Adolescent immunizations

Dr. Bethany Hall with her medical assistant, Halie Johnson

An interview with Dr. Bethany Hall

What do you do in your practice to encourage your adolescent patients to keep up with their immunizations?

We have a couple of things in place that help us keep our immunization rates high. For every patient visit, we print out an MCIR. We try to catch adolescents when they come in for sick visits. Often, they're not too sick to get a vaccine while they're here.

We also review their records to see when they had a physical. If they haven't had one in the last year, we send out a letter. Or if they’re in for a sick visit, my receptionist tries to schedule a physical while they’re here.

We also have a 'gaps in care' registry. One of our nurses spends time reviewing registries for patients who haven’t had a physical in the last year and she makes phone calls to schedule appointments.

We’ve been doing these things for several years and are always working to improve our immunization rates. Tracked over time, we have definitely seen improvements.

What are some of the challenges of keeping immunizations up to date for this population?

It’s mostly getting them here. Most of these teens have had all their other immunizations when they were younger. It's more making sure we take the opportunity when they are here in the office. It's a team effort. We get our whole staff involved. The biggest challenge is the HPV vaccine, specifically.

My approach is to first learn from the parent what their concerns are. I tell them the chances of getting cancer from HPV is much higher than getting meningitis, and most parents consent to the Menactra vaccine.

Most parents are worried about a severe reaction to the vaccine. They can rationally know it’s a good vaccine, but the fear of something horrible happening is strong. You can talk that through.

When the child is due at 11 years, some parents say, "I don’t want him or her to have it yet." So you need to listen to the parent and hear their concerns. I have four children of my own and they've all had the vaccine. Sometimes it's helpful for parents to hear from a provider that they are recommending the very vaccines they give to their own children. I've personally never have had a patient who's had a severe reaction. So my own personal experiences are important and helpful in advising parents.

Is there anything you’d like to add?

Immunizations are so important, and we continue to educate parents and hear their concerns. The best way to immunize adolescents is to get them in the door. You have to keep focused and commit to addressing vaccines at every visit.