TY - JOUR
T1 - Missed Vaccination Opportunities Among U.S. Adolescents by Area Characteristics
AU - Pruitt, Sandi L.
AU - Tiro, Jasmin A.
AU - Kepka, Deanna
AU - Henry, Kevin
N1 - Funding Information:
The authors wish to thank Rong Rong, MS and Bhumika Maddineni, MPH for their assistance with tables and figures. The findings and conclusions in this paper are those of the author(s) and do not necessarily represent the views of the Research Data Center, National Center for Health Statistics, or Centers for Disease Control and Prevention. The study sponsor had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication. The University of Utah IRB deemed this study exempt (IRB #00080885). This work was supported by funding from the National Cancer Institute (3P30CA142543-10S2; Principal Investigator: Arteaga; Project Lead: JAT). DK receives a small portion of her salary from an American Cancer Society grant, which received funding from Merck, for the purpose of the Mission: HPV Cancer Free Quality Improvement Initiative. No other financial disclosures were reported. Sandi L. Pruitt: Conceptualization; Investigation; Writing - original draft. Jasmin A. Tiro: Investigation; Project administration; Resources; Writing - review and editing. Deanna Kepka: Investigation; Project Administration; Supervision; Writing - review and editing. Kevin Henry: Data curation, Formal analysis, Investigation, Methodology, Writing - review and editing.
Funding Information:
DK receives a small portion of her salary from an American Cancer Society grant, which received funding from Merck, for the purpose of the Mission: HPV Cancer Free Quality Improvement Initiative. No other financial disclosures were reported.
Funding Information:
This work was supported by funding from the National Cancer Institute (3P30CA142543-10S2; Principal Investigator: Arteaga; Project Lead: JAT).
Publisher Copyright:
© 2021 American Journal of Preventive Medicine
PY - 2022/4
Y1 - 2022/4
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85124029749&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85124029749&partnerID=8YFLogxK
U2 - 10.1016/j.amepre.2021.10.014
DO - 10.1016/j.amepre.2021.10.014
M3 - Article
C2 - 35125272
AN - SCOPUS:85124029749
VL - 62
SP - 538
EP - 547
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
SN - 0749-3797
IS - 4
ER -