State cutting immunizations for some children

Budget cuts mean the state will no longer cover the cost of some childhood vaccines for children with insurance.

Children who are uninsured, underinsured, eligible for Medicaid or Native American are still able to receive the immunizations for free.

"During tough economic times, those that have resources, we're going to just ask them to perhaps contribute more than they have in the past, where those without resources we certainly want to protect," state health director Dr. Jeff Engel said.

That means private health insurance companies, like Blue Cross Blue Shield North Carolina, will most likely cover the vaccines the state used to pay for and the cost will be passed along to consumers in the form of higher premiums.

"The legislation will increase BCBSNC medical costs in that hat used to be state-funded will not be paid for by our member's premium dollars," said Bob Michael, a spokesman for the insurance company. "We have not quantified the cost impact."

The change, which takes effect Dec. 1, applies to 11 vaccines, including combination shots, Hepatitis A and the second dose of Varicella, the chicken pox vaccine.

Engel said the state estimates the change will cut about $4 million from the $18 million North Carolina Immunization Program.

Pediatricians were notified of the change in an Oct. 30 memo from the North Carolina Department of Health and Human Services. They are now trying to determine how they will pay for the vaccines with no guarantee they will get reimbursed from insurance companies.

The immunizations can cost up to $100 or more each.

"It will put pediatricians in the position of having to purchase those vaccines if we want to offer them," said Dr. Leanna Willey, a pediatrician with Carolina Kids Pediatric Associates in Raleigh.

Her practice, she said, plans to continue to offer the vaccines.

"You just see what happens – whether the insurance will cover the cost of the vaccine or not," Willey said. "Typically, vaccines are not money-making propositions for pediatricians. We just know it's the right things to do for the kids and their health."

The change comes as a surprise to some parents, leaving them with questions.

"Why are they cutting that? Why can't they cut something else?" said parent Boumet Boutavong, who has a 1-year-old daughter.

"I don't want to pay a high price for it or anything like that, but my kids need these vaccinations."

60 Comments

WRAL.com welcomes your comments on this story. All comments are moderated prior to publication based on our posting guidelines. Please review them prior to posting and if your message is not approved.

VIEW ALL 60 COMMENTS

This story is closed for comments. Comments on WRAL.com news stories are accepted and moderated between the hours of 8 a.m. and 8 p.m. Monday through Friday.

Latest Comments

Mako II - Now for the reading comprehension part that you STILL haven’t grasped – in the article it read “The immunizations can cost up to $100 or more each.” The word ‘CAN’ is the operative word here – it does not read that $100 is the average, only that the immunization MAY be $100 or even more. NOWHERE does the article give a specific vaccination with cost, therefore you have been talking out of YOUR rear end this entire time about gouging/excessive profits. Here I am going to try to use small words to explain my meaning – let’s use YOUR vaccine of choice – Hepatitis A pediatric at $12.75 per shot (CDC) or $28.74 per shot (private). The Hepatitis A pediatric vaccination probably does not cost $100 or more. I make this assumption because if it did cost $100 or more (with only 5 other vaccines less expensive i.e. 23 other vaccines MORE expensive) the article PROBABLY would have read “Most of the immunizations cost $100 or more.”

gov watchdog
November 16, 2009 10:22 a.m.

Mako II - Here is a quote from YOUR post – “So the CHARGE of 100 bucks, is essentially "labor" and profit. Now it take how long to give you your shot? 5 minutes? At $98 bucks labor/profit? So you're telling me it costs near $2000 dollars an HOUR to have a Nurse administer shots? (about $1930 actually)”

So, per YOUR example, it costs $100 for a 5 minute shot – but that somehow becomes $2000 per hour?? Do you realize the 5 minutes divides into 60 minutes only 12 times (please tell me I am discussing this with a first grader, because anybody in the second grade or higher should know this) – therefore (AGAIN) you have a math problem because 12 times $100 is still $1200 – of course, this is assuming that all of your other assumptions are correct, which I have already proven they were not. (Do NOT accuse me of attacking a stupid issue here, this is YOUR example that YOU have used throughout your entire trainwreck of a thought process.)

gov watchdog
November 16, 2009 10:21 a.m.

Mako (my avatar brain is larger than my real brain) II - At 3:44 you also wrote “You haven't been correct in any ONE of your posts. Try talking FACTS. How about getting JUST ONE FACT right!” to which I challenged you to PROVE me factually inaccurate in ANY of the posts where I stated FACTS (2:51, 2:58, and 3:42 – I also should have listed 2:26) to which your response was deafening silence. You are allowed an opinion, just as I am – but you are NOT allowed to have your own FACTS.

Lastly, also from the article - "Typically, vaccines are not money-making propositions for pediatricians. We just know it's the right things to do for the kids and their health."

gov watchdog
November 16, 2009 8:47 a.m.

Mako (my avatar brain is larger than my real brain) II – Here is a direct quote from my post at 12:36 on 13 Nov (approximately 1 hour BEFORE your first post) “To those commenting on the price of the vaccine - do you KNOW how much it costs to manufacture a vaccine? Seriously, there is a huge expense for every medicine that is produced.”

MY original point (again, BEFORE you made the FIRST of your many erroneous points) was that as consumers we know how much we pay, but that does not mean that we know how much it cost to manufacture what we are purchasing. Without that information, we do not know whether it is a fair price or not. You attacked me, calling me uneducated, but YOU took the conversation in a different route – I specifically addressed the cost of MANUFACTURE, you acted like I was an idiot and started discussing COST to CDC (and attacked me again for not providing a link to the information that was not pertinent to what I was talking about).

gov watchdog
November 16, 2009 8:42 a.m.

gov watchdog,

First, it's obviously the total costs (shot, labor) because the article is about the Government PAYING for the kids to be immunized. Seeing how being "immunized" is a VERB, and the vaccine is a NOUN, that would be apparent to someone with adequate "reading comprehension". But no, YOU think it could be argued both ways. Maybe "both ways" is your world view?

Second, most ALL the shots are WAY below the 100 dollar mark. I making an educated guess that the 100 is an average, even though it doesn't say so. Why? Because I have NEVER had a shot below $75 bucks and KNOW some cost more than 100. So it's likely an average. And AS an average, when you subtract the average of the COST of the DOSE from the COST of Immunizing someone, the difference is HUGE. Added up per patient, per hour, it's GOUGING HUGE. My Point.

Third, I picked a typical shot. You picked one of the most expensive. Difference? You cherry-pick. I use averages.