The addition of three vaccines to the immunization
schedule for adolescents was linked to significant increases in coverage rates
for those vaccines, according to study findings.
The aim of the study was to assess implementation of the
three adolescent vaccines that were added to the schedule from 2005 to 2007:
tetanus-diphtheria-acellular pertussis; meningococcal conjugate (MenACWY); and
human papillomavirus for girls.
Data for the study were taken from the 2006-2009
National Immunization Survey-Teen.
The primary outcome measures included the following:
- Percentage of adolescents who received each vaccine according to
- Potential coverage if all vaccines were administered during the same
vaccination visit; and
- Among unvaccinated adolescents, the reasons for not receiving
Coverage with one or more
Tdap doses increased from 11% to 65% between 2006 and
2009. During that same period, coverage with at least one MenACWY dose
increased from 12% to 54%.
Coverage with one or more HPV dose among girls increased
from 25% to 44% between 2007 and 2009. Between 2008 and 2009, the coverage rate
for at least three
HPV doses increased from 18% to 27%.
If providers had administered all recommended vaccines
during the same vaccination visit in 2009, coverage rates for that year could
have reached more than 80% for Td/Tdap and MenACWY, and as high as 74% for the
initial dose of the HPV vaccine.
For all years, the top reasons cited for nonvaccination
with Tdap and MenACWY included no knowledge about the vaccine, the provider did
not recommend the vaccine and that the vaccine is not needed/necessary. For
HPV, the reasons for not receiving the vaccination were that the adolescent is
not sexually active, there was no knowledge about the vaccine and that the
vaccine is not needed/necessary.
“Adolescent vaccination coverage is increasing but
could be improved,” the researchers wrote. “Strategies are needed to
increase parental knowledge about adolescent vaccines and improve provider
recommendation and administration of all vaccines during the same visit.”
Disclosure: The researchers report no
As time moves forward, and adolescent vaccination at specific ages
becomes further ingrained as a standard of care, vaccination rates among this
vulnerable population will continue to rise. Although more may need to be done
to reach adolescents in their social environment, many of the same strategies
used among infants and children will ultimately improve adolescent vaccination
rates, including simultaneous vaccine administration, minimizing missed
opportunities, and making sure providers and parents are aware of vaccine
Focusing on the protection from disease, regardless of
mode of disease transmission - as providers do with hepatitis B vaccination
among infants - may help dispell confusion regarding the benefits of HPV
vaccination among youth. As more providers and parents view immunizations as a
primary prevention strategy to combat a multitude of diseases across the life
span, vaccine adherence among adolescents, and eventually adults, will
hopefully become as expected as the 2-, 4- and 6-month visits that most would
not dare to miss for their infants.
Amy Middleman, MD, MPH
in Children Editorial Board member
Disclosure: Dr. Middleman reports no relevant