WASHINGTON A pilot project in North Carolina among 18 health
centers increased adolescent
immunization coverage rates by 26% in 1 month,
according to data presented here this week.
The project was designed to increase age-appropriate immunization rates
for the tetanus-diphtheria-pertussis vaccine, meningococcal conjugate vaccine
(Menactra, Sanofi-Pasteur) and
human papillomavirus vaccine and was conducted through
federally qualified health centers. In North Carolina, the average coverage
rates for the three vaccines recommended for adolescents was 73.8% compared
with the national average of 76%.
Even at best, we are abysmal in North Carolina at giving the
meningococcal conjugate vaccine, Marti Wolf, RN, MPH, said during
a presentation at the 45th Annual National Immunization Conference.
The North Carolina Community Health Center Association set up a
competition among 18 community health centers that volunteered to compete
during an April 2010 event, which corresponded with the states Adolescent
Eighteen sites competed; one site was a pediatric practice and the
others were primary care/family practice sites. The total adolescent population
served by these clinics totaled 7,971. Initial immunization coverage rates
ranged from 18% to 38% for HPV, 42% to 90% for Tdap, and 5% to 86% for MCV4.
The data shows that most anyone who tried did make an
improvement, Wolf said.
Throughout the monthlong competition to raise adolescent immunization
rates, the sites worked together to administer targeted immunizations to their
adolescent population. Various tools, including AFIX sessions provided
by the North Carolina Immunization Program recall tools, immunization
toolkits and weekly email contact, were made available. On May 1, repeat
immunization reports were compiled by the North Carolina Immunization Registry
(NCIR) and compared with the baseline immunization data compiled from the NCIR.
One of the things we found is that people are using our registry
for babies, but people were not thinking about it once the children were past 2
or 3 years old. Nobody was using it much for the adolescents, and they are not
using it at all for the adults, Wolf said. The lesson learned is
that recall works. Letters to the parents work. They actually open them and
Wolf said last years event went so well that the competition this
year will take place in May.
The end result was that we sneaked in quality improvement and had
some fun, she said.
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Disclosure: This project was partially supported by