Parents not keeping up with teen vaccines

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.