Addressing adolescent immunization disparities: a retrospective analysis of school-based health center immunization delivery

Am J Public Health. 2010 Sep;100(9):1630-4. doi: 10.2105/AJPH.2009.176628. Epub 2010 Jul 15.


Objectives: We compared completion rates for adolescent immunization series administered at school-based health centers (SBHCs) to completion rates for series administered at community health centers (CHCs) within a single integrated delivery system.

Methods: We performed a retrospective analysis of data from an immunization registry for patients aged 12-18 years. Patients were assigned to either an SBHC or a CHC during the study interval based on utilization. We used bivariate analysis to compare immunization series completion rates between the 2 groups and multivariate analysis to compare risk factors for underimmunization. We performed subanalyses by ages 12-15 years versus ages 16-18 years for human papillomavirus (HPV) and for the combination of HPV; tetanus, diptheria, and pertussis (Tdap); and tetravalent meningococcus virus.

Results: SBHC users had significantly higher completion rates (P<.001) for hepatitis B, Tdap, inactivated poliovirus, varicella, measles/mumps/rubella, and HPV for ages 16-18 years, and for the combination of HPV, Tdap, and MCV4 for ages 16-18 years. CHC users had higher completion rates for tetanus and diphtheria.

Conclusions: SBHCs had higher completion rates than did CHCs for immunization series among those aged 12-18 years, despite serving a population with limited insurance coverage.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Child
  • Colorado
  • Community Health Services / organization & administration
  • Female
  • Humans
  • Immunization Programs / organization & administration*
  • Logistic Models
  • Male
  • Registries
  • Retrospective Studies
  • School Health Services / organization & administration*
  • Urban Population