Receipt of recommended vaccinations by 11- and 12-year-old children appears to be increasing, although clinicians often do not administer all indicated vaccines during vaccination visits, according to a report in the September issue of Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.
A 1996 recommendation to administer tetanus-diphtheria (Td) vaccine to 11- and 12-year-old children prompted the suggestion that this vaccination visit could be used as an opportunity for patients to catch up on other recommended vaccines they were missing, such as hepatitis B and measles-mumps-rubella vaccines, according to background information in the article. More vaccination recommendations for pre-adolescents and adolescents were made from 2005 to 2008, including administration of meningococcal conjugate vaccine (MCV4), a booster dose of tetanus and diphtheria toxoids with acellular pertussis (Tdap) vaccine, quadrivalent human papillomavirus (HPV) vaccine for girls, influenza vaccine and, for some adolescents, a second dose of varicella vaccine. Research has shown that vaccination rates among adolescents are increasing. "However," the authors write, "the estimates do not reflect the specific ages at which the vaccines were received."
Shannon Stokley, M.P.H., from the Centers for Disease Control and Prevention, Atlanta, and colleagues examined data from the 2009 National Immunization Survey -- Teen telephone interview. They assessed for all adolescents and for specific age groups the immunization rates for measles, hepatitis B and varicella, as well as Td, Tdap, MCV4 and HPV vaccination (for girls). These last four vaccines are specifically recommended at ages 11 to 12 years with catch-up doses later. The researchers calculated the age in years at which each adolescent received each dose of vaccine, and the percentage of 11-to-12-year-old children and of adolescents who made at least one vaccination visit.
Childhood immunizations in general appeared to be obtained by most patients by age 11 years. Immunization rates for Td/Tdap, MCV4 and, in girls, HPV increased among adolescents who were born in the mid-1990s compared with adolescents born earlier in the 1990s. At ages 11 to 12 years, more than half (54.9 percent) of patients made at least one vaccination visit. Among adolescents who made a vaccination visit at ages 11 to 12 years and were eligible for vaccination, 19.5 percent did not receive Td and/or Tdap vaccines, 60.9 percent did not receive meningococcal-containing vaccines and 62.4 percent did not receive HPV vaccines.
"This analysis shows encouraging progress with implementing the three vaccines specifically recommended for 11- and 12-year-old children," write the authors. However, they add that many adolescents are not receiving all of the recommended vaccinations, and they encourage immunization efforts to include adolescents as well as 11- and 12-year-olds. The results, the authors conclude, suggest "that more can be done to increase the frequency with which adolescents receive all necessary vaccines during a visit."
- S. Stokley, A. Cohn, N. Jain, M. M. McCauley. Compliance With Recommendations and Opportunities for Vaccination at Ages 11 to 12 Years: Evaluation of the 2009 National Immunization Survey-Teen. Archives of Pediatrics and Adolescent Medicine, 2011; 165 (9): 813 DOI: 10.1001/archpediatrics.2011.138
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