Improving Rates of Routine Vaccinations in Adolescents at an Academic Children's Hospital

Area of Science:

• Adolescent Medicine
• Public Health Interventions
• Vaccinology

Background:

• Low vaccination completion rates in adolescents pose a public health concern.
• Ensuring equitable vaccine administration across diverse patient populations is crucial.

Purpose of the Study:

• To increase overall vaccination completion rate to 95% in an adolescent medicine practice.
• To improve rates of specific adolescent vaccinations, including meningococcal, human papillomavirus (HPV), and tetanus, diphtheria, and pertussis (Tdap), to 80%.
• To assess the impact of interventions on healthcare equity.

Main Methods:

• Utilized the Model for Improvement framework.
• Implemented a bundled intervention including record retrieval, provider notifications, and electronic medical record (EMR) alerts.
• Incorporated patient vaccine education and utilized numbing spray to address needle-related hesitancy.

Main Results:

• Achieved a shift in complete vaccination records from 88% to 95%.
• Increased combined meningococcal, HPV, and Tdap vaccination completion from 70% to 76%.
• Observed improvements across all racial and payer subgroups, reducing observed disparities.

Conclusions:

• Bundled interventions effectively increased vaccine documentation and administration rates.
• High nursing staff engagement and technological integration were key drivers of success.
• The project demonstrated a pathway to more equitable adolescent vaccination practices.