ArticleVaccine2025
Time intervals from vaccine administration to reimbursement for an updated Advisory Committee on Immunization Practices (ACIP) recommendation: Evidence from pneumococcal conjugate vaccinations among privately insured adults, 2021-2022.
Article in Vaccine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
7 authors.
Funding
Abstract
backgroundVaccination implementation challenges can lead to lower uptake, reducing health and economic benefits from vaccines. Healthcare provider confidence in receiving timely reimbursement for vaccination is one such potential challenge for newly recommended vaccines. This study investigates the time interval between pneumococcal vaccination and reimbursement.
methodsWe used 2021-2022 Merative™ MarketScan® Commercial Database and Medicare Database (MarketScan) data among those aged 19-64 and ≥65 years for two vaccines: the 13-valent pneumococcal conjugate vaccine (PCV13), recommended in 2012; and the newer 20-valent PCV (PCV20), recommended in 2021. We characterized vaccination claims, patient demographics, and time intervals between vaccination and reimbursement.
resultsDuring the study period, MarketScan® contained 24,508 PCV13 and 53,194 PCV20 outpatient vaccination claims for individuals aged 19-64 years and 14,693 PCV13 and 18,277 PCV20 claims for those aged ≥65 years. Among those aged 19-64 years, mean reimbursement interval of outpatient claims was 25.3 (PCV13) and 26.8 (PCV20) days. Among those aged ≥65 years, mean interval was longer, particularly for PCV20, with 31.5 (PCV13) and 41.3 days (PCV20). Outpatient claims reimbursement intervals were longer in non-metropolitan compared to metropolitan areas. Pharmacy claims had shorter intervals than outpatient claims, across both vaccines and age groups. PCV13 intervals were similar throughout the observation period, while PCV20 intervals were longer immediately following the updated ACIP recommendation and declined over time. Approximately 10 % of outpatient claims had intervals greater than 30 days among those aged 19-64 years and greater than 60 days for those aged ≥65 years.
conclusionDuring the 5 months following the ACIP recommendation, claims for the newer vaccine (PCV20) took longer to reimburse, but the interval stabilized after about 6 months to a length comparable to PCV13. Claims from outpatient settings and non-metropolitan areas took longer to reimburse, with some claims still experiencing longer intervals several months post-recommendation.
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