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The Adolescent Vaccine Platform: We Are Not Meeting Our Goals
All office visits should prompt assessment of vaccine status.
Two recent events led to the Healthy People 2010 objective to achieve more than 90% compliance among adolescents for key vaccines: New vaccines (meningococcal conjugate or MCV4, human papillomavirus or HPV, and Tdap) are now recommended for preteens and teenagers, and several medical associations (AAP, American Medical Association, and American Academy of Family Physicians) now advocate a healthcare visit for recommended vaccines for 11- to 12-year-old children. The National Immunization Survey (NIS) evaluated vaccination coverage among adolescents.
From October 2006 to February 2007, 5468 households were interviewed, and, of those, 2882 had provider-reported vaccination records. Only 60% of children older than 10 years had received at least one dose of either Td or Tdap. Among teenagers aged 13 to 17, full immunization was documented in 81% for hepatitis B and in 12% for MCV4. Among adolescents without a history of immunity to varicella, only 65% received a dose of varicella vaccine.
Comment: Despite some methodologic issues, this study identifies major deficits in our strategies to immunize teenagers. HPV compliance was not measured in this survey because the current recommendations were not in effect, but there is reason to suspect that the vaccination rate would also be low. The vaccination rate for hepatitis B is high because many teenagers in this cohort were immunized as infants. The overall low vaccination rates suggest that we need to use each office visit as an opportunity to catch up with vaccines, no matter what the reason is for a teenager’s visit. Vaccination at age 11 years, when children tend to see physicians more frequently, is a good time to begin the "teen platform."
Published in Journal Watch Pediatrics and Adolescent Medicine October 17, 2007
Citation(s):
Centers for Disease Control and Prevention (CDC). National vaccination coverage among adolescents aged 13–17 years — United States, 2006. MMWR Morb Mortal Wkly Rep 2007 Aug 31; 56:885.
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