Association s Between Clinical Preventive Services and Adolescent Immunizations, Tdap, MCV4 and HPV

Background: Immunizations and addressing other clinical preventive services (CPS) are both important components to adolescent care. Although the importance is recognized, little is known about the delivery and prioritization in the adolescent population.  

Objectives:  Investigate relationships between CPS discussion at recent doctor’s visits and adolescent vaccines.

Methods:  Surveys were collected by computer-assisted random digit dial telephone survey (RDD) from July 2009-June 2010. Eligible households were within San Diego County and had a child between 11 and 17 years of age at the time of the survey.  Those who had been to the doctor within the last two years were asked to recall the CPS topics they discussed. Analysis was limited to parents who reported being in the examining room with their child for some or all the provider visit. CPS topics from the survey were grouped into four categories: Health Maintenance, Substance Abuse, Sexual Health and Safety. This report will focus on the adolescent age ranges 11-13 and 14-17 and the recommended vaccines MCV4, Tdap and HPV for females.

Results:  For the age group 11-13 MCV4 was associated with CPS. Recalling discussion of at least one topic of each of the four categories yielded a coverage rate of 50% vs. 25% for those who did not recall discussing any of the topics in the four categories. For the 14-17 year old group Tdap was associated with CPS. Discussion of at least one topic of each of the four CPS categories yielded a coverage rate of 66% vs. 39% for those that did not recall discussing CPS.  

Conclusions:  In this preliminary study into the relationships between CPS discussion and immunizations no clear pattern was observed. Further investigation is needed into whether CPS discussion and immunizations are competing for time or are complimentary in improving immunization coverage rates.