Improvement of Immunization Rates in the Adolescent and Young Adult Medicine Practice

Background/significance: Per the advisory committee on immunization practices, “achieving and maintaining high vaccination coverage levels for adolescents will ensure they have protection from serious and sometimes life-threatening vaccine-preventable diseases.” Complete immunization records are important to help prevent infectious diseases and provide access to opportunities such as school, work, and sports. Complete immunization records may also minimize healthcare costs and prevent using extra doses of immunizations or checking lab titers to unnecessarily prove immunization status. As of April 2022, the nursing team collaborated with the current adolescent quality improvement immunizations team, who started this project in January 2020, to develop processes to increase immunization rates in our new primary care and current adolescent population.

Purpose and goals: Increase the percentage of immunizations records received for new primary care adolescent patients prior to or at their first appointment. Increase the percentage of current adolescent patients ages 12 to 16 with 15 + immunizations from 80% to 90% by September 2023. Increase the percentage of adolescent patients who are up to date on meningitis ACWY from 72% to 80% by September 2023.

Methods: Import immunization records from the Massachusetts Immunization Information System (MIIS) into the adolescent patient’s profile. Outreach to patients and/or parent without immunization records to obtain them prior to or at the adolescent patient’s first primary care appointment. Review new primary care adolescent patient’s immunization records and send a Power Chart message to the provider they are seeing outlining which immunizations are needed at their visit. Place alerts in current adolescent patient’s appointment note in EPIC if they are overdue for meningitis ACWY.

Findings: From April 2022 to September 2023, 93% of new primary care adolescent patient’s records have been entered before or at their first appointment in our office. From April 2022 to September 2023, 92.1% of adolescent patients ages 12 to 16 have 15+ immunizations. From April 2022 to September 2023, 87.5% of adolescent patients are now up to date on meningitis ACWY.

Implications/next steps: Place alerts in current adolescent patient’s appointment note in EPIC if they are overdue for Tdap and HPV. Increase percentage of adolescent patients who are up to date on meningitis ACWY from 80% to 90% by December 2023. Increase percentage of adolescent patients who are up to date on Tdap from 87% to 90% by December 2023. Increase percentage of adolescent patients who are up to date on HPV from 73% to 80% by December 2023.