Correlates of receiving recommended adolescent vaccines among youth with special health care needs: Findings from a statewide survey

Background: Many youth with special health care needs (YSHCN) have not received recommended adolescent vaccines, yet data are lacking on correlates of vaccination among this population. Such information can identify subgroups of YSHCN that may be at risk for under-immunization and strategies for increasing vaccination. Methods: We analyzed weighted data from a population-based sample of parents with an 11- to 17-year-old child with a special health care need from the 2010-2012 North Carolina Child Health Assessment and Monitoring Program (n = 604). We used ordinal logistic regression to identify correlates of how many recommended vaccines (tetanus booster, meningococcal, and HPV [at least one dose] vaccines) adolescents had received. Results: Only 12% of YSHCN (18% of females and 7% of males) had received all three vaccines. More YSHCN had received tetanus booster vaccine (91%) than meningococcal (28%) or HPV vaccines (32%). In multivariable analyses, YSHCN who were female (OR = 2.59, 95% CI: 1.57-4.24), ages 16-17 (OR = 2.06, 95% CI: 1.10-3.87), or who had a preventive check-up in the past year (OR = 2.98, 95% CI: 1.24-7.21) had received a greater number of the vaccines. YSHCN from households that contained a person with at least some college education had received fewer of the vaccines (OR = 0.57, 95% CI: 0.33-0.96). Vaccine coverage did not differ by type of special health care need. Conclusions: Vaccine coverage among YSHCN is lacking and particularly low among those who are younger or male. Reducing missed opportunities for vaccination at medical visits and concomitant administration of adolescent vaccines may help increase vaccine coverage among YSHCN.