Challenges to Vaccinating Adolescents

Sharon G. Humiston · Susan L. Rosenthal

94 citations0/0 files storedThe Pediatric Infectious Disease Journal

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Abstract

BACKGROUND: Adolescent immunization is a growing field, with many new vaccines in development and new or expanded immunization recommendations on the horizon. METHODS: Characteristics of adolescents and their health care are discussed, focusing specifically on the challenges of incorporating a potential recommendation to replace tetanus-diphtheria toxoid with tetanus-diphtheria-acellular pertussis vaccine during early or middle adolescence as part of routine preventive care. Using the framework created by the Centers for Disease Control and Prevention's Task Force on Community Preventive Services, three overlapping levels at which there are opportunities for vaccine intervention are reviewed: (1) health care systems (enhancing access to vaccination services); (2) health care providers (provider-based interventions); and (3) patients and families ("increasing community demand"). RESULTS: There are several barriers to vaccine implementation that make achieving high immunization coverage rates among adolescents a challenge. Promising interventions for improving vaccination rates at the health care system level include reducing out-of-pocket costs, expanding access to immunizations, and implementing vaccination programs in schools. Provider-based interventions for improving vaccination rates include regular assessments of immunization rate with feedback to all office personnel, provider reminders, and standing orders. Client recall and reminders, education, and requirements for school entry can assist in "increasing community demand" for vaccinations in that they motivate parents and adolescents to follow through with immunizations. CONCLUSIONS: Adolescents are unique from other populations. Previously studied interventions need to be tested in this age group as immunization becomes a more salient issue in adolescent health care.

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References

2000Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults11The names and affiliations of the Task Force members are listed on page v of this supplement and at http://www.thecommunityguide.org22Some of this material was published previously in: Shefer A, Briss P, Rodewald L, et al. Improving immunization coverage rates: an evidence-based review of the literature. Epidemiol Rev 1999;20:96–142.2000Effect of Patient Reminder/Recall Interventions on Immunization Rates 2003Parental perspectives on vaccinating children against sexually transmitted infections 2005Parental Attitudes About Sexually Transmitted Infection Vaccination for Their Adolescent Children 2003Viral Sexually Transmitted Disease Vaccine Acceptability Among College Students 1999Strategies to Sustain Success in Childhood Immunizations 1999Vaccine-Preventable Diseases: Improving Vaccination Coverage in Children, Adolescents, and Adults: A Report on Recommendations of the Task Force on Community Preventive Services 1995Hepatitis B vaccine acceptance among adolescents and their parents

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