Improving Adolescent Immunization Rates with a Phone Call-Based Reminder/Recall System

Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to:
1. Describe the reminder/recall system used to successfully increase adolescent immunization rates.

Background:
Northeast Valley Health Corporation offers free immunizations through the VFC program, however our adolescent UTD rate remains low. In September 2007, 38% of 13-year-olds were UTD for all needed immunization and 51% were UTD for Td/Tdap. In the past, a postcard-only reminder/recall system through the Los Angeles-Orange Immunization Network (LINK) did not significantly increase the 13-year-old UTD rate.

Objectives:
To increase immunization UTD rates among 13-year-old patients.

Methods:
Each month, a list of patients (who have turned 12 years old in the last month) and who are not UTD for Td is generated through LINK. Twelve year olds were targeted to give them an opportunity to get immunized before they turn 13. Td was targeted as it tends to have one of the lowest UTD rates in this age group. Three phone calls are attempted to inform the parents that their adolescent is not UTD for needed immunization. Patients are then referred to their provider or to free immunization services. In addition to the phone calls, postcards are sent to all patients not UTD. Based on the outcome of the phone call or upon receiving a returned postcard, the patient's status in LINK is updated to reflect whether or not they are active.

Results:
After implementing the phone call system, an increase in the Td UTD rate (81%) and the overall UTD rates (70%) was observed in the 12-year-old population targeted for intervention during the months of January to July 2007.

Conclusions:
Implementing a phone call system in addition to postcards significantly increased adolescent immunization rates. Focusing on Td can lead to an increase in the overall vaccination rates of adolescents. The UTD rates will continue to be monitored for improvements.