Factors Affecting Tetanus-Containing Vaccine Coverage Among Teens — United States, 2007

Background: According to the 2007 National Immunization Survey–Teen (NIS-Teen), vaccination coverage among adolescents aged 13–17 years with ≥1 dose of tetanus and diphtheria toxoids (Td) vaccine or tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine was 72.3%. Identifying factors associated with Td/Tdap vaccination could facilitate the development of strategies to increase coverage among adolescents.

Objectives: To obtain an additional Td/Tdap national vaccination coverage estimate among adolescents aged 13–17 years and identify factors associated with vaccination.

Methods: Data were analyzed from the 2007 National Survey of Children’s Health, a random-digit–dialed telephone survey of parents of children aged <18 years. Parents recalled vaccination and health care visit histories. Demographic, maternal, and household characteristics as well as insurance status and health care utilization variables were examined. Bivariate and multivariate logistic regression analyses were used to evaluate and model factors associated with vaccination.

Results: Analyses included 31,001 adolescents aged 13–17 years. Vaccination coverage with ≥1 dose of Td/Tdap was 88.2% (95% CI: 87.2–89.1). In the final model, factors associated with receipt of Td/Tdap included having a preventive health care visit in the past 12 months (OR: 2.52; 95% CI: 1.99–3.19) and age. Compared with adolescents aged 13 years, teens aged 16 years were more likely to be reported as vaccinated (OR: 2.87; 95% CI: 2.15–3.84). Compared with teens living in the Northeast and urban or suburban areas, teens living in other regions and rural areas were less likely to be reported as vaccinated.

Conclusions: Although some results, including coverage estimates higher than 2007 NIS-Teen provider-validated findings, might have been affected by recall bias, having a recent preventive health care visit was strongly associated with reported Td/Tdap vaccination. Promoting annual health visits might increase vaccination coverage for Td/Tdap as well as other vaccines and preventive services routinely recommended for adolescents.