Get Vaccinated for Conditions That Affect Teens

OVERVIEW

While the vast majority of childhood vaccinations are scheduled during the first several years of life, some vaccinations are, ideally, administered during the preteen and teen years. These include the Tdap and meningococcal vaccines. In the case of the human papillomavirus, it should be administered at the ages of 11 and 12 years. And, of course, teens and young adults need a yearly influenza (flu) vaccine.

The Tdap vaccine is similar to Td vaccine, which was given every 10 years for tetanus and diphtheria. However, Tdap now also offers protection from pertussis or whooping cough. Over time, immunity from pertussis diminishes. Thus, the disease is no longer uncommon in older children and adults. And, it is the older children and adults who have the potential to pass along their illness to infants who are not yet protected by immunization. These young children may become seriously ill and require hospitalization. The elderly are also at increased risk.

Meningococcal vaccine protects against most of the bacteria that can cause meningococcal diseases, such as sepsis and meningitis. It is recommended that the first dose be administered between the ages of 11 and 12 years, and the second dose be administered at age 16 years.

Like everyone else, teens are at risk for the flu, a miserable viral illness that has respiratory symptoms, body aches, and an elevated body temperature. Unless someone has an allergy to some component of the influenza vaccine, all children over the age of six months should have a flu vaccine each year, preferably in the fall.

WHAT THE EXPERTS SAY

Direct Messaging to Parents Appears to Improve Adolescent Immunization Compliance 1

In a study that was also published in 2015 in the Journal of Adolescent Health, researchers from San Diego and La Jolla, California, used data from the San Diego Immunization Registry to assess the effectiveness and cost efficacy of vaccination reminder messages sent via postal mail, text messaging, and/or emails. Parents of 5,050 adolescents, between the ages of 11 and 17 years, whose records at the San Diego Immunization Registry indicated that they lacked one or more vaccines, were contacted by telephone. The parents who consented to further communication were then asked how they would like to be contacted in the future. The vast majority wanted to be sent postcards. But, because that form of reminder has been previously studied, the number was limited. In the end, 963 were sent emails, 552 were sent text messages, and 282 were sent postal mailings. Subjects who declined to participate were placed in the primary control group. A second control group consisted of teens who met the criteria for inclusion but were not contacted by phone. Three follow-up reminders were sent to participants who did not update their vaccinations. The researchers found that the participants who received any type of reminder were more likely to update their vaccinations than those who only received the initial enrollment call. By the end of the study, 32.1 percent of the text message recipients, 23.0 percent of the postcard recipients, and 20.8 percent of the email recipients were up-to-date on their vaccinations. Those figures stood in contrast to the 12.4 percent of the enrollment call recipients who were up-to-date. Only 9.7 percent of the nonintervention teens were up-to-date. The researchers concluded that “text messaging and email as reminder methods for receiving vaccinations should be considered for use to boost vaccination completion among adolescents.” 2

Parents of Adolescents Tend to Support School-Based Vaccinations 3

Provider Recommendations Make a Difference

In a study published in 2015 in Women’s Health Issues, researchers from Boston compared factors associate with the vaccination of meningococcal vaccine and HPV vaccine in adolescent teens in the United States. Data were obtained from the public files of the National Immunization Survey-Teen for the years 2008 to 2012, which contained parental/guardian input on 48,527 girls between the ages of 13 and 17 years. The researchers found that providers who recommended both vaccinations had higher rates of compliance. In fact, provider recommendation “was the most important factor in receipt of both vaccines.” However, white girls were 10 percent more likely than black or Hispanic girls to report that their provider recommended vaccination. Yet, the white girls did not have higher rates of vaccination. According to the researchers, this suggested that the parents of the white girls had higher rates of refusal. The researchers commented that because the rates of meningococcal vaccination are 20 percent higher than HPV vaccination, “improving provider recommendation for co-administration of HPV and meningococcal vaccines would reduce missed opportunities for initiating the HPV vaccine series.” 4

BARRIERS AND PROBLEMS

School-Based Influenza Vaccinations May Improve Rates of Immunization, But Large Numbers of Parents Do Not Want Their Children to Be Included 5

Parents Vary in Their Support of School-Based Vaccinations; Those Who Are More Economically Challenged Appear to Be More Supportive

In a study published in 2012 in Journal of Adolescent Health, researchers from Colorado and Georgia wanted to learn more about parental attitudes about school-based vaccinations for adolescents. From July 2009 to September 2009, the researchers mailed 806 surveys to the parents of incoming sixth graders in three urban/suburban middle schools in Aurora, Colorado. Five hundred parents (62 percent) responded. They reported that 82 percent of their teens had a regular site for obtaining healthcare, but 17 percent were uninsured. Overall, 71 percent of the parents indicated that they would give consent to have their teen vaccinated at school. However, while 72 percent would give permission for a Tdap vaccination, only 53 percent would give permission for their girls to be vaccinated for HPV. Single parents of uninsured children and children who received free and reduced lunches “were significantly more willing to consent for vaccinations at school.” The researchers suggested that it may be more useful to focus school-based vaccination programs in schools in lower-income areas where there are more underserved teens. Furthermore, “targeting schools with a high percentage of uninsured and low-income teens for school-located vaccination program may be particularly effective in increasing vaccination rates in these adolescents who are often difficult to reach.” 6

Some States Need to Increase Their Efforts to Improve Immunization Rates 7

NOTES

1. David S. Bar-Shain, Margaret M. Stager, Anne P. Runkle et al., “Direct Messaging to Parents/Guardians to Improve Adolescent Immunization,” Journal of Adolescent Health 56 (2015): S21-S26.

2. Jessica Morris, Wendy Wang, Lawrence Wang et al., “Comparison of Reminder Methods in Selected Adolescents with Records in an Immunization Registry,” Journal of Adolescent Health 56 (2015): S27-S32.

3. Lisa M. Gargano, Paul Weiss, Natasha L. Underwood et al., “School-Located Vaccination Clinics for Adolescents: Correlates of Acceptance Among Parents,” Journal of Community Health 40, no. 4 (2015): 660-69.

4. Rebecca B. Perkins, Mengyun Lin, Rebecca A. Silliman et al., “Why Are U. S. Girls Getting Meningococcal but Not Human Papilloma Virus Vaccines? Comparison of Factors Associated with Human Papilloma Virus and Meningococcal Vaccination Among Adolescent Girls 2008 to 2012,” Women’s Health Issues 25, no. 2 (2015): 97-104.

5. Allison Kempe, Matthew F. Daley, Jennifer Pyrzanowski et al., “School-Located Influenza Vaccination with Third-Party Billing: What Do Parents Think? Academic Pediatrics 14, no. 3 (2014): 241-48.

6. Karen Kelminson, Alison Saville, Laura Seewald et al., “Parental Views of School-Located Delivery of Adolescent Vaccines,” Journal of Adolescent Health 51 (2012): 190-96.

7. Monique M. Naifeh, James R. Roberts, Benyamin Margolis et al., “Adolescent Vaccination in Oklahoma: A Work in Progress,” OSMA Journal (2014): 510-16.

REFERENCES AND RESOURCES

Magazines, Journals, and Newspapers

Bar-Shain, David S., Margaret M. Stager, Anne P. Runkle et al. “Direct Messaging to Parents/Guardians Improve Adolescent Immunization.” Journal of Adolescent Health 56 (2015): S21-S26.

Gargano, Lisa M., Paul Weiss, Natasha L. Underwood et al. “School-Located Vaccination Clinics for Adolescents: Correlates of Acceptance Among Parents.” Journal of Community Health 40, no. 4 (2015): 660-69.

Gilkey, Melissa B., Annie-Laurie McRee, and Noel T. Brewer. “Forgone Vaccination During Childhood and Adolescence: Findings of a Statewide Survey of Parents.” Preventive Medicine 56 (2013): 202-6.

Kelminson, Karen, Alison Saville, Laura Seewald et al. “Parental Views of School-Located Delivery of Adolescent Vaccines.” Journal of Adolescent Health 51 (2012): 190-96.

Kempe, Allison, Matthew F. Daley, Jennifer Pyrzanowski et al. “School-Located Influenza Vaccination with Third-Party Billing: What Do Parents Think?” Academic Pediatrics 14, no. 3 (2014): 241-48.

Morris, Jessica, Wendy Wang, Lawrence Wang et al. “Comparison of Reminder Methods in Selected Adolescents with Records in an Immunization Registry.” Journal of Adolescent Health 56 (2015): S27-S32.

Naifeh, Monique M., James R. Roberts, Benyamin Margolis et al. “Adolescent Vaccination in Oklahoma: A Work in Progress.” OSMA Journal (2014): 510-16.

Perkins, Rebecca B., Mengyun Lin, Rebecca A. Silliman et al. “Why Are U. S. Girls Getting Meningococcal but Not Human Papilloma Virus Vaccines? Comparison of Factors Associated with Human Papilloma Virus and Meningococcal Vaccination Among Adolescent Girls 2008 to 2012.” Women’s Health Issues 25, no. 2 (2015): 97-104.

Rambout, Lisa, Mariam Tashkandi, Laura Hopkins, and Andrea C. Tricco. “Self-Reported Barriers and Facilitators to Preventive Human Papillomavirus Vaccination Among Adolescent Girls and Young Women: A Systematic Review.” Preventive Medicine 58 (2014): 22-32.

Web Site

Centers for Disease Control and Prevention. www.cdc.gov .

  This information is not a tool for self-diagnosis or a substitute for professional care.