• February 13, 2018

Data on early-childhood vaccination rates rank North Dakota No. 1 in U.S.

Subsequent report reveals consistently low HPV vaccination rates among teens

FARGO – A recent Health of America report released by the Blue Cross Blue Shield Association (BCBSA) shows that 86 percent of North Dakota children age 0 to 3 and covered under Blue Cross Blue Shield of North Dakota (BCBSND) received CDC-recommended immunizations for their age range.

While BCBSND is pleased to see a key indicator like child immunizations performing well, organizational leaders believe there is opportunity to do even better with increased well-child visits.

Importance of primary care and well-child visits
Alongside the goal of improving well-child visits statewide, BCBSND attributes North Dakota's overall vaccination success rates to its focus on value-based care through the BlueAlliance program, which helps parents focus on the right kind of care for their children, including vaccination schedules, through regular well-child visits.

"There is a direct correlation between well-child visits and meeting the immunization requirements. With BlueAlliance, we're seeing stronger relationships between family and primary care provider through the patient-centered medical home approach that the BlueAlliance program embraces," said BCBSND Vice President of Clinical Excellence and Quality Management Jacquelyn Walsh.

The national average for BCBSND-covered children vaccinated during the same time period is 77 percent. The lagging 23 percent who did not follow vaccination schedules or were under-vaccinated is due in part to missed well-child visits, according to the report.

Adolescent meningococcal, Tdap vaccinations up, but HPV continues to have low uptake
In a subsequent Health of America addressing adolescent vaccination rates in America reports 58 percent of adolescents with BCBSND insurance received a first dose of the HPV vaccine by their 13th birthday, ranking North Dakota No. 2 in the nation for first-dose vaccinations*.

The rate for girls completing the first dose of the HPV vaccines in 2016 was 61 percent compared to 56 percent for boys.

Despite this growth, HPV vaccinations fall behind meningococcal vaccines and Tdap, which have rates of 89 percent and 92 percent, respectively, in North Dakota. HPV, meningococcal and Tdap are on the list of adolescent vaccines recommended by the CDC.

Why rates of HPV vaccinations remain low
One reason for the lag in HPV vaccinations is because the 2-part vaccination series is considered voluntary. The other reason, according to Walsh, is consistent doctor visits. "Like well-child visits for infants and older, teenagers also benefit from consistent and regular visits to their primary care team," she said.

Walsh added that, in addition to regular primary care visits, sports physicals are a good time to discuss adolescent-related health topics, like HPV, depression and substance use.

*The report, "Adolescent Vaccination Rates in America," examines outpatient medical claims for BCBS members born from 2000 through 2003 and who were vaccinated by their 13th birthday between 2010 and 2016. In October 2016, the CDC changed the adolescent HPV vaccination recommendation from three to two doses, starting the vaccine series before the child's 15th birthday. The report defines a completed regimen as three doses. The second dose of the HPV vaccine should be given six to twelve months after the first dose. It is recommended for teens and young adults who start the series at ages 15 through 26 to complete three doses of the HPV vaccine.