Overcoming barriers to adolescent vaccination: perspectives from vaccine providers in North Carolina

To capture strategies for achieving high adolescent coverage of tetanus-diphtheria-acellular pertussis (Tdap), meningococcal conjugate (MenACWY), and human papillomavirus (HPV) vaccination, we surveyed employees of 20 North Carolina (N.C.) clinics that achieved adolescent vaccination coverage higher...

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Bibliographic Details
Published in:Women & health 2020-11, Vol.60 (10), p.1129-1140
Main Authors: Vielot, Nadja A., Islam, Jessica Yasmine, Sanusi, Busola, Myers, Jenny, Smith, Sara, Meadows, Beth, Brewer, Noel T., Smith, Jennifer S.
Format: Article
Language:English
Subjects:
Abbreviations
Adolescent
Adolescents
Advisory Committees
Barriers
Clinics
Conjugates
Diphtheria
Diphtheria-Tetanus-acellular Pertussis Vaccines - administration & dosage
Disease control
Disease prevention
Electronic health records
Electronic medical records
Employees
Female
Health Education
Health Knowledge, Attitudes, Practice
Health problems
Health Services Accessibility
Human papillomavirus
Humans
Immunization
Male
Medical records
meningococcal conjugate vaccine
Meningococcal Vaccines - administration & dosage
North Carolina
Pain
Papillomavirus Vaccines - administration & dosage
Parental behavior
Parents
Parents & parenting
Pertussis
providers
Sexual behavior
Teenagers
Tetanus
tetanus-diphtheria-acellular pertussis
Vaccination
Vaccination - statistics & numerical data
Vaccination Coverage
Vaccines
Whooping cough
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Summary:To capture strategies for achieving high adolescent coverage of tetanus-diphtheria-acellular pertussis (Tdap), meningococcal conjugate (MenACWY), and human papillomavirus (HPV) vaccination, we surveyed employees of 20 North Carolina (N.C.) clinics that achieved adolescent vaccination coverage higher than the state average. One employee per clinic completed a surveysummarizing clinic practices regarding adolescent vaccination; perceived barriers and facilitators to Tdap/MenACWY/HPV vaccination; and the role of "champions" who made special efforts to promote adolescent vaccination. Common perceived barriers for all vaccinations were parental opposition and logistical barriers to receiving vaccination. For HPV vaccination, employees cited parental concerns about sexual behavior and injection site pain; no school vaccination requirement; and low-perceived benefit in boys. Most clinics (80%) implemented successful changes to increase adolescent vaccination: consistently offering vaccination, tracking vaccination status using existing data, providing appointment reminders, updating providers on vaccination recommendations, and expanding vaccination hours. Strategies to improve HPV vaccination included co-administration with Tdap and MenACWY, and providing reminders to complete the vaccination series. Vaccine champions strongly recommended vaccination to parents (55%) and educated parents on vaccination recommendations (36%). Clinics in N.C.and similar settings can implement these and other low-resource strategies to overcome adolescent vaccination barriers. CDC=Centers for Disease Control and Prevention; EHR=Electronic health record; HPV=Human papillomavirus; Tdap=Tetanus-diphtheria-acellular pertussis vaccine; MenACWY=Meningococcal Conjugate Vaccine; NCIB=North Carolina Immunization Branch; NCIR=North Carolina Immunization Registry; ACIP=Advisory Committee on Immunization Practices
ISSN:0363-0242
1541-0331
DOI:10.1080/03630242.2020.1802639