title: Effectiveness and net cost of reminder/recall for adolescent immunizations.
abstract: OBJECTIVE
  To assess the effectiveness of reminder/recall (R/R) for immunizing adolescents in private pediatric practices and to describe the associated costs and revenues.
  
  
  METHODS
  We conducted a randomized controlled trial in 4 private pediatric practices in metropolitan Denver. In each practice, 400 adolescents aged 11 to 18 years who had not received 1 or more targeted vaccinations (tetanus-diphtheria-acellular pertussis, meningococcal conjugate, or first dose of human papillomavirus vaccine for female patients) were randomly selected and randomized to intervention (2 letters and 2 telephone calls) or control (usual care) groups. Primary outcomes were receipt of >1 targeted vaccines and receipt of all targeted vaccines 6 months postintervention. We calculated net additional revenue for each additional adolescent who received at least 1 targeted vaccine and for those who received all targeted vaccines.
  
  
  RESULTS
  Eight hundred adolescents were randomized to the intervention and 800 to the control group. Baseline rates of having already received tetanus-diphtheria-acellular pertussis, meningococcal conjugate, and first dose of human papillomavirus vaccine before R/R ranged from 33% to 54%. Postintervention, the intervention group had significantly higher proportions of receipt of at least 1 targeted vaccine (47.1% vs 34.6%, P < .0001) and receipt of all targeted vaccines (36.2% vs 25.2%, P < .0001) compared with the control group. Three practices had positive net revenues from R/R; 1 showed net losses.
  
  
  CONCLUSIONS
  R/R was successful at increasing immunization rates in adolescents and effect sizes were comparable to those in younger children. Practices conducting R/R may benefit financially if they can generate additional well-child care visits and keep supply costs low.
authors.affiliation: Children’s Outcomes Research Program, Children’s Hospital Colorado, Aurora, Colorado 80045, USA. christina.suh@ucdenver.edu
authors.forename: Christina A
authors.initials: CA
authors.lastname: Suh
authors.forename: Alison
authors.initials: A
authors.lastname: Saville
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Daley
authors.forename: Judith E
authors.initials: JE
authors.lastname: Glazner
authors.forename: Jennifer
authors.initials: J
authors.lastname: Barrow
authors.forename: Shannon
authors.initials: S
authors.lastname: Stokley
authors.forename: Fran
authors.initials: F
authors.lastname: Dong
authors.forename: Brenda
authors.initials: B
authors.lastname: Beaty
authors.forename: L Miriam
authors.initials: LM
authors.lastname: Dickinson
authors.forename: Allison
authors.initials: A
authors.lastname: Kempe
mesh_terms: D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007114:Immunization / Q000191:economics* / Q000639:trends; D007115:Immunization Schedule; D008297:Male; D022401:Meningococcal Vaccines / Q000191:economics / Q000627:therapeutic use; D053918:Papillomavirus Vaccines / Q000191:economics / Q000627:therapeutic use; D010358:Patient Participation / Q000191:economics* / Q000639:trends; D017010:Reminder Systems / Q000191:economics* / Q000639:trends; D016896:Treatment Outcome
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D022401:Meningococcal Vaccines; D053918:Papillomavirus Vaccines