Teen VaxScene Educational Vaccination Study

• Effect of Mailed Reminders: Study 1 and 2 [ Time Frame: 24 Months ] [ Designated as safety issue: No ]

  To examine the effect(s) of email vaccination reminders, there are two types of primary outcomes to be measured:

  1. Changes in the vaccination levels (for four adolescent vaccines) of children of parents who receive monthly email vaccination reminders between the start of the study and after the study has concluded; and
  2. Differences in vaccination levels (for four adolescent vaccines) between children of parents who receive email reminders plus usual reminders and children whose parents receive only postal mail reminder strategies.
  
  

• Effect of Using an Informational Kiosk: Study 1 [ Time Frame: 24 Months ] [ Designated as safety issue: No ]
  Kiosk utilization will be considered as a potential modifying variable to adolescent vaccination rates in the larger analysis that investigates the impact of email vs. no email reminders on vaccine utilization. We will also determine any differences in parental vaccination intentions for their adolescent children at baseline and after reviewing educational material provided by the intervention.
  
  
• Characteristics of Parents Who Use the Intervention: Study 1 and 2 [ Time Frame: 24 months ] [ Designated as safety issue: No ]
  To help target the most appropriate population for future interventions, we will also determine the characteristics of parents who were most likely to access clinic waiting room kiosks and the educational web intervention for vaccine-related information.
  
  
• Effect of Tailored vs Untailored Web-based Information: Study 2 [ Time Frame: 24 months ] [ Designated as safety issue: No ]

  To examine the effect(s) of a web-based educational information intervention, there are two types of primary outcomes to be measured:

  1. Changes in the parental vaccination intention for their adolescent children (for four adolescent vaccines) among those who access the educational intervention; and
  2. Differences in vaccination levels (for four adolescent vaccines) between children of parents who receive tailored education in the intervention and children whose parents receive only untailored education.
  
  

Adolescents are a reservoir population for a variety of vaccine preventable diseases (VPDs). Despite this, adolescent vaccination rates lag substantially behind national goals of 80% coverage for adolescent vaccines set forth by Healthy People 2020. This has been particularly the case for the vaccines most recently recommended for adolescents, such as the HPV (human papilloma virus) and seasonal influenza (flu) vaccines; national coverage levels in 2010 for HPV were 32% (for series completion among females only) and 35% for flu vaccine. Uptake levels for the two other adolescent-targeted vaccines, tetanus-diphtheria-acellular pertussis (Tdap) and meningococcal conjugate (MCV4) vaccines are currently at 69% and 63%, respectively.

A major barrier to increased adolescent vaccination levels is the lack of parental and provider recognition that an adolescent is due for vaccine doses. For providers, there are the dual challenges of getting adolescents to come in for annual preventive care visits and also minimizing "missed opportunities" for vaccination (i.e. clinical interactions with a patient where a needed vaccine could have been provided but was not). Reminder/recall systems are one mechanism to help address both of these challenges for providers while also informing parents about the need for adolescent vaccines.

An additional barrier is that parents report not knowing enough about vaccinations to feel comfortable with the decision to allow their child to be vaccinated. Although parents would like more information about vaccines, providers lack adequate time during clinical encounters to address all parental concerns. Many parents use the Internet to gather additional information about vaccines, however, many websites provide inaccurate information and/or fail to address the specific concerns that parents may have. Individual message tailoring, whereby educational materials are individually crafted to address each person's specific beliefs, concerns and experiences, has been shown to be more effective than providing generic information for compliance with a number of preventive health activities.