Immunization rate increases among teens: NIS report

In light of today's report of the National Immunization Survey results, the Society for Adolescent Health and Medicine (SAHM) encourages increased efforts in fully immunizing all adolescents.

The report issued by the National Immunization Survey (NIS) shows progress in increasing immunization rates among teens 13-17 years of age. However, rates remain unacceptably low for those vaccines that are targeted specifically to prevent disease in adolescents: meningococcal meningitis (53.6 %), human papillomavirus (44.3% received one dose, while only 26.7% received all three recommended doses), tetanus/diphtheria/pertussis (Tdap) (55.6 %). Low rates among adolescents may be responsible for the epidemic of pertussis (whooping cough) that is presently occurring in California.

"Adolescents, in particular, are in a unique position to serve as reservoirs for disease and transmit disease to others," notes Dr. Amy Middleman, SAHM's liaison to the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention. "We know that transmission from adolescents and young adults is responsible for a significant number of cases of pertussis in infants, so properly immunizing adolescents can play a major role in stopping the epidemic and preventing the deaths we see in outbreaks similar to the one occurring in California now." She adds, "It is critical that adolescents receive all vaccines recommend for their age group, including the Tdap vaccine."

Current estimates for 2010 are that California may see its highest number of pertussis-related deaths in fifty years, having already had eight deaths, seven of which were infants under two months old. Other states have also seen increasing numbers of cases, including Arizona, Georgia, Idaho, Michigan, Minnesota, New York, North Carolina, Ohio, Oregon and South Carolina. Routine vaccinations, as recommended by the CDC and advocated by SAHM, will help reduce the spread of pertussis and deaths related to the disease.

A variety of challenges face providers and public health authorities in vaccinating adolescents. SAHM recommends the following steps to help providers overcome these barriers: 1) Vaccinate adolescents at every opportunity possible, regardless of the reason for a medical visit; 2) Make sure vaccinations are a priority for comprehensive health visits, including sports physicals; 3) Utilize standing orders which instruct office staff to vaccinate adolescents when indicated, even if a provider forgets; 4) Utilize a vaccine reminder and recall system to get patients to return for additional vaccines when they need them; 5) Lobby for and utilize centralized statewide vaccine registries where all adolescents can have their vaccine status documented; 6) support the use of school-located programs and other alternative sites to provide immunization services for those with less access to comprehensive services, and 7) educate patients at every opportunity about the benefits of vaccines. SAHM urges patients and parents to talk to their providers about vaccines including the efficacy and safety of this most important primary prevention tool.

"The bottom line is these diseases can and should be prevented. We must continue to create strong initiatives to get teens vaccinated," concluded Dr. Middleman.