Summary

Introduction

Vaccination is the best way to prevent illness and severe outcomes from several communicable diseases and prevent them from spreading in the community. Vaccines recommended for adolescents protect against diphtheria, tetanus, pertussis, meningococcal disease, and human papillomavirus. Adolescents should also catch up on any missed polio, measles, mumps, rubella, hepatitis A, hepatitis B, and varicella childhood vaccines. The Georgia Department of Public Health evaluated immunization coverage for adolescents who were aged 13 through 17 years in 2021.

Methods

All vaccine administration and demographic data for adolescents born between January 01, 2004 and December 31, 2008 were obtained from the Georgia Registry of Immunization Transactions and Services (GRITS). Data cleaning removed records if they contained no childhood or adolescent vaccines, were out-of-state, duplicated, created for testing, created as a placeholder at birth, or if an adolescent died, resulting in 1,133,110 records. Each record was evaluated and if all doses of a vaccine were correctly by 18 years, the adolescent was considered up-to-date on (or covered by) that vaccine.

The 13-17 year age range was selected to match the ages sampled by CDC’s National Immunization Survey (NIS-Teen)¹.

Coverage was calculated for each of the following:

• 2 doses of hepatitis A (Hep A) vaccine

• 3 doses of hepatitis B (Hep B) vaccine

• 2 or 3 doses of human papillomavirus (HPV) vaccine, depending on age at first vaccine

• 3 doses of inactivated polio virus (IPV) vaccine

• 1 dose of meningococcal conjugate vaccine for serogroups A, C, W, and Y (MenACWY)

• 2 doses of measles, mumps, rubella (MMR) vaccine

• 1 dose of tetanus, diphtheria, acellular pertussis (Tdap) vaccine

• 2 doses of varicella (Var) vaccine, and

• the adolescent series (1 dose Tdap, 3 doses IPV, 2 doses MMR, 2 doses HepB, 2 doses Var, and 1 dose MenACWY)

Coverage was further examined by race, ethnicity, birth year, type of insurance, district, and county.

Key Findings

Overall, Georgia’s vaccine coverage for the adolescent series was 63.3%. By individual vaccines, coverage was highest for hepatitis B (HepB) vaccine at 94.5% and lowest for human papillomavirus (HPV) vaccine at 36.0%. Coverage for the adolescent series was highest among adolescents of other race (74%); adolescents not of Hispanic or Latino ethnicity (72.8%); adolescents born in 2005 (64.7%); and adolescents with multiple insurance types (76.3%). Coverage for the adolescent series was lowest among adolescents of unknown race (16.7%); adolescents of unknown ethnicity (23.6%); adolescents born in 2008 (60.9%); and adolescents with unknown insurance coverage (16.2%).

Limitations

Some records have multiple addresses associated with them. In these cases, the first complete Georgia address was used to assign county of residence. Adolescents may not have received their vaccines at only one address or at the address selected. In cases where there was no address, the adolescent was assumed to be a Georgia resident and county was left as “unknown.”

The number of records assigned to a county based on GRITS address may be higher or lower than the expected population of a county based on 2021 census data. Counties bordering other states may have adolescents who see providers out-of-state. Counties with high population immigration or emigration (e.g., counties with military bases) may appear to have lower coverage as adolescent more frequently leave before their vaccines are completed.

Additionally, pockets of high or low coverage within or across multiple counties may be obscured by a county-level analysis.

Due to the volume of records (1,133,110 records), it is not feasible to individually determine correct addresses, and therefore county- and district-level coverage are estimates.

Differences from Past Studies

Previous adolescent immunization studies used a cross-sectional study design where private and public schools were sampled from each district. From these schools, a number of 7th grade students were randomly sampled. Georgia’s Immunization Regional Consultants (IRCs) collected identifying information and vaccination history from school 3231 files for the selected students and input them into an electronic web-based data collection system. This system interfaced with GRITS to extract vaccination data.

Footnotes

¹ https://www.cdc.gov/nis/about/index.html

Interacting with this Report

There are two tabs beside the “Summary.” The “Report Sections Drop-Down” tab allows navigation to different data tables. The “Maps” tab allows navigation to different county-level maps of vaccination coverage. The bar graph can be enlarged by clicking and dragging over an area then reset by double clicking. Data tables can be copied onto the clipboard, printed, or downloaded as a .csv file, an Excel file, or a PDF with their respective buttons. The search bar allows filtering data in large tables. For example, typing “1-1” in the search bar and pressing the enter key will show any rows for public health district 1-1.

Georgia Totals

Data by Race

Data by Ethnicity

Data by Birth Year

Data by Insurance Coverage

Data by District

Data by County

Adolescent Series

HepA

HepB

HPV

IPV

MCV

MMR

Tdap

Varicella