key aim of ACA was to require insurance coverage for immunization services recommended by the Advisory Committee on Immunization Practices with no cost-sharing, while also providing a means to expand Medicaid coverage for states that choose to do so. We assessed the impact of Medicaid expansion on human papillomavirus vaccine uptake, following passage of the ACA.

Methods: We analyzed National Immunization Survey-Teen (NIS-Teen) data from 2008 to 2016, using Poison Regression to calculate the average annual change in rates of HPV vaccine coverage, among states that expanded Medicaid, compared to those that did not expand Medicaid, relative to the year of expansion.

Results: States that expanded Medicaid had a lower average annual rate of change for HPV vaccine coverage during the pre-expansion years compared to the non-expansion states in the same years, but had a higher average annual rate of change for HPV vaccine coverage in the post-expansion years compared to non-expansion states after stratification by poverty status. 

Conclusions: HPV vaccine coverage increased more rapidly in the states that expanded Medicaid though with limited years of follow-up post-Medicaid expansion, we were limited in our ability to assess the statistical significance of these findings. Continued monitoring of changes in HPV vaccine rates post-ACA is needed to understand continuing barriers to HPV vaccine uptake. 

Table of Contents

Table of Contents 

Chapter I: Manuscript………………………………………………………………….1

            Introduction……………….…………………………………………………1

            Methods…………………………….………………………………………...2

            Results……………………………………………………………………….4

Discussion………………………………...………………………………….5

Chapter II: Implications………………………………………………………………. 8                                                                                                              

References……………………………………………………………………………….10

Tables………………………………………………....…………………….……………13

 

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Human papillomavirus vaccine HPV vaccine ACA NIS-Teen
Committee Chair / Thesis Advisor	Bednarczyk, Robert, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

Last modified

Primary PDF

Thumbnail	Title	Date Uploaded	Actions
	Impact of Affordable Care Act on gender specific HPV Vaccine coverage: Analysis using NIS-Teen Data from 2008-2016 ()	2018-04-25 12:56:46 -0400	Press to Select an action Download

Supplemental Files

Thumbnail	Title	Date Uploaded	Actions