Factors influencing adolescents' immunization status

Vaccine preventable deaths account for 5.4 million deaths worldwide, and contribute to unnecessary outbreaks of infections. Rates of immunization decrease sharply from the age of two years to school entry, and most dramatically by the period of adolescence. A principal goal of Healthy People 2010 is to increase vaccination levels for adolescents to at least 90 percent for the nine childhood diseases for which vaccines are available.; The purpose of this case-control study was to examine the relationships between parental perceived barriers and motivating factors, socio-demographics, and family characteristics and immunization status of adolescents attending Hillsborough County Public Schools. In addition, the study explored selected characteristics of the adolescent's family that may place adolescents at risk for inadequate immunizations. Immunization status was determined using American Academy of Pediatrics (AAP) recommendations for age-appropriate vaccines for these adolescents through the use of a secondary data source.; Among the sample of 180 adolescents, 51% were inadequately immunized and 49% were adequately immunized. Twenty-six subjects were excluded from the study due to medical, or religious beliefs. Results of a multi-stage stratified random sample of 180 parents of adolescents enrolled in Hillsborough County Public Schools who responded to the survey revealed that race/ethnicity categories included: Caucasians (29%), African-Americans (11%), and Hispanics (9%) whose adolescents were inadequately immunized; while parents of adolescents who were adequately immunized included; Caucasians (27%), African-Americans (12%), and Hispanics (12%) represent parents of adolescents that were adequately immunized. The parents of both groups were predominantly female (44% female, 7% male parents of the inadequately immunized adolescents; and 43% female, 6% male parents of the adequately immunized adolescents). The results of a univariate logistic regression analysis revealed that socioeconomic status (OR = 3 .2, p < .01), parental age (OR = 2.6, p < .01), health insurance coverage (OR = 5, p < .01), type of health care provider (OR = 2.3, p < .05), transportation (OR = 5.5, p < .01) and barriers (OR = .51, p < .05) were significantly associated with adequately immunized adolescents. A multivariate logistic regression analysis was then conducted to determine the best set of predictors of adolescent immunization status. These predictors included: socioeconomic status (OR = 2.4, p < .01), parental age (OR = 2.4, p < .01) and health insurance coverage (OR = 3.4, p < .05).; The findings of this study indicate that there is a need for effective intervention programs to increase vaccination rates among adolescents. The variables associated with immunization status of adolescents, and the Health Belief Model may be helpful in planning future immunization intervention programs for this age group. Further research, recommendations and implications are discussed.