Meningococcal conjugate vaccination among adolescents aged 13-17 years, United States, 2007
ABSTRACT An estimated 1000-2000 cases of invasive meningococcal diseases occur annually in the United States. In 2005, a new quadrivalent meningococcal conjugate vaccine (MCV4) was approved and, because of supply constraints, was recommended for routine vaccination of some groups of adolescents. In August 2007, vaccination recommendations were expanded for all adolescents 11-18 years.
We analyzed data from the 2007 National Immunization Survey-Teen (NIS-Teen), a nationally representative random digit dialed telephone survey. Estimates of MCV4 coverage were assessed from provider-reported vaccination histories. A multivariable logistic regression analysis and predictive marginal model were performed to identify factors independently associated with MCV4 vaccination.
Provider-reported vaccination histories were available for 2947 adolescents aged 13-17 years with a response rate of 55.9%. Overall, MCV4 coverage was 32.4% (95% confidence interval (CI)=30.2-34.7%) in 2007. Vaccination coverage was similar among adolescents aged 13-14 years compared to those aged 15-17 years (32.1% vs. 32.6%, respectively). Coverage was 30.6% for non-Hispanic whites, 35.9% for non-Hispanic blacks, and 36.1% for Hispanics; however, these variations were not statistically significant. Characteristics independently associated with a higher likelihood of MCV4 vaccination included having > or =2 physician contacts in the past year, having a well child visit at age 11-12 years, and ever having a doctor recommendation for meningitis vaccination of the adolescent.
In 2007, MCV4 coverage among 13-17 years old increased 20.7 percentage points from 2006. Achieving high vaccination coverage among adolescents will be challenging. Targeting adolescents with no health insurance and no recent healthcare provider visits may be important to increase coverage.
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ABSTRACT: We compared (1) characteristics of adolescents who are and are not entitled to receive free vaccines from the Vaccines for Children (VFC) program and (2) vaccination coverage with meningococcal conjugate (MCV4), quadrivalent human papillomavirus (HPV4), and tetanus-diphtheria-acellular pertussis (Tdap) vaccines among VFC-eligible and non-VFC-eligible adolescents. We analyzed data from the 2009 National Immunization Survey-Teen, a nationally representative, random-digit-dialed survey of households with adolescents aged 13-17 years (n = 20,066). Differences in sociodemographic characteristics and provider-reported vaccination coverage were evaluated using t-tests. Overall, 32.1% (+/- 1.2%) of adolescents were VFC-eligible. VFC-eligible adolescents were significantly less likely than non-VFC-eligible adolescents to be white and to live in suburban areas, and more likely to live in poverty and to have younger and less educated mothers. Nationally, coverage among non-VFC-eligible adolescents was 57.1% (+/-1.5%) for > or = 1 dose of Tdap, 55.4% (+/-1.5%) for > or = 1 dose of MCV4, and 43.2% (+/- 2.2%) for > or = 1 dose of HPV4. Coverage among VFC-eligible adolescents was 52.5% (+/- 2.4%) for > or = 1 dose of Tdap, 50.1% (+/- 2.4%) for > or = 1 dose of MCV4, and 46.6% (+/- 3.5%) for > or =1 dose of HPV4. Only 27.5% (+/- 1.8%) of non-VFC-eligible adolescents and 25.0% (+/- 2.9%) of VFC-eligible adolescents received > or = 3 doses of HPV4. Vaccination coverage was significantly higher among non-VFC-eligible adolescents for Tdap and MCV4, but not for one-dose or three-dose HPV4. Conclusions. Coverage with some recommended vaccines is lower among VFC-eligible adolescents compared with non-VFC-eligible adolescents. Continued monitoring of adolescent vaccination rates, particularly among VFC-eligible populations, is needed to ensure that all adolescents receive all routinely recommended vaccines.Public Health Reports 01/2011; 126 Suppl 2:124-34. DOI:10.2307/41639292 · 1.64 Impact Factor
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ABSTRACT: We performed a mail-based survey of health education teachers in 6 states with diverse health education environments to better understand health education curricula in secondary schools related to adolescent vaccination and human papillomavirus (HPV) infection. Of the 198 respondents (response rate 68%), 66% and 71% reported teaching adolescents about recommended vaccines and HPV, respectively. Middle schools were significantly less likely to include these topics in their health curriculum than high schools even though middle schools are generally the school type attended by 11-12 year olds, the preferred target age for adolescent vaccination and HPV prevention activities.Vaccine 10/2010; 28(44):7179-83. DOI:10.1016/j.vaccine.2010.08.066 · 3.49 Impact Factor
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ABSTRACT: Cultivating healthy workplaces is a critical aspect of comprehensive worksite health promotion. The influence of healthy workplace exposures on employee health outcomes warrants research attention. To date, it is unknown if nature contact in the workplace is related to employee stress and health. This study was designed to examine the effects of nature contact experienced at work on employee stress and health. Office staff at a southeastern university (n = 503, 30% response rate) participated in the cross-sectional study. We used a 16-item workplace environment questionnaire, the Nature Contact Questionnaire, to comprehensively measure, for the first time, nature contact at work. The Perceived Stress Questionnaire and 13 established health and behavioral items assessed the dependent variables, general perceived stress, stress-related health behaviors, and stress-related health outcomes. There was a significant, negative association between nature contact and stress and nature contact and general health complaints. The results indicate that as workday nature contact increased, perceived stress and generalized health complaints decreased. The findings suggest that nature contact is a healthy workplace exposure. Increasing nature contact at work may offer a simple population-based approach to enhance workplace health promotion efforts. Future researchers should test the efficacy of nature-contact workplace stress interventions.Public Health Reports 01/2011; 126 Suppl 1:124-30. DOI:10.2307/41639273 · 1.64 Impact Factor