SEATTLE -- Seattle doctors are rarely talking to adolescent patients about recommended vaccines, a new study reports.
A team of researchers at the Seattle Children’s Research Institute reviewed health records for 1,628 patients ages 11 to 18 at the University of Washington’s Pediatric Care Center from November 2006 through June 2011. Doctors failed to suggest vaccines to patients in up to 85 percent of clinic visits.
Patients in this age range should be offered vaccines for tetanus, diphtheria and pertussis, human papillomavirus and meningococcal disease, according to the study’s lead author, Dr. Rachel Katzenellenbogen.
“Reducing these missed vaccination opportunities would improve young people’s health, including the risk for certain types of cancer and sexually transmitted infections,” she said.
Katzenellenbogen said more research is needed to explore why the percentage of missed opportunities is so high, but co-author Dr. Jeff Wright said part of the problem might be that adolescents tend to require less primary care compared to younger children. The study showed patients who had at least one preventive care visit, such as a yearly check-up, were less likely to have missed opportunities for some vaccinations.
“When they come in it’s often for a specific concern – an injury or illness,” Wright said. “That’s not always the best time to offer vaccines.”
Wright said there is also a higher rate of vaccine refusal in the Pacific Northwest compared to other parts of the country, especially when it comes to the HPV vaccine.
“Parents have a hard idea adjusting to the idea that their kids are going to grow to become adults and be sexually active,” Wright said. “Usually it takes a few conversations.”
Wright said many parents don’t understand the importance of preventing diseases like whooping cough or meningitis because they likely have never known anyone infected with the illnesses.
Adolescents are also likely to refuse vaccines because they are afraid of needles, Wright said.
“We use distraction techniques, numbing spray, hold hands, whatever it takes to get them through it,” he said.
Wright recommends clinics use computerized prompts through an electronic health record or even manual flags on a chart or record by nurses or medical assistants to indicate which vaccines a patient might need.
“Anytime a kid in this age group comes in for any reason we should think about [vaccines] – not just during checkups,” Wright said. “This may be the one chance to give them the opportunity to get vaccinated.”