Parents not keeping up with teen vaccines

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Parents not keeping up with teen vaccines

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Volume 29
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Issue 4
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Vaccines are an important strategy for keeping people healthy and preventing the spread of illness. In the US, vaccines have long been recommended for babies and at kindergarten entry; more recently, several vaccines have been recommended for the adolescent age group. However, data from the Centers for Disease Control and Prevention (CDC) indicate that national vaccination rates are well below public health targets for certain adolescent vaccines, particularly those that require more than one dose, such as meningitis vaccine, human papillomavirus (HPV) vaccine, and annual flu shots.

To explore parents’ understanding of adolescent vaccine recommendations, the C.S. Mott Children’s Hospital National Poll on Children’s Health asked a national sample of parents about getting vaccines for their teens 13-17 years old.

Parent Knowledge of Teen Vaccine Needs

Most parents reported their teen definitely (79%) or probably (14%) has gotten all vaccines recommended for his or her age. However, many parents were unclear when or if their teen is due for another vaccine. Nineteen percent said their teen is supposed to get another vaccine within the next year, and 26% believed additional dose(s) would be due in more than a year. One in five (19%) said their teen does not need any more vaccines, while 36% did not know about the need for additional vaccines.

Parents named the doctor’s office as the primary way they know when their teen is due for another vaccine: either because the doctor’s office scheduled an appointment for vaccination (44%), the doctor or nurse mentioned vaccination while the parent/teen were at a doctor visit (40%), and/or the doctor’s office sent a reminder that a vaccine was due (11%). Infrequently, parents received a notice from their teen’s school (10%), health plan (1%) or the public health department (0.3%). Ten percent of parents weren’t sure how they would know when a vaccine is due.

Timing of teens' next vaccine: Sooner, later, or never?

Highlights

Among parents of teens age 13-17:

  • Most parents think their teen has received all recommended vaccines, despite national data suggesting otherwise.
  • Over one third of parents do not know when or if their teen is due for another vaccine.
  • Parents expect child health providers to guide them on teen vaccines, by scheduling appointments or sending reminders.

Implications

This Mott Poll indicates that many parents likely overestimate their teens’ vaccination status. Over 90% of poll respondents thought their teen had received all vaccines recommended for that age, but CDC data indicate that nationally, only one third of teens have received the second dose of meningitis vaccine by age 17. Similarly, less than half of boys age 13-17 have completed the HPV vaccine series, and less than half of adolescents receive an annual flu shot.

Knowledge gaps about adolescent vaccine recommendations play a role, as over half of the parents in this poll did not know their teen was due for additional vaccines. This lack of awareness may reflect the evolution of the US immunization schedule, where adolescent vaccine recommendations have undergone numerous changes. Since 2006, the CDC has recommended that at age 11-12, around the time of middle school entry, children receive pertussis and meningitis vaccines, and begin the multi-dose HPV vaccine series. More recent recommendations include a second dose of meningococcal vaccine for all teens, and an option to receive a newer vaccine that protects against meningitis B. Many states have vaccination requirements at middle school entry, which compel parents to bring children for vaccination. In contrast, few states have added requirements for vaccines recommended in the later teen years.

Flu vaccine is recommended every year for all ages, yet only 1 out of 5 Mott Poll respondents thought their teen was due for another vaccine within the next year. These results suggest that many parents may still think of flu vaccine as primarily for older adults and people with chronic disease, yet every year healthy teens face serious complications from influenza.

It is clear from this Mott Poll that parents view their teen’s health care provider as the main source of information about when their teen is due for another vaccine. Nearly half of parents believe the provider will schedule an appointment when the teen’s next vaccine is due. This is common during the early childhood period, when practices schedule the child’s next well-child visit to coincide with the timing of vaccine doses. However, as children get older and well-child visits occur less frequently, both parents and practices find it difficult to schedule a year or more in advance. Thus, parents may perceive that a lack of scheduled appointment means that no vaccines are due.

Another challenge is many adolescents do not have regular well-child visits, and busy child health practices may not address vaccines during brief visits for illness or injury. When teens go for several years without a well visit, there is limited opportunity for the doctor or nurse to discuss vaccines during a visit – which may contribute to parent beliefs that no additional vaccines are needed. For this reason, techniques such as reminder notices or phone calls from child health providers can serve an important function in raising parents’ awareness about teen vaccines.

To address the challenge of teen vaccines, the CDC recently revised the format of its recommended vaccine schedule to put a focus on age 16 years, to ensure that teens receive the second dose of meningococcal vaccine on time, to provide an opportunity to catch up on any remaining doses of HPV or other vaccines, and to discuss the new meningococcal B vaccine. This new schedule may help providers put more of a focus on the unique needs of older teens, including scheduling well-child visits at age 16 to address immunizations and other aspects of preventive care.

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Data Source & Methods

This report presents findings from a nationally representative household survey conducted exclusively by GfK Custom Research, LLC (GfK), for C.S. Mott Children’s Hospital. The survey was administered in January 2017 to a randomly selected, stratified group of parents age 18 and older (n=2,001). Adults were selected from GfK’s web-enabled KnowledgePanel® that closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 61% among panel members contacted to participate. This report is based on responses from 614 parents who had at least one teen age 13-17 years. The margin of error is ±1 to 4 percentage points.

Findings from the C.S. Mott Children’s Hospital National Poll on Children’s Health do not represent the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

Citation

Clark SJ, Gebremariam A, Singer DC, Kauffman AD, Schultz SL, Freed GL. Parents not keeping up with teen vaccines. C.S. Mott Children's Hospital National Poll on Children's Health, University of Michigan. Vol 29, Issue 4, July 2017. Available at: http://mottpoll.org/reports-surveys/parents-not-keeping-teen-vaccines.

Poll Questions