Article2001

Adolescent Immunization Practices

Stanley J. Schaffer · Sharon G. Humiston · Laura Pollard Shone · Francisco M. Averhoff · Peter G. Szilagyi

79 citations0/0 files storedArchives of Pediatrics and Adolescent Medicine

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Vaccine Coverage and Hesitancy Child and Adolescent Health Pediatric Pain Management Techniques

Abstract

BACKGROUND: Adolescent immunization rates remain low. Hence, a better understanding of the factors that influence adolescent immunization is needed. OBJECTIVE: To assess the adolescent immunization practices of US physicians. DESIGN AND SETTING: A 24-item survey mailed in 1997 to a national sample of 1480 pediatricians and family physicians living in the United States, randomly selected from the American Medical Association's Master List of Physicians. PARTICIPANTS: Of 1110 physicians (75%) who responded, 761 met inclusion criteria. OUTCOME MEASURES: Immunization practices and policies, use of tracking and recall, opinions about school-based immunizations, and reasons for not providing particular immunizations to eligible adolescents. RESULTS: Seventy-nine percent of physicians reported using protocols for adolescent immunization, and 82% recommended hepatitis B immunization for all eligible adolescents. Those who did not routinely immunize adolescents often cited insufficient insurance coverage for immunizations. While 42% of physicians reported that they review the immunization status of adolescent patients at acute illness visits, only 24% immunized eligible adolescents during such visits. Twenty-one percent used immunization tracking and recall systems. Though 84% preferred that immunizations be administered at their practice, 71% of physicians considered schools, and 63% considered teen clinics to be acceptable alternative adolescent immunization sites. However, many had concerns about continuity of care for adolescents receiving immunizations in school. CONCLUSIONS: Most physicians supported adolescent immunization efforts. Barriers preventing adolescent immunization included financial barriers, record scattering, lack of tracking and recall, and missed opportunities. School-based immunization programs were acceptable to most physicians, despite concerns about continuity of care. Further research is needed to determine whether interventions that have successfully increased infant immunization rates are also effective for adolescents.

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References

1993Standards for Pediatric Immunization Practices 1999A Randomized Study of Tracking With Outreach and Provider Prompting to Improve Immunization Coverage and Primary Care 1994Immunization Practices of Pediatricians and Family Physicians in the United States 1997Immunization of Adolescents: Recommendations of the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Medical Association 1999Vaccine-Preventable Diseases: Improving Vaccination Coverage in Children, Adolescents, and Adults: A Report on Recommendations of the Task Force on Community Preventive Services 1999Vaccines for Children Program, United States, 1997 1994A Randomized Trial of the Effectiveness of Computer-Generated Telephone Messages in Increasing Immunization Visits Among Preschool Children 1998Effectiveness and Cost-effectiveness of Letters, Automated Telephone Messages, or Both for Underimmunized Children in a Health Maintenance Organization

Cited by

2013Missed Opportunities for Adolescent Vaccination, 2006–2011 2006Effect of Telephone Reminder/Recall on Adolescent Immunization and Preventive Visits 2008How Effectively Can Health Care Settings Beyond the Traditional Medical Home Provide Vaccines to Adolescents?2009

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