The Uptake of Recommended Vaccines In American Indian and Alaska Native Adolescents Served by Indian Health Service-Funded Facilities

Background:  The Advisory Committee on Immunization Practices recommends that adolescents 11-18 years of age receive tetanus, diphtheria, acellular pertussis (Tdap), meningococcal conjugate (MenACWY), and for females, human papillomavirus (HPV) vaccines. The Indian Health Service (IHS) monitors coverage with these vaccines on a quarterly basis, among American Indian/Alaska Native (AI/AN) adolescents 11-17 years seen at IHS-funded facilities. Approximately 24% of the total AI/AN adolescent population are captured in the IHS adolescent report.

Objectives:  Assess coverage with the recommended adolescent vaccines among AI/AN adolescents receiving care at IHS-funded healthcare facilities. 

Methods:  The IHS adolescent immunization coverage report is a facility-based report limited to AI/AN adolescents receiving care at an IHS-funded facility. Reports include patients who have had 2 primary care visits in the last 3 years. The July 1 – September 30, 2010, quarterly report included data on approximately 81,000 adolescents. Using quarterly immunization reports from IHS-funded facilities nationwide, we will extract adolescent immunization coverage data from July 1, 2010, through December 31, 2010. Data will be aggregated to provide regional and national level adolescent immunization coverage data for IHS.

Results:  Based on preliminary data from July 1 – September 30, 2010, coverage among adolescents 13 – 17 year olds was as follows: Tdap - 74%, MenACWY - 69%, and HPV one dose - 62%, two doses - 51%, and three doses - 37%. Coverage in the IHS regions ranged from 61% - 82% for Tdap,  31% - 96% for  MenACWY , 29% - 93%  for HPV dose 1, 21%-83% for HPV dose 2, and 14% to 64% for HPV dose 3.

Conclusions: IHS quarterly reports show relatively high coverage overall among AI/AN adolescents, though considerable regional variation exists. Further exploration of factors contributing to the variation is needed, but may include differences in service provision, population characteristics in the different IHS regions, and state immunization rules and regulations.