BEIJING, Aug. 8 (Xinhuanet) -- A new research indicates that a million or more kids in the U.S. are not receiving vaccines due to complex vaccine policies and costly dose.

    The research led by Dr. Grace Lee of Harvard Medical School appeared in Wednesday's Journal of the American Medical Association.

    Lee and her colleagues surveyed the states to find out which shots they provide and to whom.

    Program managers from 48 states responded. Sixteen of them required health insurers to cover all recommended vaccines. Seventeen reported they were unable to give a vaccine for meningitis to children with inadequate private insurance, and eight didn't give pneumococcal shots to underinsured infants and toddlers. Five states said they lacked funds to provide hepatitis A vaccines and two states did not supply varicella vaccine or Tdap.

    They reported that 10 states between 2004 and early 2006 changed their rules to limit public purchases of selected vaccines for residents whose insurance policies do not cover vaccines and often carry high deductibles. The shift forced the underinsured to pay as much as 89 dollars per dose for a surging array of new and costly vaccines, or simply skip the injections.

    That puts more than a million children at risk, researchers said.

    The new or expanded recommendations for meningococcal conjugate, tetanus-diphtheria-acellular pertussis (Tdap), hepatitis A, influenza, rotavirus, and human papillomavirus vaccines (HPV) resulted in a 7.5-fold increase in the cost to fully vaccinate a child in the public sector, from 155 U.S. dollars in 1995 to 1,170 dollars in 2007.

    The problems reflect an impossibly complex system for patients, parents, practitioners, payers and policy makers, they said.

    "Until we can ensure that such enhancements are made, we need to be able to support the public sector safety net so these children have some place to go, because right now, they have nowhere to go," said Lee.

    (Agencies)