Timing of adolescent vaccinations: vaccination at the recommended 11 to 12 year old visit and catch-up vaccination at ages 13-17

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to understand the ages when adolescents receive recommended vaccines.

Background:
A health visit is recommended at age 11-12 years for routine adolescent vaccinations and catch-up of childhood vaccinations. Vaccinations missed should be caught up at ages 13-17 years.

Objectives:
To determine the proportion of adolescents who receive routine and catch-up vaccines at age 11-12 years and describe catch-up among those aged 13-17 years.

Methods:
The 2006 National Immunization Survey–Teen (NIS-Teen) used random-digit dialing of households and mailings to vaccination providers to estimate vaccination coverage for US adolescents aged 13-17 (birth cohorts reported, 1989–1993). The sample included 2,882 adolescents with provider-reported vaccinations. Routine adolescent vaccines studied were tetanus-diphtheria and the new pertussis-containing formulation (Td/Tdap), and meningococcal-containing vaccine (mening). Childhood vaccines studied were measles-containing (MCV), hepatitis B (HepB), and varicella (among those without history of disease).

Results:
Overall, the percentage of adolescents who received the routinely recommended vaccines at ages 11-12 was 27% for Td/Tdap and 2% for mening; for catch-up vaccination during ages 13–17, coverage reached 62% for Td/Tdap and 12% for mening. For childhood vaccine catch-up, the percentage vaccinated at ages 11-12 and the percentage with up-to-date coverage among 13 to 17-year-olds was 8% and 86%, respectively, for MCV; 22% and 81%, respectively, for HepB; and 6% and 65%, respectively, for varicella. Vaccination at ages 11-12 decreased with each successive birth cohort for MCV and HepB and increased by birth cohort for Td/Tdap and mening.

Conclusions:
Overall, neither routine vaccination at ages 11–12 nor catch-up at ages 13–17 resulted in high coverage. Mening was recently recommended and not available when the majority of teens were 11-12 years, which likely explains the low coverage at this age. Strategies for increasing preventive healthcare visits and administering vaccines at age 11-12 years are a needed first step.