title: Changes in Tdap and MCV4 vaccine coverage following enactment of a statewide requirement of Tdap vaccination for entry into sixth grade.
abstract: OBJECTIVE
  We evaluated changes in tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap), and tetravalen meningococcal (MCV4) vaccine coverage following enactment of a New York State mandate requiring Tdap before entering sixth grade.
  
  
  METHODS
  Using data from a hospital-based immunization registry, we measured Tdap and MCV4 coverage among youths aged 11 to 14 years in New York City at 3 time points: premandate, mandate year 1, and mandate year 2.
  
  
  RESULTS
  Among overlapping cohorts of 4316 (premandate), 4131 (mandate year 1), and 3639 (mandate year 2) youths, Tdap coverage increased steadily over time (29%, 58%, and 83%, respectively). Increases were observed among all ages. Across the same time points, MCV4 coverage also increased (10%, 30%, and 60%, respectively). Most adolescents did not receive MCV4 during the same visit they received Tdap.
  
  
  CONCLUSIONS
  A Tdap school-entry mandate was associated with substantial increases in immunization coverage, even in age groups not directly affected by the mandate. At the postmandate time points, MCV4 coverage remained lower than Tdap coverage. Provider education should emphasize the importance of reviewing vaccine records and administering all recommended vaccines at every clinical encounter.
authors.affiliation: Department of Pediatrics, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University, 622 West 168th St, VC 402, New York, NY 10032, USA. eo85@columbia.edu
authors.forename: Elyse Olshen
authors.initials: EO
authors.lastname: Kharbanda
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Stockwell
authors.forename: James
authors.initials: J
authors.lastname: Colgrove
authors.forename: Karthik
authors.initials: K
authors.lastname: Natarajan
authors.forename: Vaughn I
authors.initials: VI
authors.lastname: Rickert
mesh_terms: D000293:Adolescent; D002648:Child; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D022401:Meningococcal Vaccines / Q000008:administration & dosage*; D009519:New York City; D012042:Registries; D012574:Schools; D013334:Students / Q000706:statistics & numerical data*; D014505:Urban Population; D014611:Vaccination / Q000331:legislation & jurisprudence*
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D022401:Meningococcal Vaccines