Vaccination concordance and discordance between parents and provider-verified data of NIS-teen 2018 Open Access

Huang, Sean (Spring 2021)

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Background: Understanding concordance and discordance between parental self-report and provider-verified vaccination data is crucial for interpretation of more easily collected self-report data in the service of improving vaccine coverage. Limited research has investigated and compared vaccine concordance and discordance among adolescent vaccines evaluated in the National Immunization Survey-Teen.

Methods: This analysis examined reporting concordance and discordance for human papillomavirus (HPV), meningococcal disease (MenACWY), and tetanus, diphtheria, and pertussis (Tdap) vaccines by different sociodemographic variables. Sensitivity and specificity measures were measured for each vaccine to assess how well NIS-Teen capture true positive and true negative We computed adjusted estimates for individuals without adequate provider verified data, using the sensitivity and specificity estimates from individuals with both self-report and provider-verified data. Bivariate and multivariate Poisson regression analysis were performed to evaluate associations between sociodemographic characteristics and self-report concordance and discordance.

Results: For all vaccines, sensitivity of self-report was high (HPV 1+ shot: 90.4%, HPV 3+ shots: 85.5%, MenACWY: 90.8%, Tdap: 89.8%), with lower specificity (HPV 1+ shot: 57.4%, HPV 3+ shots: 58.4%, MenACWY: 26.3%, Tdap: 32.7%). Adjusted estimates were lower than the self-reported values (63.1% for 1+ HPV; 51.4% for 3+ HPV; 86.4% for MenACWY, 88.1% for Tdap), demonstrating the moderate accuracy of obtaining valid data from the method of self-reporting. For HPV and Tdap, Hispanic and non-Hispanic black were discovered to be more likely to under-report than non-Hispanic white, while mother with education level of less than 12 years and mother with education level of 12 years were more likely to under-report than mother with education level of college graduate. For MenACWY, region of Northeast was less likely to over-report than South.

Discussion: The sensitivity, specificity, adjusted estimates, and overall discordance stratums demonstrated that parental under-reporting was more likely to occur when utilizing self-reporting methods. The specific reason behind differences in and discordance within these sub-categories is unclear and merits further investigation. In addition, more studies need to be conducted to provider a better understanding of limitations of self-report. An alternative method may be preferred to capture more accurate immunization data in the future.

Table of Contents

Literature review 1

Introduction/Background 7

Methods 8

Results 10

Discussion 17

Table 23

References 47

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