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Multifaceted approach to vaccine implementation needed
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Adolescent immunization rates have improved in the past 5 years, but there are still areas of improvement needed, according to a speaker the CDC’s 1st National Immunization Conference Online.
Amy Middleman, MD, MPH, who is an Infectious Diseases in Children Editorial Board member, said rates of vaccination with the HPV vaccine among adolescents continue to lag. However, for these particular vaccines, “we haven’t had as long to implement and watch the progress.”
Middleman said public policy planners, providers and patients must work together to boost immunization rates in this age group. State mandates for school entry and better reimbursement policies for health care providers are some of the areas where immunization rates can and have improved.
She highlighted the hepatitis B vaccination program as evidence that “mandates work.” Also, she said schools can play an important role as settings for vaccinations.
According to Middleman, looking at all strategies to boost immunization rates are key, as one of the stated Healthy People 2020 goals is to get immunization rates to more than 90%.
Disclosure: Dr. Middleman reports a financial relationship with Sanofi-Pasteur.
Perspective
Back to TopGerald Whitman, MD
While Dr. Middleman showed the overall improvement in adolescent immunization rates over the past 5 years, she also pointed out areas that were lagging behind and discussed some of the reasons for this lag as well as ideas on how to improve our success in immunizing adolescents.
With a goal of reaching at least 80% to 90% vaccination rates by 2020, several vaccines are already at that level but some lag significantly below that level, especially HPV vaccines and the yearly influenza vaccinations (both less than 20%). One very useful technique in improving immunization rates is by having school mandates for vaccines. An example given by Dr. Middleman was related to hepatitis B vaccine. She pointed out that with a school mandate for that vaccine, 75% of adolescents have been fully immunized, while only 39% have been fully immunized in states without a school mandate.
Adolescents, in general, have a lower immunization rate than younger children. Among Dr. Middleman’s suggestions to improve this situation included not only encouraging more state school mandates for immunizations but also included utilizing alternative immunization sites related to where vaccines are given (schools, EDs, OB/GYN offices, family planning clinics, city and county clinics, etc.) as well supporting insurance reforms to improve coverage of vaccines.
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Middleman A. #30211. Presented at: 1st National Immunization Conference Online; March 26-28, 2012.
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