Reminding both teens and their parents about missed shots may help increase vaccination rates, a new study suggests. Teens in the study were ages 13 through 17. All of them were missing at least 1 recommended shot. They were randomly divided into 3 groups. One group received reminder phone calls to parents from the doctor's office. Another group received reminders for both the parents and the teens. People in the third group were not contacted. Vaccination rates increased in the next month for teens who received reminders for themselves and their parents. The other groups did not show this improvement. But any differences were gone a year later. Doctors also had problems reaching many of the teens and their parents. The journal Pediatrics published the study online August 20.

By Henry H. Bernstein, D.O.
Harvard Medical School

What Is the Doctor's Reaction?

Immunization rates for teenagers are well below where they should be. As children get older, their protection from early vaccines may begin to wear off. Some teens also may be at higher risk for certain infections because of their age or health status. The infections include meningitis, which affects the coverings of the brain.

Taking time out of their schedules to get vaccines is not a high priority for most teens. Between friends, school, after-school activities and homework, teenagers are busy.

So how can we be sure teens have received all the vaccines they need? Experts are always looking for ways to improve.

A new study in the journal Pediatrics looks at the effects of one program. Researchers tried contacting teens, their parents or both about the shots the teens had missed. The idea was that immunization rates might increase when both the parent and the child were contacted.

Teens in this study were 13 to 17 years old. Each one was missing at least one recommended vaccine. The teens were divided into 3 groups:

• Group 1: No outreach efforts were made about missing vaccines.
• Group 2: Parents or guardians were called and told their teens were overdue for a vaccine. The caller also offered to schedule an appointment for the vaccine.
• Group 3: The parent or guardian and the teen were called and told the teen was overdue for a vaccine. Again, the caller offered to schedule an appointment.

The researchers found better vaccine rates in Group 3 than in the other 2 groups. Making contact with both the parent and the child increased the likelihood of the child getting the missing vaccine dose within 4 weeks. However, this improvement did not last long. The improved rates were not seen a year later.

Although calling the parent and the teen worked, researchers also found a problem with it. Many parents and teens could not be reached, even after four tries. This shows how important it is for pediatric offices to keep up-to-date contact information for all patients and their parents.

What Changes Can I Make Now?

Make sure your teen is up to date with his or her vaccines. The newest recommendations include:

• Tdap vaccine -- This booster protects against tetanus, diphtheria and whooping cough (pertussis). Children get similar vaccines as infants, but their protection (immunity) may begin to wear off. Your child should get a single dose of Tdap if he is:
  
  • 11 or 12 years old
  • 13 years or older and has not yet had this new vaccine
  • 7 to 10 years old and did not get all doses of pertussis vaccines as an infant or preschooler


• MCV4 vaccine -- This vaccine helps to protect against meningococcal disease. There are 1,000 to 2,000 cases of this disease each year in the United States. Even with treatment, many people die or are disabled. Vaccination is the best way to keep children healthy. Your child should receive MCV4 based on her age:
  
  • 11 or 12 years old: Get 1 dose now and a booster at age 16.
  • 13 to 15 years old (and never had this vaccine): Get 1 dose now and a booster at age 16 to 18.
  • 16 years or older (and never had this vaccine): Get 1 dose now, especially if your child is about to go to college or join the military.


• HPV vaccine -- This vaccine helps protect against the types of human papilloma virus that cause cancer of the cervix, penis, anus, head and neck. It can also help protect against genital warts. HPV vaccine is now recommended for all girls and boys:
  
  • Children 11 or 12 years old get 3 doses over 6 months.
  • If your teenager has never had this vaccine, talk with the doctor about getting it now.


• Influenza vaccine -- This vaccine protects against the viruses predicted to be causing the flu this season. It is especially important for children with chronic medical conditions, such as asthma and diabetes. Your child should receive flu vaccine every year beginning at age 6 months.

What Can I Expect Looking to the Future?

Expect to hear more about teen vaccines from your child's doctor. It is very important that every teen be protected against these serious diseases.

All teens need an increasing number of vaccines, so doctors are likely to bring up vaccines at each visit to the office. You may even receive a phone call if your child is missing some recommended vaccines.

Researchers also are studying other ways to contact patients about missing vaccines. Newer ways include e-mail, texting, social media and school-based outreach.