Journal of Adolescent Health
Volume 46, Issue 2, Supplement 2 , Pages S24-S33 , February 2010

Barriers and Potential Solutions to Increasing Immunization Rates in Adolescents

  • David W. Kaplan, M.D., M.P.H.

      Affiliations

    • Corresponding Author InformationAddress correspondence to: David W. Kaplan, M.D., M.P.H., Department of Pediatrics, University Colorado Denver School of Medicine, The Children's Hospital, 13123 East 16th Avenue, Aurora, CO 80045.

Received 9 July 2009 ,Accepted 8 December 2009.

References 

  1. U.S. Census Bureau. Annual estimates of the population by sex and five-year age groups for the United States: April 1, 2000 to July 1, 2007 (NC-EST2007–01). Population Division, U.S. Census Bureau, 2008. Available at www.census.gov/popest/national/asrh/NC-EST2007/NC-EST2007-01.xls. Accessed December 23, 2009.
  2. Mandates for adolescent immunizations. Recommendations from the National Vaccine Advisory Committee. Am J Prev Med. 2008;35:145–151
  3. The promise and challenge of adolescent immunization. Am J Prev Med. 2008;35:152–157
  4. Middleman AB. Adolescent immunizations: Policies to provide a shot in the arm for adolescents. J Adolesc Health. 2007;41:109–118
  5. Middleman AB, Rosenthal SL, Rickert VI, et al. Adolescent immunizations: A position paper of the Society for Adolescent Medicine. J Adolesc Health. 2006;38:321–327
  6. Rupp R, Rosenthal SL, Middleman AB. Vaccination: An opportunity to enhance early adolescent preventative services. J Adolesc Health. 2006;39:461–464
  7. Fiore AE, Shay DK, Broder K, et al. Prevention and control of seasonal influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. MMWR Recomm Rep. 2009;58:1–52
  8. Centers for Disease Control and Prevention. Vaccination coverage among adolescents aged 13–17 years—United States, 2007. MMWR Morb Mortal Wkly Rep. 2008;57:1100–1103
  9. Elster A, Kuznets N. AMA Guidelines for Adolescent Preventive Services (GAPS): Recommendations and Rationale. Baltimore, MD: Williams & Wilkins; 1994;
  10. Hagan J, Shaw J, Duncan P. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 3rd edition. Elk Grove Village, IL: American Academy of Pediatrics; 2008;
  11. University of California SF. Fact sheet on health care access and utilization: Adolescent and young adults. San Francisco, CA: National Adolescent Health Information Center, University of California; 2008;
  12. National Adolescent Health Interview Survey. The Public Policy Analysis and Education Center for Middle Childhood, Adolescent and Young Adult Health; 2005. San Francisco, CA: University of California, San Francisco; 2005;
  13. Park MJ, Paul Mulye T, Adams SH, et al. The health status of young adults in the United States. J Adolesc Health. 2006;39:305–317
  14. Yu SM, Bellamy HA, Schwalberg RH, et al. Factors associated with use of preventive dental and health services among U.S. adolescents. J Adolesc Health. 2001;29:395–405
  15. Rand CM, Shone LP, Albertin C, et al. National health care visit patterns of adolescents: Implications for delivery of new adolescent vaccines. Arch Pediatr Adolesc Med. 2007;161:252–259
  16. Emans SJ, Bravender T, Knight J, et al. Adolescent medicine training in pediatric residency programs: Are we doing a good job?. Pediatrics. 1998;102:588–595
  17. Freed GL, Nahra TA, Wheeler JR. Which physicians are providing health care to America's children? Trends and changes during the past 20 years. Arch Pediatr Adolesc Med. 2004;158:22–26
  18. GfK/Roper. Meningococcal Disease Public Awareness Disparity Survey. National Foundation for Infectious Diseases; 2008;
  19. Bilukha OO, Rosenstein N. Prevention and control of meningococcal disease. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2005;54:1–21
  20. Rosenthal SL, Kottenhahn RK, Biro FM, et al. Hepatitis B vaccine acceptance among adolescents and their parents. J Adolesc Health. 1995;17:248–254
  21. Lindley M, Orenstein W, Shen A, et al. National Vaccine Advisory Committee Vaccine Financing Working Group Assuring vaccination of children and adolescents without financial barriers: Recommendations from the National Vaccine Advisory Committee (NVAC). Washington, DC: U.S. Department of Health and Human Services; 2009;
  22. Hinman AR, Orenstein WA, Rodewald L. Financing immunizations in the United States. Clin Infect Dis. 2004;38:1440–1446
  23. American Academy of Pediatrics. Press release: Pediatricians say rising vaccine costs are putting children at risk. 2007. Elk Grove Village, IL: American Academy of Pediatrics. Available at: http://www.aap.org/advocacy/releases/apr07vaccinecosts.htm. Accessed June 12, 2009.
  24. Pollack A. In need of a booster shot; rising costs make doctors balk at giving vaccines. New York Times March 24, 2007:C119.
  25. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases. VFC Active Sites 2001 through 2006. Available at: http://www.cdc.gov/vaccines/programs/vfc/projects/data/default.htm. Accessed June 12, 2009.
  26. Glazner JE, Beaty BL, Pearson KA, et al. The cost of giving childhood vaccinations: Differences among provider types. Pediatrics. 2004;113:1582–1587
  27. Glazner JE, Steiner JF, Haas KJ, et al. Is reimbursement for childhood immunizations adequate? Evidence from two rural areas in Colorado. Public Health Rep. 2001;116:219–225
  28. Freed GL, Cowan AE, Clark SJ. Primary care physician perspectives on reimbursement for childhood immunizations. Pediatrics. 2008;122:1319–1324
  29. Gruber J. The role of consumer copayments for healthcare: Lessons from the RAND health insurance experiment and beyond. The Henry J. Kaiser Family Foundation, 2006. Available at: http://www.kff.org/insurance/upload/7566.pdf. Accessed June 12, 2009.
  30. Solanki G, Schauffler HH. Cost-sharing and the utilization of clinical preventive services. Am J Prev Med. 1999;17:127–133
  31. Smith PJ, Stevenson J, Chu SY. Associations between childhood vaccination coverage, insurance type, and breaks in health insurance coverage. Pediatrics. 2006;117:1972–1978
  32. Zara S, Briss P, Harris K. Vaccine-preventable diseases. In: The Guide to Community Preventive Services: What Works to Promote Health?. New York, NY: Oxford University Press; 2005;p. 223–303
  33. Fine P, Mulholland K. Community immunity. In:  Plotkin SA,  Orenstein WA,  Offit PA editor. Vaccines. 5th edition. New York, NY: Saunders; 2008;p. 1573
  34. Centers for Disease Control and Prevention. Outbreak of measles—San Diego, California, January-February 2008. MMWR Morb Mortal Wkly Rep. 2008;57:203–206
  35. Yih WK, Lett SM, des Vignes FN, et al. The increasing incidence of pertussis in Massachusetts adolescents and adults, 1989-1998. J Infect Dis. 2000;182:1409–1416
  36. Immunization information systems progress—United States, 2006. MMWR Morb Mortal Wkly Rep. 2008;57:289–291
  37. Hinman AR, Urquhart GA, Strikas RA. Immunization information systems: National Vaccine Advisory Committee progress report, 2007. J Public Health Manag Pract. 2007;13:553–558
  38. Offit P. Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure. New York, NY: Columbia University Press; 2008;
  39. Gellin BG, Maibach EW, Marcuse EK. Do parents understand immunizations? A national telephone survey. Pediatrics. 2000;106:1097–1102
  40. Roush SW, Murphy TV. Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States. JAMA. 2007;298:2155–2163
  41. National, state, and local area vaccination coverage among adolescents aged 13-17 years—United States, 2008. MMWR Morb Mortal Wkly Rep. 2009;58:997–1001
  42. Centers for Disease Control and Prevention. GBS and Menactra Meningococcal Vaccine. Centers for Disease Control and Prevention Web site, 2008. Available at: http://www.cdc.gov/vaccinesafety/Vaccines/gbsfactsheet.html. Accessed December 23, 2009.
  43. Centers for Disease Control and Prevention. Update: Guillain-Barre syndrome among recipients of Menactra meningococcal conjugate vaccine—United States, October 2005-February 2006. MMWR Morb Mortal Wkly Rep. 2006;55:364–366
  44. Brener ND, Wheeler L, Wolfe LC, et al. Health services: Results from the School Health Policies and Programs Study 2006. J Sch Health. 2007;77:464–485
  45. Lindley MC, Boyer-Chu L, Fishbein DB, et al. The role of schools in strengthening delivery of new adolescent vaccinations. Pediatrics. 2008;121(Suppl 1):S46–S54
  46. National Assembly on School-Based Health Care. School-Based Health Centers. National Census School Year 2004-05. Washington, DC: National Assembly on School-Based Health Care; 2005;
  47. Snyder T, Illow S, Offman C. Digest of Education Statistics 2008 (NCES 2009-020) National Center for Education Statistics. Washington, DC: Institute of Education Sciences, U.S. Department of Education; 2009;
  48. Schaffer SJ, Fontanesi J, Rickert D, et al. How effectively can health care settings beyond the traditional medical home provide vaccines to adolescents?. Pediatrics. 2008;121(Suppl 1):S35–S45
  49. Jacobs RJ, Meyerhoff AS. Effect of middle school entry requirements on hepatitis B vaccination coverage. J Adolesc Health. 2004;34:420–423
  50. Immunization Action Coalition. Hepatitis B Prevention Mandates. Saint Paul, MN: Immunization Action Coalition; 2009;Available at: http://www.immunize.org/laws/hepb.aspAccessed June 10, 2009
  51. Immunization Action Coalition . Meningococcal Prevention Mandates. Saint Paul, MN: Immunization Action Coalition; 2009;Available at: http://www.immunize.org/laws/#meninAccessed November 16, 2009
  52. Broder KR, Cortese MM, Iskander JK, et al. Preventing tetanus, diphtheria, and pertussis among adolescents: Use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2006;55:1–34
  53. English A, Shaw FE, McCauley MM, et al. Legal basis of consent for health care and vaccination for adolescents. Pediatrics. 2008;121(Suppl 1):S85–S87
  54. Deeks SL, Johnson IL. Vaccine coverage during a school-based hepatitis B immunization program. Can J Public Health. 1998;89:98–101
  55. Guajardo AD, Middleman AB, Sansaricq KM. School nurses identify barriers and solutions to implementing a school-based hepatitis B immunization program. J Sch Health. 2002;72:128–130
  56. Payment for Influenza Vaccine and Its Administration. American Academy of Family Physicians. Available at: http://www.aafp.org/online/en/home/clinical/immunizationres/payment.html. Accessed August 22, 2009.
  57. Immunization Action Coalition. Available at: http://www.immunize.org/. Accessed June 10, 2009.
  58. Centers for Disease Control and Prevention. Immunization Schedules. 2009. Available at: http://www.cdc.gov/vaccines/recs/schedules/default.htm. Accessed June 22, 2009.
  59. Pickering L, Baker C, Long S, et al. Red Book: 2006 Report of the Committee on Infectious Diseases. Elk Grove Village, IL: American Academy of Pediatrics; 2006;
  60. Centers for Disease Control and Prevention. Vaccines for Pre-Teens and Adolescents. Centers for Disease Control and Prevention, 2009. Available at: http://www.cdc.gov/vaccines/spec-grps/default.htm#adolpreteens. Accessed June 22, 2009.
  61. Centers for Disease Control and Prevention. Vaccines for College Students and Young Adults. Centers for Disease Control and Prevention, 2009. Available at: http://www.cdc.gov/vaccines/spec-grps/default.htm#cstudentteen. Accessed June 22, 2009.

PII: S1054-139X(09)00657-0

doi: 10.1016/j.jadohealth.2009.12.004

Journal of Adolescent Health
Volume 46, Issue 2, Supplement 2 , Pages S24-S33 , February 2010