Addressing adolescent immunization disparities: a retrospective analysis of school-based health center immunization delivery.
OBJECTIVE
We compared completion rates for adolescent immunization series administered at school-based health centers (SBHCs) to completion rates for series administered at community health centers (CHCs) within a single integrated delivery system.


METHODS
We performed a retrospective analysis of data from an immunization registry for patients aged 12-18 years. Patients were assigned to either an SBHC or a CHC during the study interval based on utilization. We used bivariate analysis to compare immunization series completion rates between the 2 groups and multivariate analysis to compare risk factors for underimmunization. We performed subanalyses by ages 12-15 years versus ages 16-18 years for human papillomavirus (HPV) and for the combination of HPV; tetanus, diptheria, and pertussis (Tdap); and tetravalent meningococcus virus.


RESULTS
SBHC users had significantly higher completion rates (P<.001) for hepatitis B, Tdap, inactivated poliovirus, varicella, measles/mumps/rubella, and HPV for ages 16-18 years, and for the combination of HPV, Tdap, and MCV4 for ages 16-18 years. CHC users had higher completion rates for tetanus and diphtheria.


CONCLUSIONS
SBHCs had higher completion rates than did CHCs for immunization series among those aged 12-18 years, despite serving a population with limited insurance coverage.
Federico
Steven G
SG
Denver Health and Hospital Authority, 1001 Yosemite, Suite 200, MC 1916, Denver, CO 80238, USA. steve.federico@dhha.org
Abrams
Lisa
L
Everhart
Rachel M
RM
Melinkovich
Paul
P
Hambidge
Simon J
SJ
D000293:Adolescent; D002648:Child; D003120:Colorado; D003153:Community Health Services / Q000458:organization & administration; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D016015:Logistic Models; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D012572:School Health Services / Q000458:organization & administration*; D014505:Urban Population