Trends in Influenza Vaccination among Adolescents in the United States, 2008-2012 Open Access

Rosenthal, Mark Isaac (2015)

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Background: The Advisory Committee on Immunization Practices first included adolescents up to 18 years old in its influenza vaccination recommendations in 2008 to lower the burden of influenza among this group and increase vaccine coverage. Detailed evaluations of adolescent influenza immunization patterns over time are currently lacking.

Methods: We conducted a serial cross-sectional analysis of combined data from the 2008-2012 National Immunization Survey - Teen surveys to evaluate the progression of influenza vaccination coverage among adolescents in the United States across relevant sociodemographic factors. Unadjusted coverage estimates were computed for the full period and each annual survey. Adjusted annual coverage estimates and adjusted average change per year were calculated. Adjusted odds ratios were calculated to compare vaccination coverage among levels of each covariate.

Results: Between 2008 and 2012, overall adolescent influenza vaccine coverage estimates in the US increased from 9.6% to 19.1%. The average annual change, adjusted for sociodemographic and socio-economic characteristics, was 20% (OR 1.20, 95% CI 1.17-1.24). Younger adolescents were more likely to have received influenza vaccine (18% coverage among 13 year olds) compared to older adolescents (12% coverage among 17 year olds).Adolescents who received an 11-12 year old check-up were 1.46 times (95% CI 1.24-1.72) more likely to be up-to-date for influenza vaccination than those who did not. Adolescents who are covered by any form of insurance were UTD for influenza vaccination 1.58 (95% CI 1.21-2.06) times more often than those who were not covered.

Conclusions: These findings highlight the need to encourage influenza vaccination as part of routine adolescent health care. Regular contact with healthcare providers is essential to improving influenza vaccine coverage. Because influenza vaccinations need to be performed annually, it is critical that healthcare providers take every opportunity to promote vaccination and increase awareness of its importance among adolescents and their parents.

Table of Contents

Chapter 1. Literature Review and Background. 1

Chapter 2. Thesis Manuscript. 14

Introduction. 14

Methods. 15

Results. 17

Discussion. 19

Tables and Figures. 24

Chapter 3. Summary - Public Health Implications and Possible Future Directions. 29

References. 31

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