title: Adolescent immunization coverage and implementation of new school requirements in Michigan, 2010.
abstract: OBJECTIVE
  We examined the effect of Michigan's new school rules and vaccine coadministration on time to completion of all the school-required vaccine series, the individual adolescent vaccines newly required for sixth grade in 2010, and initiation of the human papillomavirus (HPV) vaccine series, which was recommended but not required for girls.
  
  
  METHODS
  Data were derived from the Michigan Care Improvement Registry, a statewide Immunization Information System. We assessed the immunization status of Michigan children enrolled in sixth grade in 2009 or 2010. We used univariable and multivariable Cox regression models to identify significant associations between each factor and school completeness.
  
  
  RESULTS
  Enrollment in sixth grade in 2010 and coadministration of adolescent vaccines at the first adolescent visit were significantly associated with completion of the vaccines required for Michigan's sixth graders. Children enrolled in sixth grade in 2010 had higher coverage with the newly required adolescent vaccines by age 13 years than did sixth graders in 2009, but there was little difference in the rate of HPV vaccine initiation among girls.
  
  
  CONCLUSIONS
  Education and outreach efforts, particularly regarding the importance and benefits of coadministration of all recommended vaccines in adolescents, should be directed toward health care providers, parents, and adolescents.
authors.affiliation: Rachel C. Potter and Patricia A. Vranesich are with the Michigan Department of Community Health, Division of Immunizations, Lansing. Stefanie F. DeVita is with the University of Michigan School of Public Health, Ann Arbor. Matthew L. Boulton is with the University of Michigan School of Public Health and University of Michigan School of Medicine.
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Potter
authors.forename: Stefanie F
authors.initials: SF
authors.lastname: DeVita
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Vranesich
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Boulton
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D017589:Immunization Programs; D008297:Male; D037141:Mandatory Programs / Q000706:statistics & numerical data; D008824:Michigan / Q000453:epidemiology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use; D016016:Proportional Hazards Models; D012572:School Health Services / Q000458:organization & administration
chemical_list: D053918:Papillomavirus Vaccines