The impact of a school entry law on adolescent immunization rates

Wilson, Thad; Fishbein, Daniel B.; Ellis, Peggy; Edlavitch, Stanley A.

doi:10.1016/j.jadohealth.2005.07.009

Cited by 67 publications

(42 citation statements)

References 12 publications

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“…Anecdotal evidence from some states suggests that enforcement of school-entry laws may be less strict for this reason. 28 Correspondingly, costs associated with more vigorous efforts to promote vaccination are more prohibitive.…”

Section: Barriers To School Involvementmentioning

confidence: 99%

The Role of Schools in Strengthening Delivery of New Adolescent Vaccinations

et al. 2008

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Schools offer an opportunity to deliver new vaccines to adolescents who may not receive them in their medical home. However, school budgets and health priorities are set at the local level; consequently resources devoted to health-related activities vary widely. Partnering with schools requires soliciting buy-in from stakeholders at district and school levels and providing added value to schools. With appropriate resources and partnerships, schools could carry out vaccination-related activities from educating students, parents, and communities to developing policies supporting vaccination, providing vaccines, or serving as the site at which partners administer vaccines. Activities will vary among schools, but every school has the potential to use some strategies that promote adolescent vaccination.W ITH 3 NEW vaccines for adolescents recommended since 2005, and more on the way, effective mechanisms for delivering adolescent vaccinations are increasingly important. Because school occupies a significant part of most adolescents' lives, the potential range of roles for schools in adolescent vaccination, from education and promotion to vaccine administration, deserves special attention. Schools must devote significant energy to complying with numerous mandatory accountability measures as they fulfill their primary educational purpose, but every school has the potential to promote adolescent vaccination. Including schools as partners in promoting adolescent vaccination will complement other efforts and offer considerable access to an often hard-to-reach group.The information presented in this article rests on 3 assumptions. First, schools are not intended to replace the medical home as the primary location for vaccination of adolescents. Instead, vaccination-related activities in schools can supplement care received in the medical home. Therefore, we have focused this report on information and solutions that can be implemented in the current policy environment rather than the significant changes that would be needed to make schools the primary avenue for delivery of routine adolescent vaccinations. Second, the extent to which any strategy is implemented will vary according to vaccine and school, although every school can undertake vaccination-related activities at some level. Third, variable resources and competing priorities must be taken into account when considering options for addressing vaccination in school health programs. Issues such as pregnancy, sexually transmitted diseases, drug and alcohol abuse, obesity, and violence will often take precedence. 1 Based on these assumptions, we explore the role of schools in strengthening the delivery of vaccinations to adolescents by reviewing the current scope of school health resources, the history of US experience with school-based vaccination, and potential barriers to vaccination activities in schools. Laws that require vaccination for school attendance, which are known to be highly effective, are covered elsewhere in this supplement. 2 We have drawn on www...

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Section: Barriers To School Involvementmentioning

confidence: 99%

The Role of Schools in Strengthening Delivery of New Adolescent Vaccinations

et al. 2008

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“…59 In addition, many states currently have middle and high school vaccination laws for hepatitis B and tetanus and diphtheria toxoids vaccines, and studies have demonstrated that state laws increase coverage levels for mandated vaccines. [60][61][62] One study compared rates of preventive visits among adolescents aged 11 to 15 years who were residing in states with and without middle school laws for the hepatitis B vaccine. 63 In addition to increasing coverage for hepatitis B vaccine, the presence of a hepatitis B vaccination law was associated with increased likelihood of having a preventive health care visit (77% with a law versus 66% without a law).…”

Section: Opportunitiesmentioning

confidence: 99%

Adolescent Immunizations and Other Clinical Preventive Services: A Needle and a Hook?

et al. 2008

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Advances in technology have led to development of new vaccines for adolescents, but these vaccines will be added to a crowded schedule of recommended adolescent clinical preventive services. We reviewed adolescent clinical preventive health care guidelines and patterns of adolescent clinical preventive service delivery and assessed how new adolescent vaccines might affect health care visits and the delivery of other clinical preventive services. Our analysis suggests that new adolescent immunization recommendations are likely to improve adolescent health, both as a "needle" and a "hook." As a needle, the immunization will enhance an adolescent's health by preventing vaccine-preventable diseases during adolescence and adulthood. It also will likely be a hook to bring adolescents (and their parents) into the clinic for adolescent health care visits, during which other clinical preventive services can be provided. We also speculate that new adolescent immunization recommendations might increase the proportion and quality of other clinical preventive services delivered during health care visits. The factor most likely to diminish the positive influence of immunizations on delivery of other clinical preventive services is the additional visit time required for vaccine counseling and administration. Immunizations may "crowd out" delivery of other clinical preventive services during visits or reduce the quality of the clinical preventive service delivery. Complementary strategies to mitigate these effects might include prioritizing clinical preventive services with a strong evidence base for effectiveness, spreading clinical preventive services out over several visits, and withholding selected clinical preventive services during a visit if the prevention activity is effectively covered at the community level. Studies are needed to evaluate the effect of new immunizations on adolescent preventive health care visits, delivery of clinical preventive services, and health outcomes. Pediatricians have a unique opportunity to influence adolescents and their families by helping young people build a strong foundation of good health that will continue into their adult lives.American Academy of Pediatrics (AAP) 1 D ELIVERING PREVENTIVE services to US adolescents* is a public health priority. 2,3 Although most US adolescents are healthy, millions of adolescents initiate behaviors and lifestyles that can adversely affect their immediate and long-term health. 4 Potentially modifiable adolescent behaviors include failure to use seat belts, unsafe operation of motor vehicles, carrying weapons, using alcohol and other drugs, unprotected sex, inactivity, and overeating. These behaviors are directly linked to injuries and death, as well as to sexually transmitted infections (STIs), unintended *The definition of "adolescent" differs across studies and organizations; in this report, an adolescent is a person aged 11 to 18 years, unless otherwise specified.www.pediatrics.org/cgi

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“…[35][36][37][38][39] Most of the evidence is based on evaluations of middle school immunization requirements for hepatitis B vaccination [35][36][37][38][39][40] (see also the article by Horlick et al 41 in this issue). State laws and accreditation incentives can be effective, but inconsistencies in the interpretation and implementation of school immunization laws contribute to variability in rates of exemptions and overall immunization rates.…”

Section: State Immunization Requirementsmentioning

confidence: 99%

Vaccinating Adolescents in High-Risk Settings: Lessons Learned From Experiences With Hepatitis B Vaccine

Sneller¹,

Fishbein²,

Weinbaum³

et al. 2008

Pediatrics

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Meeting the health needs of adolescents who live in high-risk settings such as homeless shelters, migrant camps, juvenile detention centers, prisons, and other types of residential facilities presents many challenges. Although there is no doubt that adolescents in many high-risk settings are at increased risk for hepatitis B and human papillomavirus, acute medical and psychological problems may consume all of the provider's time and resources. Potential health threats such as vaccinepreventable diseases must necessarily be given lower priority. Lack of vaccination expertise, supplies, and access to records further complicate delivery of vaccines. Since the 1990s, a number of approaches have been used to deliver hepatitis B vaccine to adolescents in many high-risk settings. Close collaboration among state and federal programs, local health departments, and community-based organizations has been necessary to introduce and sustain the delivery of vaccines to these young people. Medicaid, Statute 317 of the Public Health Service Act, the Vaccines for Children program, and State Children's Health Insurance Program have been used to finance vaccinations for adolescents 18 years or younger, and the expanded Medicaid option in the Foster Care Independence Act of 1999 has been used for adolescents older than 18 years of age. A number of states allow adolescents under age 18 to consent to their own hepatitis B vaccination under laws passed to allow treatment of sexually transmitted infections without parental consent. In this article, we present the experiences of several model programs that developed successful hepatitis B vaccination programs in venues that serve adolescents at risk, the important role of state laws and state agencies in funding immunization and other preventive health services for adolescents in high-risk situations, and discuss barriers and means to resolve them. I N THEIR SENTINEL 1993 report, the National Research Council proposed that the focus for addressing high-risk behaviors by adolescents should move from the individual adolescents to the settings in which these adolescents live. 1 These settings include those that serve adolescents who are unauthorized migrants or homeless and those who are in alternative schools, detention centers, jails, and prisons (Table 1). [2][3][4][5][6] The populations served in these settings were formally defined in the McKinney-Vento Act, which was signed into law in 1987. 7 Many of these settings have long been the focus of special efforts to deliver hepatitis B vaccine and serve populations especially likely to benefit from new vaccines for adolescents, including those against human papillomavirus, pertussis, and meningococcal meningitis. This report excludes adolescents who are displaced as a result of natural or man-made disasters, refugees, and foreign students.Health care, including immunization, for the adolescents considered here is generally provided by local, state, and federal programs and their grantees. Unfortunately, missing vaccinations are b...

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The impact of a school entry law on adolescent immunization rates

Cited by 67 publications

References 12 publications

The Role of Schools in Strengthening Delivery of New Adolescent Vaccinations

The Role of Schools in Strengthening Delivery of New Adolescent Vaccinations

Adolescent Immunizations and Other Clinical Preventive Services: A Needle and a Hook?

Vaccinating Adolescents in High-Risk Settings: Lessons Learned From Experiences With Hepatitis B Vaccine

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