Varicella vaccination among US adolescents: coverage and missed opportunities, 2007–2014
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Varicella vaccination among US adolescents: coverage and missed opportunities, 2007–2014

  • Published Date:

    2019 May/Jun

  • Source:
    J Public Health Manag Pract. 25(3):E19-E26
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  • Alternative Title:
    J Public Health Manag Pract
  • Description:
    Context: Since 2007, 2 doses of varicella vaccine have been routinely recommended, with a catch-up second dose recommended for those who received only 1 prior dose. Objective: To examine ≥2-dose varicella vaccination coverage and the proportions of adolescents with evidence of immunity to varicella (≥2 doses of vaccine or varicella history) during 2007–2014. To assess timing of second-dose receipt, factors associated with ≥2 dose vaccination, and missed second dose opportunities during 2014. Design, Setting and Participants: We used data from the 2007–2014 National Immunization Survey–Teen (NIS-Teen), which collects information on adolescents ages 13–17 years in the United States. Results: From 2007 to 2014, ≥2-dose varicella vaccination coverage increased from 8.3% to 66.9% in 13–15 year-olds, and from 3.6% to 56.7% in 16–17 year-olds. The proportions with evidence of immunity also increased from 68.0% to 84.1% (13–15 year-olds) and 78.6% to 83.4% (16–17 year-olds). In 2014, 13.4% of 13–15 year-olds and 3.2% of 16–17 year-olds had received their second dose at 4–6 years. Factors most significantly associated with lower ≥2-dose coverage were not having a 11–12 year well-child visit, not receiving an adolescent vaccine, and residence in a state with no 2-dose immunization school entry requirement. Seventy-seven percent of 1-dose vaccinated adolescents had ≥1 missed opportunity to receive their second dose; were they not missed, 2-dose coverage would have increased from 79.5% to 94.8%. Conclusions: Levels of ≥2-dose varicella vaccination coverage and the proportion of adolescents with evidence of immunity increased from 2007 to 2014, though 16% lacked evidence of immunity in 2014. Though catch-up campaigns have succeeded, missed vaccination opportunities persist.
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