A subtle but significant change took place in the 2017 adolescent immunization schedule when the Advisory Committee on Immunization Practices (ACIP) created a separate column just for 16-year-olds.
The change was designed to call attention to the need for the second, or booster, dose of quadrivalent meningococcal conjugate vaccine (MenACWY) as well as for other vaccinations recommended at age 16.
The change is helping to highlight the fact that only 1 in 3 eligible teens has received the second dose of MenACWY, leaving millions of young people vulnerable to meningococcal disease, an illness that is rare but often crippling and—in more than 10% of cases—fatal. Vaccines specifically recommended at 16 years of age include the second dose of MenACWY and (based on the health provider’s discussion with patient and family) the first dose of meningococcal B vaccine.
Immunization rates in teenagers 13 through 17 are also low for influenza vaccine (47%) and human papillomavirus (HPV) vaccine. Just 28% of boys and 42% of girls have completed the full HPV vaccine series. Vaccination rates tend to be even lower in older (16 to 18 years of age) than in younger adolescents. Even when they go to see a doctor—for a school or sports physical, for example—opportunities to vaccinate are often missed.
Experts in disease prevention are also focusing on teens and vaccines. The Adolescent Immunization Initiative (AII), a multi-disciplinary group of approximately 20 leaders in adolescent health and immunization, is calling for a “16-year-old platform” in support of immunizations and overall wellness, recognizing that older adolescents not only need to get their vaccinations on time, they also need to start taking ownership of their health care.
The AII, a group supported by Sanofi Pasteur, has issued a white paper emphasizing the importance of a 16-year-old platform as an opportunity to provide currently recommended vaccines and to catch up on other vaccines that might have been missed earlier in childhood. At the same time, providing needed immunizations gives the health professional an “in” to discuss the full range of adolescent health concerns and the importance of preventive care.
“We are indoctrinated with the idea of well-care visits for children, but the concept of prevention recedes as they grow older,” noted LJ Tan, MS, PhD, Chief Strategy Officer for the Immunization Action Coalition. “During adolescence, the frequency of visits decreases, overall opportunities to see a physician decline, and the preventive mindset is lost. Healthcare professionals must engage adolescents to recognize the importance of prevention and of owning their own health.” Dr. Tan serves as co-moderator of the Adolescent Immunization Initiative along with David P. Greenberg, MD, Associate Vice President and Regional Medical Head, North America, for Sanofi Pasteur.
The concept of a 16-year-old platform has also been endorsed by the National Foundation for Infectious Diseases and the Society for Adolescent Health and Medicine.