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Lagging adolescent vaccine rates, more complicated schedules call for increased provider efforts
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21st Annual IDC NY Symposium
As the Advisory Committee on Immunization Practices continues to expand vaccine recommendations to include more adolescents and young adults, some health care providers may find it increasingly difficult to meet public health goals to vaccinate 90% of this population with the required and recommended vaccines by 2010.
“We need to figure out how to meet our targets, and it’s not going to be a one-strategy solution that leads us in this direction,” Vaughn I. Rickert, PsyD, director of research and evaluation at the Center for Community Health and Education at Columbia University, Mailman School of Public Health, said here. “We don’t have in place an adolescent visit platform like we have for infants and toddlers where it’s established, where it’s being paid for and where there are people coming in on a regular basis.”
School mandates and entry requirements have improved vaccine coverage rates among this population from around 30% to above 80% in some states, according to Rickert, but these policies remain controversial and many adolescents continue to opt out.
With adolescent schedules currently including recommendations for both first-time and catch-up vaccine doses against meningococcal disease, tetanus, diphtheria, pertussis, influenza, hepatitis A and B, measles, mumps, rubella, varicella and human papillomavirus, the source of confusion is not surprising, according to Rickert. Ongoing changes to vaccine series, coupled with infrequent adolescent visits, can sometimes leave health care providers wondering “who has what, where they got it and how are we going to get the next dose in,” Rickert said.
He emphasized the importance of standing orders; new technologies such as screening tool reminder systems and vaccine registries; and strategies such as simultaneous vaccine administration during noncomprehensive visits and at alternative sites to optimize compliance.
“Providers really can make important changes in terms of increasing the immunization rates in adolescents,” Rickert said. He recommended staying up-to-date with resources such as the CDC website (cdc.gov) and the National Foundation for Infectious Diseases website (nfid.org). – by Nicole Blazek
For more information:
- Vaughn RI. Adolescent immunization: update and recommendations. Presented at: 21st Annual IDC NY Symposium; Nov. 22-23, 2008; New York.