Keen on teen vaccines: improvement of adolescent vaccine coverage in rural North Carolina.

PURPOSE: To improve adolescent immunization coverage in a rural North Carolina county. METHODS: Adolescent immunization coverage rates in an intervention and four comparison counties were compared over 1 year. We introduced practice-based interventions in seven practices centering on immunization registry-driven recall of adolescents for immunizations with postcard reminders (Phase 1), and 6 months later employed nontargeted school-generated telephone reminders to parents of adolescents (Phase 2). RESULTS: Improvements in the intervention county among 11- to 12-year-olds occurred for first-dose human papillomavirus vaccine in both boys (overall change, 14.2%-32.1%) and girls (27.4%-43.4%) and the meningococcal vaccine (34.6%-49.4%). Improvements among adolescents 13-18 years were limited to human papillomavirus vaccine completion in boys (1.6%-4.2%). Improvements were greater during Phase 1 than Phase 2 and among younger adolescents. Coverage improvements in the comparison counties were smaller than those observed in the intervention county. CONCLUSIONS: A resource-light two-phase intervention led to modest improvements in immunization coverage, most notably in the largest adolescent practice in the county, and suggested potential for further gains, particularly among younger adolescents.

Duke Scholars

Author Emmanuel Benjamin Walter Jr. Pediatrics, General Pediatrics and Adolescent Health