For parents of young children, the flu shot itself may not come with a bill, but getting a child to an appointment still takes planning. A separate trip can mean rearranging a work shift, finding transportation or arranging care for another child. Some families may also face out-of-pocket expenses. Other costs show up in time, stress and what a parent has to give up to make the appointment.
“Children who are already at the doctor for a wellness check during the flu shot season can get their vaccination during that same visit,” said Devon Gorry, an economist in the Wilbur O. and Ann Powers College of Business. When a child’s routine visit falls outside flu shot season, Gorry said, the family may need to schedule another appointment, take time off work or school and make another trip. She described the added visit as “often stressful for the child (and parent).”
When the shot fits the checkup
Gorry co-authored “Real-World Effectiveness of the Influenza Vaccine in Young Children” with Michael L. Anderson, Carlos Dobkin and Hung-Fu Tseng. Their study found that children were 23.4 percentage points more likely to be vaccinated when their well-child visit occurred while the seasonal flu vaccine was broadly available.
The study’s survey data showed the extent of vaccination in healthcare settings. About 95 percent of vaccinated children ages 2 to 5 received the vaccine at a doctor’s office or clinic. Less than 1 percent received it at a retail location. That does not mean every family needed a separate trip, but it suggests that vaccination often depended on a visit to a doctor or clinic.
Researchers examined children ages 2 to 5 in California across eight influenza seasons, from 2008-09 through 2015-16. They used administrative healthcare records, including vaccination and routine visit records from a large California health plan and statewide records of emergency department and hospital care. They looked at whether children were more likely to get the shot when it was available during a visit they were already scheduled for.
Gorry said the findings point to a cost that may not appear on a medical bill. “Our research shows that the non-monetary costs of vaccination, such as taking the time to bring your child to a doctor’s visit, prevent many children from getting vaccinated.” In economic terms, a parent’s opportunity cost is what they give up to make that appointment, such as paid work hours or time for another responsibility.
What the cost estimate means
The researchers also counted visits to doctors and emergency departments. Vaccination was associated with an estimated 24.6 fewer broad respiratory illness visits per 100 children, about 31 percent of the average rate. For emergency department visits coded as influenza or influenza-like illness, the estimated reduction was about 0.2 visits per 100 children.
To estimate potential healthcare benefits, the authors applied average per-visit costs from prior research to the estimated changes in visits. Their model estimates about $4,688 in avoided healthcare costs per 100 vaccinated children, or roughly $50 per vaccination.
More convenient access needs testing
The authors suggest that offering flu shots in more convenient locations could increase vaccination and produce positive net benefits. Gorry said, “Our paper shows that many children will get the vaccination when it is convenient. Thus, making vaccinations more convenient has the potential to increase uptake substantially.”
Although the study did not test pharmacies, schools or community clinics to determine which would be most convenient, it raises a practical question parents can ask at their next appointment: Could the flu shot be given here, or is there another nearby option that fits our schedule? Asking a child’s healthcare provider what is available can help families plan for the time and travel involved before adding another trip to the calendar.
