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Adolescent Vaccination

Preteens and teens can be at risk for potentially serious diseases. A check-up is a good time to talk with patients and their parents about health issues and diseases that may affect preteens and teens.

Understanding adolescent vaccination rates

Understanding your adolescent vaccination rates is the first step toward making practice improvements. Before you can create a plan for improving vaccination rates in your practice, it’s important to understand how you are performing at a practice level. By leveraging the QIC in OP, you can better understand vaccination rates and performance. Understanding the data can help empower you to create an improvement plan.

Vaccine preventable disease statistics

When aiming to improve vaccination rates in your practice, it may be helpful to share the following disease-related information with your office staff, your preteen and teen patients and their parents when discussing vaccination.

Influenza

The overall health impact (eg, infections, hospitalizations, and deaths) of a flu season varies from year to year.

The Centers for Disease Control and Prevention (CDC) estimates that influenza has resulted in between 9.2 million and 60.8 million illnesses, between 140,000 and 710,000 hospitalizations, and between 12,000 and 56,000 deaths annually since 20101.

The first and most important step in preventing flu is to get a flu vaccination each year, according to the CDC2.

Tetanus, diphtheria, pertussis

Before vaccines, as many as 200,000 cases of diphtheria, 200,000 cases of pertussis, and hundreds of cases of tetanus were reported in the United States each year. Since vaccination began, reports of cases for tetanus and diphtheria have dropped by about 99% and for pertussis by about 80%11.

Preteens should get 1 Tdap vaccine when they are 11 or 12 years old to help protect against these diseases11.

Human papillomavirus (HPV)

Every day about 38,000 new HPV infections occur in the United States 3.

Modeling estimates suggest 75% to 80% of males and females will be infected with HPV in their lifetime4,5,a.  Approximately 79 million people in the US are currently infected with HPV and approximately 14 million people become newly infected with HPV each year3,a. For most people, HPV clears on its own. But for others who don’t clear the virus, it could cause certain precancers, cancers, and other diseases.

The CDC advises that HCPs recommend the HPV vaccine for all appropriate 11- to 12-year-old males and females with the same importance as other vaccines6.

According to the CDC, 11- to 12-year-olds should receive 2 doses of HPV vaccine at least 6 months apart. Teens and young adults who start the series later, at ages 15 through 26 years, need 3 doses of HPV vaccine to help protect against cancer-causing HPV infection7. Completing the series is important to help deliver the best protection. Some patients may expect to be reminded of additional doses, so it’s important to communicate follow-up expectations clearly. Remind your patients when they are due for additional doses8.

Meningococcal disease

Rates of meningococcal disease are highest in children younger than 1 year, followed by a second peak in adolescence. Among adolescents and young children, those who are ages 16 through 23 have the highest rates of meningococcal disease9.

There are two types of meningococcal vaccines for preteens and teens10:

  • Meningococcal conjugate vaccines: Protect against four serogroups (A, C, W, and Y)
  • Serogroup B meningococcal vaccines: Protect against one serogroup (B)

CDC recommends meningococcal conjugate vaccination for all 11 to 12 year olds.

A booster dose is also recommended at 16 years old so teens continue having protection when they are at highest risk of meningococcal disease9,10.

All teens may also be vaccinated with a serogroup B meningococcal vaccine, preferably at 16 through 18 years old10.

Improving vaccination rates

Take action to improve your practice’s vaccination rates:

 Review local, state, and national vaccine coverage rates.

  • National vaccination rates are provided on this page for your easy reference.

 Take note of how your practice’s vaccination rates compare. Remember, you can review your vaccination rates by leveraging the QIC in OP.

 Share this information with your office staff and colleagues.

 Identify ways to improve vaccination rates within your practice.

  • You can use OP’s proprietary VacLogic algorithm to automate vaccine forecasting, making it easy to recall patients that are due, overdue, and will become due for a vaccination so they can be scheduled for a visit.
  • The DAR (Demographic Analysis Recall) reporting in OP allows you to send emails, and calls right from the DAR to effectively manage your active patient list, keeping them up to date and on schedule for all of their vaccines.

 Collaborate with other practices to learn how they were successful in the efforts to improve immunization rates among adolescents.

National averages for adolescent vaccination:

Influenza (2015-16 season)12:

  • 5-12 years old: 61.8%
  • 13-17 years old: 46.8%

HPV13:

  • Teen girls: 63%
  • Teen boys: 50%

Meningococcal14: 80.8% (MMWR, August 2016)

Tdap14: 87.1% (MMWR, August 2016)

Remember: You can use the QIC (Quality Improvement Calculator) in OP to find out how vaccination rates at your practice compare to the national averages.

In addition to the national rates, you can also use the interactive maps, trend lines, bar charts, and data tables within the CDC’s Teen VaxView to view regional, state, and selected local area adolescent vaccination coverage.

Act now

Check vaccine status at every patient interaction. The likelihood of seeing your 11- or 12-year-old patients in your office for a well visit decreases as they get older15. [VACC-1214012-0000]. That said, there are opportunities to ensure your preteen and teen patients are up to date with vaccinations, including back-to-school check-ups, sports physicals, new patient evaluations, urgent and acute care, and follow-up visits. Use these opportunities to teach patients and their parents about the importance of staying up to date on their vaccinations.

Consider ways to help patients better understand your recommendations.

 Explain their personal risk

 Discuss the potential complications or consequences of getting a vaccine-preventable disease

 Share a professional experience

 Share the efficacy and safety profile of the vaccine

 Let them know you recommend they receive the vaccine today

Staff education is also important and creates a positive culture and team-based approach for vaccinating. Setting goals and measuring success on an ongoing basis is a great way to make gradual improvements and hold your practice accountable.

Remember, OP offers tools that can also help you improve vaccination rates in your practice:

  • QIC (Quality Improvement Calculator) gives you the ability to rev iew vaccination rates at your practice.
  • The VacLogic algorithm enables you to automate vaccine forecasting, making it easy to recall patients that are due, overdue, and will become due for a vaccination so they can be scheduled for a visit.
  • DAR (Demographic Analysis Recall) allows you to identify key areas for improvement and then act on it by sending recall texts, emails, and calls to effectively manage your active patient list, keeping them up to date and on schedule for all of their vaccines.
  • PMX (Patient Message eXchange) and Patient Portal allow you to proactively reach out to patients and parents to make appointments.
1. Centers for Disease Control and Prevention (CDC). Disease burden of influenza. https://www.cdc.gov/flu/about/disease/burden.htm. Last updated May 16, 2017. Accessed June 7, 2017. 2. Centers for Disease Control and Prevention (CDC). Key facts about influenza (flu). Last updated August 25, 2016. Accessed June 8, 2017. 3. Centers for Disease Control and Prevention (CDC). Epidemiology and prevention of vaccine-preventable diseases, 13th ed. Washi ngton, DC: Public Health Foundation, 2015. 4. Centers for Disease Control and Prevention (CDC). Human papillomavirus. In: Atkinson W, Hamborsky J, Stanton A, et al, eds. Epidemiology and prevention of vaccine-preventable diseases, 12th rev ed, 2nd printing. Washington, DC: Public Health Foundation; 2012:139–150. 5. Koutsky L. Epidemiology of genital human papillomavirus infection. Am J Med. 1997;102(5A):3–8. 6. Reagan-Steiner S, Yankey D, Jeyarajah J, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2014. MMWR Morb Mortal Wkly Rep. 2015;64(29):784–792. 7. Centers for Disease Control and Prevention (CDC). Human papillomavirus (HPV) vaccination: what everyone should know. Updated November 22, 2016. Accessed June 8, 2017. 8. Perkins RB, Chigurupati NL, Apte G, et al. Why don’t adolescents finish the HPV vaccine series? A qualitative study of parents and providers. Hum Vaccines Immunother. 2016;138(2):e20154387. 9. Centers for Disease Control and Prevention (CDC). Meningococcal disease: technical and clinical information. https://www.cdc.gov/meningococcal/clinical-info.html. Published March 28, 2017. Accessed June 8, 2017. 10. Centers for Disease Control and Prevention (CDC). Meningococcal vaccination: what everyone should know. https://www.cdc.gov/vaccines/vpd/mening/public/index.html. Updated May 19, 2017. Accessed June 8, 2017. 11. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.html. Updated October 18, 2016. Accessed June 8, 2017. 12. Centers for Disease Control and Prevention. Flu vaccination coverage, United States, 2015–16 influenza season. https://www.cdc.gov/flu/fluvaxview/coverage-1516estimates.htm. Published September 29, 2016. Accessed June 8, 2017. 13. Centers for Disease Control and Prevention. HPV vaccination coverage data. https://www.cdc.gov/hpv/hcp/vacc-coverage.html. Updated March 10, 2017. Accessed June 8, 2017. 14. Reagan-Steiner S, Yankey D, Jeyarajah J, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2015. MMWR Morb Mortal Wkly Rep 2016;65:850–858. 15. Data available on request from Merck Professional Services-DAP, WP1-27, PO Box 4, West Point, PA 19486-0004.

Copyright © 2016 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. All rights reserved.

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