Vaccination rates among teens increase but remain low

Though in recent years, more teenagers are receiving vaccination against human papillomavirus, meningococcal meningitis and pertussis, the rates remain low, according to findings discussed by a panel of experts convened by the National Foundation for Infectious Diseases.

Some of the topics addressed by the panel included strategies for increasing HPV vaccination in both girls and boys, 2010 target rates for all vaccinations in teenagers and ethnic and socioeconomic disparities in vaccination rates.

William Schaffner, MD, president-elect of the National Foundation for Infectious Diseases, commented on HPV vaccination in adolescent boys. “Voting for a permissive HPV vaccination strategy in boys puts the choice squarely in the hands of the parents and puts the onus for educating boys and their parents about HPV squarely on the health care providers’ shoulders,” he said “It is a good way to get the conversation going about human papillomavirus in boys, but if current rates are any indication, this strategy will not make a big dent in vaccination coverage.”

The inability to reach target rates for vaccinations that are routinely recommended was discussed by Amy B. Middleman, MD, MPH, MsEd, director of Adolescent and Young Adult Immunization at Texas Children’s Hospital Center for Vaccine Awareness and Research, liaison representative to the ACIP for the Society for Adolescent Medicine and member of the Infectious Diseases in Children editorial board. “Adolescents are less likely to have regular wellness visits,” she said. “They are a challenging group to reach, with increasingly busy lives; their health needs are uniquely different from those of infants and adults. We need to address this challenge and develop immunization delivery strategies that make sense for this specific age group.”

Members of the panel discussed the fact that parents and healthcare providers make vaccination a priority among infants but fail to follow through with that priority as children move into adolescence. Infants and toddlers have regular wellness visits where their general health is observed and they are inoculated, but adolescents tend to visit the doctor only when they are sick. Vaccinations are not likely to be offered at those visits.

Ethnic and socioeconomic disparities

Findings from the CDC National Immunization Survey demonstrated that Hispanic females were more likely than black and white females to receive an initial HPV vaccination but less likely to complete the series. Hispanics also had higher rates of vaccination against meningococcal disease, hepatitis B, Varicella and Tdap than whites and blacks.

In socioeconomic terms, teenagers living below the poverty level had higher rates of initiation of the HPV series than those living at or above the poverty level. The highest rates for MMR vaccination and the lowest rates for HPV vaccination were seen among teens living at or above the poverty level.

Lance E. Rodewald, MD, director of the Immunization Services Division at the National Center for Immunization and Respiratory Diseases at CDC addressed the ethnic and socioeconomic disparities in vaccination rates. “It is great to report that we are doing better at reaching Hispanic females and those living below the poverty level about the threat of the human papillomavirus, but we need to do more to increase the rate of those actually completing the three-dose schedule,” he said.