NEWS RELEASES
Study by Texas Children's physician underscores strong need for multiple immunization strategies for adolescents

HOUSTON, TX March 2, 2009 – There are a number of vaccine-preventable diseases that threaten adolescents. Because their schedules and lifestyles make these young people harder to reach, a new study conducted by a Texas Children’s Hospital pediatric subspecialist calls for more inventive ways to ensure adolescents receive the recommended preventative vaccines.

“A ‘one-size-fits-all’ approach will not work,” said Dr. Amy Middleman, an adolescent medicine specialist and a director at Texas Children’s Hospital Center for Vaccine Awareness and Research. “We will need to consider multiple delivery strategies to ensure success in immunizing this age group.”

The findings of the first phase of Dr. Middleman’s pilot program, “Vaccinating Adolescents: Taking It To The Schools,” were presented in Dallas late last month at the National Immunization Conference.

Among her findings, Dr. Middleman reported that a combination of medical home and school-based immunization programs are needed to increase vaccination rates among adolescents; more vaccine education and outreach is needed for non-English speaking families; and that school-based programs will be more effective if scheduled so that parents can be present when shots are administered to their children.

"Many parents still want to be present for the vaccination of their adolescent children; it will be important to learn more about parents' specific concerns, as well as the concerns of the adolescent vaccine recipients, and address them in the design of future school-based immunization programs,” Dr. Middleman said.

The findings are based on a program involving eight Houston middle schools between October and December of last year. A total of 7,300 parental questionnaires were distributed, 1,838 of which were returned, or 25 percent. As part of the program, more than 800 vaccinations were given to 430 Houston children.

Dr. Middleman found that while 86 percent of parents surveyed had taken their child to a medical visit in the past two years, only 38 percent answered “yes” as to whether their doctor recommended vaccines for their 11- or 12-year-old. Those speaking primarily English at home had 1.5 greater odds of answering “yes”, illustrating the need for greater education among Houston’s non-English speaking households.

These findings come just after the state issued new immunization requirements for students, including new vaccinations for adolescents, which begin phase-in this fall.

The Center for Disease Control and the American Academy of Pediatrics recommend that pre-teens get several vaccines at their 11- or 12-year-old check-up: tetanus-diphtheria acellular pertussis vaccine (Tdap); meningococcal conjugate vaccine (MCV4); human papillomavirus (HPV) vaccine for girls; the second varicella vaccine if they have not had it; and their annual influenza (flu) vaccine. These vaccines prevent serious, sometimes life-threatening diseases.

Unfortunately, there are multiple barriers to adolescent immunization including issues of access, information tracking, consent, time, finances and other disparities. The October 2008 death of a Houston teenage girl from meningitis and the influenza deaths of three Houston teenagers between October 2008 and January 2009 are examples of the seriousness of the disease threats and the importance of developing strategies to overcome any existing barriers to adolescent immunization.

The project was sponsored by Texas Children’s Hospital Center for Vaccine Awareness and Research, in collaboration with the Houston Independent School District, the Harris County Hospital District, Texas Department of State Health Services and Memorial Hermann Hospital.

Dr. Middleman said she plans to conduct the final phase of study, which involves follow-up questionnaires to the parents of the middle school students, in the next two months. Among her objectives is to learn whether respondents’ reported preference for school-based immunization programs is supported by actual immunization behavior. In addition, she hopes to learn from parents and students who are comfortable getting vaccine shots at school what shots, specifically, they are willing to receive.

More details on the results of Dr. Middleman’s adolescent vaccine study can be found at www.vaccines.texaschildrens.org.


About the Center for Vaccine Awareness and Research

The Vaccine Awareness and Research Center at Texas Children’s Hospital promotes healthier children and families. This is done by providing parents and health care professionals with the latest information and recommendations on vaccines for infants, children, adolescents, pregnant women and adults through its Web site, www.vaccine.texaschildrens.org and by conducting research that contributes to effective vaccine delivery models. An ongoing program, the center is the creation of four Texas Children’s Hospital physicians who are experts in the fields of vaccine education and research, pediatrics, infectious diseases and adolescent medicine.

About Texas Children's Hospital

Texas Children's Hospital is committed to a community of healthy children by providing the finest pediatric patient care, education and research. Renowned worldwide for its expertise and breakthrough developments in clinical care and research, Texas Children’s is ranked in the top ten best children’s hospitals by U.S. News and World Report. Texas Children’s also operates the nation’s largest primary pediatric care network, with over 40 offices throughout the greater Houston community. Texas Children’s has embarked on a $1.5 billion expansion, Vision 2010, which includes a neurological research institute, a comprehensive obstetrics facility focusing on high risk births, and a community hospital in suburban West Houston.