Tuesday, March 18, 2008

Adolescent Immunization Coverage Level Assessments-Design, Processes and Results

Elissa Jones, Marcia H. Levin, and Evelyn Green. Immunization Program, Chicago Department of Public Health, 2160 W. Ogden, Chicago, IL, USA

Learning Objectives for this Presentation:
Describe CoCASA set up for conducting adolescent immunization assessment.
Identify issues related to data collection for adolescent assessment.
Understand provider barriers related to low coverage levels among adolescent providers.

In 2006, the National Immunization Survey included estimates of the percentage of 13-17 year olds who had received the recommended vaccines for MMR (2), hepatitis B (3), varicella (1), Td or Tdap (1). The survey highlighted the work that needs to occur to protect older children with appropriate vaccination. Assessing immunization coverage levels among pediatric practices began in the early 1990's and led to increases in vaccine knowledge, awareness and increased immunization coverage levels on the part of health care providers. These results help to booster efforts to increase adolescent immunization coverage and replicate this effect among adolescent health care providers. Adolescents have fewer health visits, and efforts to increase coverage must be intensified to capture adolescents when they visit. Providers need to recognize and seize opportunities to screen and vaccinate these at-risk patients.

Private and public outpatient practices within Chicago.

A cohort of approximately 360 15 year olds.

Project Description:
Twelve VFC providers were selected based on their ordering patterns for adolescent vaccines. Coverage levels were assessed for MMR, hepatitis B, varicella, MCV 4 and Tdap. HPV was also assessed for females. CoCASA was used to input data of 30 patients per clinic. Findings were discussed with providers. Providers were given education, suggestions and support for improvement.

Results/Lessons Learned:
Utilizing CoCASA to conduct assessments required several modifications. Coverage levels were low because providers failed to offer vaccines or information about recommended vaccines. Patients deferred at the time of the visit were not recalled. Providers need to implement a system to routinely screen and immunize all adolescents for the recommended vaccines.