The 36th National Immunization Conference of CDC

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Reliability of Adolescent Self-Reports for Varicella Susceptibility Assessments in West Philadelphia Schools

Dana Perella1, Barbara Watson1, Jonathan Adriano1, Robert Levenson1, James Lutz1, Aisha Jumaan2, Jane Seward2, and Shelley Applegate3. (1) Division of Disease Control, Philadelphia Dept. Public Health, 500 S. Broad St, 2nd Fl, Philadelphia, PA, USA, (2) Child Vaccine Preventable Disease Branch, Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-61, Atlanta, GA, USA, (3) Family Resource Network, School District of Philadelphia, John F. Kennedy Center, Rm 500, 734 Schuykill Ave, Philadelphia, PA, USA


KEYWORDS:
Varicella, Adolescent, Susceptibility, Vaccine

BACKGROUND:
The Philadelphia Department of Public Health (PDPH) has been collaborating with CDC in an active varicella surveillance and epidemiological studies project since October 1994. PDPH has observed that some adolescents attend Philadelphia public clinics without their parents; therefore, screening for varicella vaccine may occur on the basis of self-reported varicella history or vaccination.

OBJECTIVE(S):
To evaluate the reliability of self-reported varicella susceptibility by adolescents attending inner city schools.

METHOD(S):
A varicella susceptibility questionnaire capturing information on demographics, history of disease, and vaccination status was administered to students attending West Philadelphia schools who were in 6th grade during Spring 2000 and 7th grade during Fall 2000. To assess the reliability of the students’ responses, a sample of 100 respondents was chosen randomly and parents/guardians were contacted and interviewed by telephone using the same questionnaire.

RESULT(S):
A total of 2798 students were surveyed; their median age was 12 years. The majority of the students were non-Hispanic African Americans (72.2%). Based on the students’ responses, 2236 (79.9%) reported that they were not susceptible; in contrast, 86 (91.5%) of the 94 parents interviewed reported that their children were not susceptible. A similar percentage of students (5.5%) and parents (5.3%) reported that the children were susceptible. A higher proportion of adolescents (14.6%) did not know their susceptibility status compared with only 3.2% of parents. The Kappa measure of agreement between the students’ and the parents’ responses were 0.556 for history of varicella, 0.007 for varicella vaccination, and 0.229 for overall varicella susceptibility.

CONCLUSIONS(S):
More parents reported that their children were not susceptible to varicella compared to the students surveyed. Considering parents’ responses as the gold standard, relying on self-reporting of varicella susceptibility by adolescents would lead to higher use of vaccine.

LEARNING OBJECTIVES:
Evaluate the reliability of adolescent self-reports for varicella susceptibility in inner city schools.

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