Correlates of receiving recommended adolescent vaccines among adolescent females in North Carolina

Abstract

Background. Immunization is a successful and cost-effective method for preventing disease, yet many adolescents do not receive recommended vaccines. We assessed correlates of uptake of three vaccines (tetanus booster, meningococcal, and human papillomavirus [HPV] vaccines) recommended for adolescent females. Methods. We examined cross-sectional data from 647 parents of 11-20 year-old females from North Carolina who completed the Carolina HPV Immunization Measurement and Evaluation (CHIME) Project follow-up survey in late 2008. Analyses used ordinal and binary logistic regression. Results. Only 17% of parents indicated their daughters had received all three vaccines. Eighty-seven percent of parents indicated their daughters had received tetanus booster vaccine, 36% reported vaccination against meningococcal disease, and 36% reported HPV vaccine initiation. Daughters aged 13-15 years (OR=1.70, 95% CI: 1.09–2.64) or 16-20 years (OR=2.28, 95% CI: 1.51–3.44) had received a greater number of these vaccines compared to daughters aged 11-12 years. Daughters who had preventive care visits in the last year (OR=4.81, 95% CI: 3.14–7.34) or whose parents had at least some college education (OR=1.90, 95% CI: 1.29–2.80) had also received a greater number of these vaccines. Conclusions. Few daughters, particularly 11-12 years olds, had received all three vaccines recommended for adolescent females. Ensuring annual preventive care visits and increasing concomitant administration of adolescent vaccines may help increase vaccine coverage.

Acknowledgements

This study was funded by the Centers for Disease Control and Prevention (S3715-25/25), the American Cancer Society (MSRG-06-259-01-CPPB), and the Cancer Control Education Program at Lineberger Comprehensive Cancer Center (Grant No. R25 CA57726). Although we do not believe we have any conflicts of interest, we wish to share the following information in the interest of full disclosure. Authors have received research grants from Merck & Co., Inc. (N.B. and P.R.) and GlaxoSmithKline (N.B.), but neither has received honoraria or consulting fees from these companies. These funds were not used to support this research study.

Figures and Tables

Figure 1 Adolescent vaccines received as reported by parents (n = 647). Figure does not show 51 parents (8%) who reported their daughters had not received any of these vaccines. Tetanus booster vaccine includes tetanus, diphtheria and acellular pertussis (Tdap) vaccine or tetanus and diphtheria toxoids (Td) vaccine. Meningococcal vaccine includes meningococcal conjugate vaccine (MCV4) or meningococcal polysaccharide vaccine (MPS V4).

Table 1 Characteristics of parents and their daughters in the follow-up study (n = 647)

Table 2 Correlates of receiving recommended adolescent vaccines (tetanus booster,a meningococcal,b and HPV vaccines) (n = 647)

Table 3 Correlates of receiving each recommended adolescent vaccine (n = 647)