Large and increasing coverage differences between the tetanus, diphtheria and acellular pertussis vaccine and other vaccines recommended for adolescents show that many valuable opportunities are being missed to vaccinate boys and girls, especially against HPV infection, according to a CDC report.
Providers should administer recommended HPV and meningococcal vaccinations to boys and girls during the same visits when Tdap is given, as recommended by the CDCs Advisory Committee on Immunization Practices, CDC researchers wrote in the Aug. 30 issue of the Morbidity and Mortality Weekly Report.
To monitor vaccination coverage among adolescents ages 13 to 17, researchers analyzed data from the National Immunization SurveyTeen. From 2011 to 2012, coverage increased from 78.2% to 84.6% for the Tdap vaccine dose and from 70.5% to 74% for the meningococcal conjugate vaccine. Among males, the HPV vaccination rate increased from 8.3% to 20.8%, but estimates among females remained essentially stagnant from 2011 to 2012 (53.8% for at least one dose and 33.4% for the recommended three doses).
Since 2009, the yearly national vaccination coverage estimate among teens for one dose of meningococcal conjugate vaccine has been lower than the estimate for one dose of Tdap vaccine, and the difference in coverage between the two vaccines is widening.
National Healthy People 2020 coverage targets for teens were met or exceeded by 36 states for Tdap vaccination and by 12 states for meningococcal vaccination, but no state met the HPV vaccination target of 80% for female teens.
These findings indicate that healthcare providers are missing opportunities to administer recommended HPV and meningococcal vaccinations to boys and girls during visits when Tdap is given, according to the report. “In addition, whether for health problems or well-checks, providers, parents and adolescents should use every healthcare visit as an opportunity to review adolescents immunization histories and ensure that every adolescent is fully vaccinated.”
Along with making a point to administer all age-appropriate vaccines during a single visit, the authors wrote, clinicians “should provide strong, clear consistent vaccination recommendations to adolescents and their parents or guardians. Clinicians, public health agencies and other stakeholders can also improve vaccination rates by reducing out-of-pocket vaccination costs for patients and their families.”
Healthcare reform might present solutions, the authors wrote. The Affordable Care Act requires nongrandfathered private health plans to offer ACIP-recommended vaccines at no cost to beneficiaries. The same rule applies to qualified health plans on the new health insurance exchanges.
“Achieving high vaccination coverage among adolescents is feasible, and progress is evident for most vaccines,” the authors wrote. “Lack of progress with HPV vaccination among females warrants immediate action by healthcare providers, parents, public health agencies and other immunization stakeholders.”
Read the report: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6234a1.htm?s_cid=mm6234a1_w.