Studies give a shot in the arm to promoting vaccination
MedWire News: Schools can play an important role in promoting vaccination of children and adolescents, suggest investigators in studies from two groups.
In a demonstration study, 265 girls in the Denver, Colorado public school system who were missing one or more recommended adolescent vaccinations received reminders about the need for additional immunizations.
At the end of the 6-month study, 77% of the girls had received one or more vaccines, and 45% had received all of their recommended adolescent immunizations. In all, 68% received needed vaccines for tetanus toxoid, reduced diphtheria toxoid and acellular pertussis, 57% received quadrivalent meningococcal conjugate vaccine, and 59% received the first human papillomavirus vaccine.
Allison Kempe (University of Denver, Colorado) and team also conducted a randomized controlled trial in which 264 sixth-grade boys were assigned to receive either reminders or usual care. In all, 66% of boys assigned to receive reminders received at least one recommended vaccine, and 59% received all study vaccines. The cost of the recall program was estimated to range from $ 1.12 to 6.87 per child immunized.
In a second study, investigators from the National Center for Immunization and Respiratory Diseases in Atlanta, Georgia, examined whether middle school vaccination requirements were associated with better vaccine coverage of adolescents.
Erin Bugenske and co-workers looked at middle-school entry requirements for three recommended vaccines in all 50 states and the District of Columbia for the 2008-2009 school year. The vaccines were tetanus/diphtheria-containing (Td) or tetanus/diphtheria/acellular pertussis (TdaP), meningococcal conjugate (MenACWY), and human papillomavirus. Some states required only that parents/guardians be given information about the vaccine-preventable diseases covered by the immunization; others had no patient-education requirements.
In all, 32 states had requirements for Td or TdaP, with 14 specifically requiring TdaP; no states required patient education about this vaccine. Three states required MenACWY vaccine and 10 others required only education. Only one state (Virginia) required HPV vaccine, and five required education.
The authors found that compared with states without vaccine or education requirements, immunization requirements were associated with significantly higher coverage for MenACWY (71 vs 53%) and Td/TdaP (80 vs 70%). Education-only requirements did not improve coverage levels.
By Neil Osterweil