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Missed Vaccination Opportunities Among U.S. Adolescents by Area Characteristics.
Pruitt, Sandi L; Tiro, Jasmin A; Kepka, Deanna; Henry, Kevin.
  • Pruitt SL; Department of Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas; Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: sandi.pruitt@utsouthwestern.edu.
  • Tiro JA; Department of Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas; Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas.
  • Kepka D; College of Nursing, The University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute, Salt Lake City, Utah.
  • Henry K; Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania; Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
Am J Prev Med ; 62(4): 538-547, 2022 04.
Article in English | MEDLINE | ID: covidwho-1663375
ABSTRACT

INTRODUCTION:

A total of 3 vaccines are recommended for U.S. adolescents tetanus, diphtheria, and acellular pertussis; meningococcal conjugate; and human papillomavirus. To understand the disparities in vaccine availability and hesitancy, adolescent-, household-, and area-level characteristics associated with patterns of vaccine coverage are described.

METHODS:

In 2020-2021, the authors generated national estimates among 8 possible combinations of vaccine coverage and identified the associated characteristics using 2015-2017 National Immunization Survey-Teen for male and female adolescents aged 13-17 years (N=63,299) linked to area (ZIP code) characteristics. Next, the factors associated with a missed opportunity for human papillomavirus vaccine (i.e., receipt of tetanus, diphtheria, and acellular pertussis and meningococcal conjugate only compared with coverage of all the 3 vaccines) were identified using logistic regression.

RESULTS:

Most U.S. adolescents received all the 3 vaccines (42.9%) or tetanus, diphtheria, and acellular pertussis and meningococcal conjugate only (32.1%); fewer received no vaccines (7.7%) or tetanus, diphtheria, and acellular pertussis only (6.6%); and the remainder received some combination of 1-2 vaccines. Missed opportunities for human papillomavirus vaccination were more likely among adolescents who were male, were of White race, were uninsured, were in middle-income households, and were living in rural areas and were less likely among adolescents who were older, who were Medicaid insured, whose parents completed surveys in Spanish, who were in poverty-level households, and who were living in high-poverty areas.

CONCLUSIONS:

A substantial number of U.S. adolescents are not fully vaccinated, and coverage varies by vaccine type, population, and place. Providers should routinely stock all the 3 vaccines and promote simultaneous, same-day vaccination to avoid missed vaccine opportunities. More research and interventions are needed to understand and modify patient, provider, payer, vaccine supply/storage, or other reasons for suboptimal coverage of all the recommended vaccines.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Diphtheria-Tetanus-acellular Pertussis Vaccines / Meningococcal Vaccines / Papillomavirus Infections / Papillomavirus Vaccines Type of study: Observational study Topics: Vaccines Limits: Adolescent / Female / Humans / Male Country/Region as subject: North America Language: English Journal: Am J Prev Med Journal subject: Public Health Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diphtheria-Tetanus-acellular Pertussis Vaccines / Meningococcal Vaccines / Papillomavirus Infections / Papillomavirus Vaccines Type of study: Observational study Topics: Vaccines Limits: Adolescent / Female / Humans / Male Country/Region as subject: North America Language: English Journal: Am J Prev Med Journal subject: Public Health Year: 2022 Document Type: Article