News & Views: Test Yourself on the State of Teen Vaccines (NIS-Teen)

The August 25, 2023, Morbidity and Mortality Weekly Report (MMWR) included data from the latest National Immunization Survey of Teens (NIS-Teen). The NIS-Teen is similar to the similarly named NIS used to track immunization coverage among infants, except that the focus is on 13- to 17-year-olds. Using a random-digit-dialed telephone survey, households are invited to participate if they include a child in the appropriate age range. In addition to answering questions about their household, they are asked permission for their child’s healthcare provider to complete a survey related to immunizations the child has had. The 2022 NIS-Teen represents data from just over 16,000 adolescents born between January 2004 and January 2010.

To see whether your sense of vaccine coverage among teens aligns with the data, check yourself with these questions, based on the MMWR article.

Questions

Scroll down for answers.

Q 1. Vaccine coverage among teens born in which years were most affected by the COVID-19 pandemic?

1. 2006 and 2007
2. 2007 and 2008
3. 2008 and 2009
4. 2009 and 2010

Q 2. Between 2015 and 2021, more teens covered by Medicaid received at least one dose of HPV vaccine compared with those covered by private insurance. What did the 2022 survey show?

1. The trend reversed, so that those covered with private insurance are now more vaccinated.
2. The findings were similar.
3. The differences expanded to make an even wider gap between these groups.
4. The coverage among Medicaid patients decreased, resulting in similar coverage rates between the groups.

Q 3. In the NIS-Teen, “up to date” on HPV vaccine was defined as two or three doses (depending on age at first receipt) and proper interval between doses. What is the approximate percentage drop in up-to-date HPV vaccination compared with those who had at least one dose of HPV vaccine?

1. 20%
2. 15%
3. 10%
4. 5%

Q 4. VFC vaccine ordering data supported findings related to which vaccine in the 2022 NIS-Teen data?

1. Tdap
2. Meningococcal ACWY
3. HPV
4. Meningococcal B

Bonus question! Twenty-five years of the varicella vaccine program was recently celebrated (1995-2020). In the 2022 survey, what total percent of 13- to 17-year-olds had a “history of varicella disease” as reported by the parent, guardian or provider?

1. 5%
2. 7%
3. 9%
4. 11%

Answers

A 1. The answer is C. Children born during 2008 and 2009 turned 12 or 11, respectively, during 2020, so many of them missed their typical adolescent well visits.

To do: As you look at charts, watch for these birth years and make sure the teens you see have every opportunity to catch up!

A 2. The answer is D. Fewer Medicaid patients were vaccinated against HPV, causing the numbers to be similar for teens covered by Medicaid and those covered by private insurance.

To do: Make sure all patients are getting HPV vaccine, working to at least reach pre-pandemic levels of coverage among your families.

A 3. The answer is A. An approximate 20% drop in coverage resulted when comparing up-to-date status versus start of HPV vaccination.

To do: Consider whether teens in your practice are not getting their final doses of HPV vaccine, so that you and your team can address local barriers to follow-up doses.

A 4. The answer is C. While Vaccines for Children (VFC) orders for other vaccines have returned to pre-pandemic levels, HPV vaccine orders have not, leaving teens susceptible to this virus that will cause cancer in some of them during their adult years.

To do: Check your pre- and post-pandemic vaccine orders. Are they back to pre-pandemic levels? If not, can you discern why?

Bonus question! The answer is B. About 7% of teens have had varicella. Before the vaccine, the estimated number of annual cases was about 4 million per year, with about 90% of cases occurring in those younger than 15 years of age. How about that vaccine?

To do: Celebrate this success and make sure your patients and families hear about these types of success stories too!