1. Immunization rate at 24 months of age for children currently enrolled in Medicaid.

  2. Immunization rate at 24 months of age for children enrolled in WIC.

    Children enrolled in Medicaid or WIC are an identifiable population that generally is at higher risk for underimmunization. Because enrollment in Medicaid is often not continuous, the numerator and denominator for the Medicaid rate would require clear definition. Some children enrolled at 24 months of age may not have been enrolled at ages when immunizations were due, and other children not currently enrolled might have been enrolled at those ages.

  3. Among children with commercial health insurance coverage, percentage with full coverage for childhood immunizations.

    The cost of vaccines and the fees charged to administer them have contributed to delayed immunization even for children who have health insurance. Full coverage ensures that immunizations will be paid for by the insurer whether or not a deductible requirement has been met. In some states, this indicator will be less relevant because free vaccines are available to all children, regardless of health insurance status.

  4. Number and percentage of health insurance policies that cover influenza immunizations for persons at high risk.

    The population at high risk must be defined clearly, and criteria for counting health insurance policies would be required. Policies that provide full coverage should be distinguished from those that require payment of a deductible.

  5. Existence in the community of a computerized immunization registry that provides automated appointment reminders; if a registry exists, percentage of children in the community included.

    At present, few communities have registries. This indicator should become more useful in the future as registry development proceeds. If a statewide registry is developed, a community would still want to know what proportion of its children were included.

  6. Existence in the community of an active childhood immunization coalition involving health service providers, the lo



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