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Military children may be missing out on important childhood vaccines, researchers reported on Monday.
A check of their medical records shows many are either missing vaccines, or they are missing the records to show they had them. Either way, it’s not good, says Dr. Angela Dunn, who led the study, published in the journal Pediatrics.
“Is it that they are not getting vaccines? Or that they are not documented?” asked Dunn, who did the study while she was at the University of California San Diego.
“Both have a risk factor. They move around a lot, they don’t have the same primary care providers all throughout childhood,” added Dunn, who now works as a Centers for Disease Control and Prevention epidemiologist in Utah. “All of those risk factors can cause them to be undervaccinated and also not to have documentation.”
Dunn and colleagues looked at the immunization records of 3,421 military children aged 19 months to 3 years old. They found 28 percent of them didn’t have evidence of being up to date on their vaccines. That compared to 21 percent of a group of U.S. children in general they studied.
“I don’t want the message to be ‘Oh, my god, military kids aren’t being taken care of.’"
“The recommendation of the paper is to further explore what is the true reason for these lower vaccination coverage rates that we found,” said Dunn.
“I don’t want the message to be ‘Oh, my god, military kids aren’t being taken care of.’ We don’t know that,” she said.
Ironically, Dunn said she was originally trying to show that a single-payer health insurance system would solve some of the problems that she found. She had assumed the U.S. military’s Tricare health insurance plan would set an example for the disjointed U.S. health care system.
“So we were kind of surprised to see that we have lower coverage rates (in the military),” Dunn told NBC News.
“Unfortunately, bureaucracy and red tape get in the way of good healthcare at times.”
Under the current schedule, kids should get about 25 different vaccinations by age 6, protecting against 14 different diseases, including polio, rotavirus, measles, influenza, a family of bacteria that cause pneumonia and other ills.
Vaccine experts say it’s important for kids to get their vaccines on time. The CDC has found vaccine coverage varies widely from one state to another. Overall, about 92 percent of U.S. kids have had at least one dose of measles, mumps and rubella vaccine on time and nearly 93 percent are properly vaccinated against polio. But just 70 percent had all their vaccine doses on time in 2013.
“I think that this mirrors what is going on within non-military families as well,” Dunn added. “Healthcare is confusing. If your insurance changes, you are changing providers. Patients find it hard to keep track of all their documentation. Unfortunately, bureaucracy and red tape get in the way of good healthcare at times.”
Military families at one time had to use military doctors, or pay out of pocket. But now the Tricare health insurance system allows them to see civilian providers as well. That may allowfor some of the confusion, Dunn said.
“Sometimes it can be easier to make changes in closed systems like the military healthcare system,” she said.
“If we can find a solution within the military system, I think that would be a great starting point for the rest of the U.S. as well.” Keeping track of immunizations in a better way could lead to improvements in tracking mammograms, colonoscopies and other preventive services, said Dunn.
That’s what the 2010 Affordable Care Act seeks to do in encouraging adoption of better electronic health records that could be accessed by any doctor approved by a patient, leading to fewer lost documents. But it’s hard to get universal software systems that work together, and even harder to ensure patient privacy.