MedicalResearch.com Interview with:
S. Hughes Melton, MD, MBA, FAAFP
AAFP Foundation president
MedicalResearch: What is the background for this initiative? What are the main vaccinations that teens should have?
Response: The Centers for Disease Control and Prevention (CDC) recommends adolescents receive four immunizations – two of which are administered as multi-dose series – to help protect against meningococcal meningitis caused by serogroups A, C, W and Y; human papillomavirus (HPV); tetanus, diphtheria and pertussis (Tdap); and influenza (flu).1 Despite these recommendations, millions of teens remain vulnerable to serious infectious disease.2,3
Family physicians are well equipped to immunize their patients against a host of common infectious diseases and improve public health. However, discussing teen vaccinations during annual appointments may present challenges due to other issues teens and their parents/guardians may be focused on at this age. The American Academy of Family Physicians Foundation (AAFP Foundation) launched Highlight on VACCINATIONS 4 TEENS to help remind family physicians and their care teams to make immunization a priority at these key appointments for teens.
MedicalResearch: What recommended vaccinations are teens more likely to not receive?
Response: Despite CDC recommendations, in 2015 only 33 percent of adolescents who received the first dose of MenACWY vaccine received the recommended second dose, only 42 percent of girls and 28 percent of boys completed the HPV vaccine series, and less than half of adolescents 13 through 17 years of age were vaccinated against the flu. While the majority (86 percent) of teens had received the Tdap booster, there is still room for improvement.2,3,4 While the rates for all of these important vaccinations could be higher, they are particularly low for the second dose of MenACWY, the complete HPV vaccine series and flu vaccination.
The CDC recommends a first dose of the MenACWY vaccine to help protect against meningococcal meningitis at age 11-12 years and a second dose at age 16 years because protection from the vaccine wanes within five years. The two doses help protect teens during the years they are at increased risk.5 The 2017 Childhood and Adolescent Immunization Schedule now features a specific 16-year-old immunization platform visit to highlight the importance of scheduling 16-year-old adolescent patients for necessary vaccinations to help protect them against serious infectious diseases.6
To help protect against HPV, the Advisory Committee on Immunization (ACIP) voted last year to recommend a two-dose series if the first dose is received before age 15, in which case the CDC recommends both doses at least six months apart. Teens and young adults who start the series later, at ages 15 through 26, are recommended to receive three doses to help protect against potentially cancer-causing HPV infection.7 While the HPV vaccine is recommended for boys and girls at age 11 or 12 to help protect them before ever being exposed to HPV, teens who are not yet vaccinated should be.8
Persons six months of age and older, including preteens and teens, should get the flu vaccine every year, ideally by the end of October; however, vaccination should continue through January or even later since the flu virus can continue to circulate into May. Preteens and teens who have health problems like diabetes or asthma are at greater risk for complications from the flu, but even healthy preteens and teens can get very sick.9
MedicalResearch: How will the Highlight on VACCINATIONS 4 TEENS program encourage more teens to be vaccinated?
Response: With support from Sanofi Pasteur, 15 American Academy of Family Physicians Chapters each received a $5,000 grant to bring this program to members. The 15 AAFP Chapters were chosen through the AAFP Foundation’s Family Medicine Philanthropic Consortium. The program provides financial support for Chapters to host a multi-disciplinary panel discussion featuring local immunization champions. Some panels will also feature family members who have been impacted by under-vaccination. Events have already been held in Oklahoma, New Jersey and Montana, with 12 more events planned by the end of 2017.
Additionally, all 125,000 AAFP members will receive access to the program’s library of resources, which help family physicians, their care teams and office staffs speak with teens and their families about recommended immunizations. Educational videos are featured to help health care professionals better understand the 2017 Childhood and Adolescent Immunization Schedule and discuss recommended immunizations with their patients. The resource library also includes patient educational materials such as appointment reminders, personal testimonials from families who have been impacted by under-vaccination, videos, in-office posters and digital content.
To learn more about the AAFP Foundation or Highlight on VACCINATIONS 4 TEENS, including the full list of Chapters who received grants, please visit www.aafpfoundation.org/vaccinations4teens.
- Centers for Disease Control and Prevention (2016). Vaccines for Your Children: Protect Your Child at Every Age. Retrieved from http://www.cdc.gov/vaccines/parents/protecting-children/index.html.
- Centers for Disease Control and Prevention. (2016). National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2015. Retrieved from http://www.cdc.gov/mmwr/volumes/65/wr/mm6533a4.htm?s_cid=mm6533a4_e.
- United States Census Bureau. (2013). Age and Sex Composition in the United States. Retrieved from https://www.census.gov/data/tables/2013/demo/age-and-sex/2013-age-sex-composition.html. Accessed June 26, 2017.
- Centers for Disease Control and Prevention. (2015, September 29). Flu Vaccination Coverage, United States, 2015-16 Influenza Season. Retrieved from http://www.cdc.gov/flu/fluvaxview/coverage-1516estimates.htm.
- Centers for Disease Control and Prevention. (2011, January 28). Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report (MMWR). Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6003a3.htm.
- Centers for Disease Control and Prevention (2017). Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger, UNITED STATES, 2017. Retrieved from https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-combined-schedule-bw.pdf.
- Meites E, Kempe A, Markowitz LE. Use of a 2-Dose Schedule for Human Papillomavirus Vaccination — Updated Recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep 2016;65:1405–1408. Retrieved from http://dx.doi.org/10.15585/mmwr.mm6549a5.
- Centers for Disease Control and Prevention. (2015, December 3). HPV Vaccine for Preteens and Teens. Retrieved from http://www.cdc.gov/vaccines/parents/diseases/teen/hpv.html.
- Centers for Disease Control and Prevention. (2016, October 28). Influenza (Flu): Key Facts About Influenza (Flu). Retrieved from https://www.cdc.gov/flu/keyfacts.htm.