Health care providers are missing opportunities to improve teens' vaccination coverage

Aug 2 2013

Health care providers are missing opportunities to improve teens' vaccination coverage, reports a new study in the Journal of Adolescent Health.

Recommendations for routine vaccination of meningococcal (MCV), tetanus, diphtheria, and acellular pertussis (Tdap) and human papillomavirus (HPV) in adolescents are fairly new and many parents may be unaware of the need for adolescent vaccines.

"Our study found that when adolescents who are vaccine-eligible come to their health care provider for preventive visits, there are missed opportunities for vaccination. Adolescents who come in for non-preventive visits have even greater missed opportunities," said Rachel A. Katzenellenbogen, M.D., lead author, assistant professor of pediatrics at the University of Washington and Seattle Children's Hospital.

"Our data found that adolescents who have an appointment come into their health care provider's office and leave without receiving all three recommended vaccines—Tdap, HPV and MCV."Adolescents need fewer preventive care visits than infants and are a relatively new population to be targeted for vaccination when compared to infants and children, she explained.

Katzenellenbogen and her colleagues analyzed vaccination rates for 1,628 adolescents aged 11- 18 with 9,180 visits to health care providers between 2006 and 2011. All of the teens in the study were seen at a pediatric clinic in Seattle. During that time frame, 82 percent missed being vaccinated against MCV, 85 percent missed Tdap and 82 percent missed the first dose of HPV1.

"If parents know to expect that their adolescent should receive three vaccines when they turn 11 or 12, they may be more likely to schedule a preventive visit or bring up vaccination with their child's health care provider during any office visit," commented Kristen A. Feemster, M.D., assistant professor in the division of infectious diseases at the University of Pennsylvania School of Medicine.

Feemster said she was not surprised that missed opportunities occur because there are many challenges to implanting adolescent vaccine recommendations. "It is more challenging, for example, to establish eligibility for adolescent vaccines—many registries do not yet reliably capture adolescent vaccination. Providers may have questions or concerns about the recommended schedule, plus adolescents may seek care in alternative locations where it is particularly difficult to establish eligibility."

The researchers suggest that improved vaccine tracking and screening systems, such as provider prompts through electronic health records or manual flags by nurses or medical assistants, would enable providers to more easily identify those teenagers eligible for vaccines at all visit types.

Source: The University of Washington