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IID-11.1 Data Details

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IID-11.1 Increase the vaccination coverage level of 1 dose of tetanus-diphtheria-acellular pertussis (Tdap) booster vaccine for adolescents by age 13 to 15 years

About the Data: National

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Immunization Survey-Teen (NIS-Teen); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
85.3 (2012)
Target: 
80.0
Target-Setting Method: 
Maintain consistency with national programs, regulations, policies, and laws.
Target-Setting Method Justification: 
High coverage rates for adolescents are important, but many of the adolescent vaccines are relatively recent additions to the ACIP recommendations. Additionally, vaccinating adolescents is more challenging than vaccinating young children (e.g., recommended vaccines for young children often coincide with well-child visits in the first years of life), and adolescents make fewer medical visits on average, compared with younger children. Thus, an 80 percent target for these adolescent vaccines is both ambitious and achievable. Varicella vaccine has been routinely recommended for many years for preschool-aged children, with catchup for older kids. The target for adolescent varicella is lower than kindergarten varicella because approximately two to three cohorts of children will have missed the kindergarten varicella vaccine requirement during the Healthy People 2020 reporting period.
Numerator: 

Number of persons aged 13 to 15 years receiving at least 1 dose of a tetanus-diphtheria-acelluar pertussis (Tdap) booster vaccine

Denominator: 

Number of persons aged 13 to 15 years

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From the 2013 National Immunization Survey-Teen Provider-Immunization History Questionnaire:

    [NUMERATOR:]

    Specify month, day, and year that each vaccine was given, either by the office or another provider, and type of vaccine, as documented in the records.

Data Collection Frequency: 
Annual
Methodology Notes: 

    The National Immunization Survey-Teen (NIS-Teen) collects vaccination information for adolescents aged 13–17 years in the 50 states, the District of Columbia, selected areas, and the U.S. Virgin Islands, using a random-digit-dialed sample of landline and, starting in 2011, cellular telephone numbers. Parent/guardian respondents provide vaccination and sociodemographic information on adolescents in their care. After the parent/guardian grants permission to contact their child's vaccination provider, a questionnaire is mailed to that provider to obtain a vaccination history from the medical record. Data for this measure are restricted to adolescents aged 13–15 and weighted to represent the population of adolescents age 13–15, with adjustments for households with multiple telephone lines and mixed telephone use (landline and cellular), household nonresponse, and exclusion of households without telephone service.

    In 2006, the Advisory Committee on Immunization Practices (ACIP) recommended that 1) adolescents aged 11–18 years should receive a single dose of Tdap for booster immunization if they had completed the recommended childhood DTP/DTaP vaccination series and have not received Td or Tdap; 2) adolescents aged 11–18 years who received Td, but not Tdap, are encouraged to receive a single dose of Tdap to provide protection against pertussis if they have completed the recommended childhood DTP/DTaP vaccination series; and 3) vaccine providers should administer Tdap and tetravalent meningococcal conjugate vaccine (tracked in Healthy People objective to adolescents aged 11–18 years during the same visit if both vaccines are indicated and available. In 2010, ACIP approved the following additional recommendations: 1) use of Tdap regardless of interval since the last tetanus- or diphtheria-toxoid containing vaccine, 2) use of Tdap in certain adults aged 65 years and older, and 3) use of Tdap in undervaccinated children aged 7 through 10 years.

    This measure tracks the proportion of adolescents aged 13–15 years receiving at least 1 dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) since the age of ten years.

Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 14-27c in that the vaccine was revised from "tetanus and diphtheria" to "tetanus-diphtheria-acelluar pertussis (Tdap) booster."

About the Data: State

Description of the data source, numerator, denominator, survey questions, and other relevant details about the state-level data.

Data Source: 
National Immunization Survey-Teen (NIS-Teen); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Measure: 
percent
Numerator: 

Number of persons aged 13 to 15 years receiving at least 1 dose of a tetanus-diphtheria-acelluar pertussis (Tdap) booster vaccine

Denominator: 

Number of persons aged 13 to 15 years

Questions Used to Obtain the State Data: 

      From the 2013 National Immunization Survey-Teen Provider-Immunization History Questionnaire:

      [NUMERATOR:]

      Specify month, day, and year that each vaccine was given, either by the office or another provider, and type of vaccine, as documented in the records.

Data Collection Frequency: 
Annual
Methodology Notes: 

      The National Immunization Survey-Teen (NIS-Teen) collects vaccination information for adolescents aged 13–17 years in the 50 states, the District of Columbia, selected areas, and the U.S. Virgin Islands, using a random-digit-dialed sample of landline and, starting in 2011, cellular telephone numbers. Parent/guardian respondents provide vaccination and sociodemographic information on adolescents in their care. After the parent/guardian grants permission to contact their child's vaccination provider, a questionnaire is mailed to that provider to obtain a vaccination history from the medical record. Data for this measure are restricted to adolescents aged 13–15 and weighted to represent the population of adolescents age 13–15, with adjustments for households with multiple telephone lines and mixed telephone use (landline and cellular), household nonresponse, and exclusion of households without telephone service.

      In 2006, the Advisory Committee on Immunization Practices (ACIP) recommended that 1) adolescents aged 11–18 years should receive a single dose of Tdap for booster immunization if they had completed the recommended childhood DTP/DTaP vaccination series and have not received Td or Tdap; 2) adolescents aged 11–18 years who received Td, but not Tdap, are encouraged to receive a single dose of Tdap to provide protection against pertussis if they have completed the recommended childhood DTP/DTaP vaccination series; and 3) vaccine providers should administer Tdap and tetravalent meningococcal conjugate vaccine (tracked in Healthy People objective to adolescents aged 11–18 years during the same visit if both vaccines are indicated and available. In 2010, ACIP approved the following additional recommendations: 1) use of Tdap regardless of interval since the last tetanus- or diphtheria-toxoid containing vaccine, 2) use of Tdap in certain adults aged 65 years and older, and 3) use of Tdap in undervaccinated children aged 7 through 10 years.

      This measure tracks the proportion of adolescents aged 13–15 years receiving at least 1 dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) since the age of ten years.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2014, the data source name was revised to the “National Immunization Survey (NIS) – Teen” to distinguish this survey from the “National Immunization Survey (NIS),” which samples children between the ages of 19 and 35 months. Neither the data nor the target were revised. In 2015, the baseline year was revised from 2008 to 2012 due to expanding the sampling frame from landline phones only to a dual frame sample including landline and cell phones. The baseline statement was changed from "46.7 percent of adolescents aged 13 to 15 years had received at least 1 dose of a Tdap booster in 2008" to "85.3 percent of adolescents aged 13 to 15 years had received at least 1 dose of a Tdap booster in 2012." The target remains unchanged.

References

Additional resources about the objective

  1. Datasets for the National Immunization Survey - Teen [online]. Atlanta (GA): National Center for Immunization and Respiratory Diseases. c2013 – [cited 2013 June 6].