State level vaccination systems: Is there a correlation of success for childhood and adolescent immunizations? Open Access
McKinstry, Sarah (2015)
Objective: To evaluate whether states’ childhood vaccination coverage rates (≥4 doses of DTaP, ≥3 doses of poliovirus vaccine, ≥1 doses of measles vaccine, full series of Hib (depending on product), ≥3 doses of HepB, ≥1 doses of varicella vaccine, and ≥4 doses of PCV) relative to the national average, are associated with adolescent vaccination coverage (≥1 doses of Tdap and ≥1 doses of MenACWY).
Methods: A cross sectional analysis of adolescents, aged 13 to 17 years, with adequate provider verified data from all 50 states and Washington, D.C. (n=19,199) using data from the 2012 National Immunization Survey-Teen. The main outcome measure is individual adolescent vaccination coverage defined as not up-to-date (UTD) for Tdap and MenACWY, UTD for Tdap or MenACWY, or UTD for Tdap and MenACWY.
Results: A state having at or above average childhood vaccination coverage was not significantly more likely to have at or above average adolescent vaccination coverage (PPV: 59.26%, Kappa =0.217). When comparing adolescents UTD for Tdap and MenACWY to adolescents not UTD for Tdap or MenACWY, the odds of living in a state with at or above average childhood vaccination coverage was 0.87 (95% CI: 0.74, 1.03). The adjusted odds ratio was also not statistically significant (aOR: 0.85; 95% CI: 0.69, 1.04). Comparing adolescents UTD for Tdap or MenACWY to adolescents not UTD for Tdap or MenACWY, the odds of living in a state with at or above average childhood vaccination coverage was 0.94 (95% CI: 0.78, 1.1) and the adjusted odds ratio was 0.89 (95% CI: 0.70, 1.13).
Conclusions: This analysis suggests that there is not a strong correlation of success in achieving high rates of early childhood immunization with achieving high rates of immunization in the adolescent population. Adolescents who live in states with at or above average childhood vaccination coverage do not appear more likely to receive recommended adolescent vaccinations than adolescents who live in states with below average childhood vaccination coverage rates. There is a clear need for policy tailored to meet the specific needs of adolescents, which have proven to be different from that among young children.
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About this Master's Thesis
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