Measuring the Impact of New Requirements with Adolescent AFIX

Background:
The Arizona Immunization Program implemented a vaccine rule amendment adding Tdap and Meningococcal vaccines to Arizona's school immunization requirements for 11-12 year olds beginning in September 2008. To measure the baseline coverage levels of Tdap, Td, MV, and HPV in advance of the new school requirements, the first adolescent AFIX assessments were completed in Arizona at 63 VFC provider sites in 2007. The chart-based assessments included a total of 3,160 adolescents 11-15 years of age. Two follow-up assessments were completed in 2008 using data exported from the Arizona State Immunization Information System (ASIIS), and imported into CoCASA. All 11-15 year old patients seen by 54 of the providers originally assessed in 2007 were included in the 2008 assessments. The total number of adolescents included was more than 50,000. The 2008 assessments were completed one month before, and one month following, the September 1st implementation date of the new requirement

Setting:
Public and private Vaccines for Children providers located in nine Arizona counties. Pediatric, general practice, community health center and Indian Health Service providers were included

Population:
Adolescents 11-15 years of age.

Project Description:
The project includes 1) descriptions of procedures used to conduct assessments of adolescent coverage levels, 2) review of the results of 2007 adolescent AFIX visits,
3) review of the results of 2008 assessments of adolescent coverage levels, and 4) observations of the impact of a school mandate on immunization coverage levels by provider type and vaccine type.

Results/Lessons Learned:
A new school requirement for 11-12 year olds entering sixth grade to receive Tdap and Meningococcal vaccines was associated with a significant increase in the immunization coverage levels of 11-15 year olds. The coverage levels varied by provider type and vaccine type.