Vaccination Rates among Adolescents in Minnesota as Compared with the United States: Not "Above Average".

Because adolescents make relatively few visits to clinics for preventive care, their vaccination rates suffer. We examined rates among Minnesota youths to see how they compared with those among teens throughout the United States. We used National Immunization Survey-Teen (NIS-Teen) data to estimate vaccination rates for 13- to 17-year-olds in Minnesota from 2008 through 2013 and compared them to national rates for MCV4, Tdap and HPV vaccines. We also examined rates of provider recommendation for each of the three vaccines and rates of parental intention to vaccinate against HPV. We found rates for all three vaccinations increased between 2008 and 2013, but they continue to be low for both MCV4 (69%) and HPV (38% of females and 9% of males completed the three-dose series in 2013). Fortunately, the percentage of Minnesota clinicians recommending those vaccines is increasing (the percentage recommending HPV vaccination for females increased from 55% in 2008 to 74% in 2013; however, only 44% recommended it for males in 2013). The percentage of parents in Minnesota reporting intent to vaccinate their female children against HPV rose from 52% in 2008 to 58% in 2013; the percentage intending to vaccinate their male children rose from 16% in 2010 to 47% in 2013. Clinicians and public health officials must address how we can improve HPV vaccination rates among adolescents.

Adolescent vaccination in Oklahoma: a work in progress.

BACKGROUND: Nationally, uptake of adolescent vaccines is variable. OBJECTIVE: To compare adolescent immunization rates and clinician recommendation for adolescent vaccines over time in Oklahoma with the U.S. METHODS: We analyzed the 2010-2012 National Immunization Survey of Teens (NIS-Teen). RESULTS: MCV4 and Tdap are consistently lower in Oklahoma compared to the U.S. HPV rates have been comparable. Parents report that health care providers in Oklahoma are less likely to recommend adolescent vaccines compared to the national average. Intention to not receive HPV in the next 12 months is distressingly high both in Oklahoma and across the nation with both improving. CONCLUSION: Over the three years, Oklahoma's immunization rates consistently underperform national estimates for MCV4 and Tdap but not for HPV. We recommend Oklahoma health care providers improve their vaccination rates through making clear their vaccine recommendations to the parent and patient in the clinical encounter.

Adolescent Vaccination Performance in South Carolina Compared to the United States.

National data on vaccine up-to-date (UTD) suggest that insufficient numbers of adolescents receive needed vaccines. This study analyzed public use data of the National Immunization Survey-Teen (NIS-Teen) from 2010 through 2013 for South Carolina (SC) adolescents and compared immunization rates to those of United States (US) adolescents. We also examined trends for each vaccine recommended for adolescents for both SC and US adolescents. UTD rates in SC adolescents for the quadrivalent meningococcal conjugate vaccine (MCV4) and the tetanus- diphtheria, acellular pertussis (Tdap) vaccine lag those of US adolescents, despite demonstrating a trend of improvement in SC adolescents from 45% to 69% for MCV and from 48% to 72% for Tdap. Human papillomavirus (HPV) vaccine UTD rates for SC adolescents demonstrated improvement over a 4 year period. HPV vaccination for SC girls improved when compared to the US, however UTD rates for both the SC and US were still well below the Healthy People 2020 goal of 80%. For all three vaccines, parental recall for a provider recommendation to vaccinate their adolescent was around or below 50%, except for HPV in females where it reached 65% in SC and 69% in the US. Differences between state and national rates may help SC providers focus on specific interventions needed to improve UTD rates.

Vaccine hesitancy among parents of adolescents and its association with vaccine uptake.

BACKGROUND: Addressing parental vaccine hesitancy may increase adolescent vaccination acceptance. However, no validated measure exists to identify parents hesitant toward adolescent vaccines. OBJECTIVE: To determine if a modified version of the Parent Attitudes about Childhood Vaccines (PACV) survey, a previously validated tool to identify parental hesitancy toward vaccines in infants, predicts adolescent vaccine uptake at office visits. METHODS: We modified the PACV for use in the adolescent setting and distributed it to a convenience sample of parents of adolescents aged 11 to 17 presenting for care at a diverse group of six pediatric practices in Oklahoma and South Carolina. We determined the vaccination status of the parents' adolescents for 3 vaccines (Tetanus-diphtheria-acellular pertussis [Tdap], meningococcal conjugate [MCV4], and human papillomavirus [HPV] vaccines). We used Fisher's exact tests to compare vaccination status with each survey item and with an overall general hesitancy scale that we constructed. RESULTS: We analyzed 363 surveys. At the time of the visit, vaccination coverage was 84% for Tdap, 73% for MCV, and 45% for any dose of HPV. Thirty-nine percent of parents expressed concern about vaccine efficacy and 41% expressed concern about side effects. Forty-five percent of parents disagreed with the statement that "teens can get all of the vaccines that are due at a single visit." Two individual items were associated with not receiving a dose of HPV vaccine that was due. The overall modified PACV score failed to predict adolescent vaccine uptake at an office visit. CONCLUSION: Several individual items were associated with vaccine uptake. The cumulative modified PACV, a general measure of vaccine hesitancy, was not associated with vaccination status despite illuminating parental hesitancy. We need to better understand vaccine-specific concerns for the adolescent population.