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Evaluation of Vaccination Reminder/Recall Systems for Adolescent Patients

11 Years
18 Years
Not Enrolling
Human Papilloma Virus (HPV), Tetanus-diphtheria-acellular Pertussis (Tdap), Meningococcal Infection, Varicella

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Trial Information

Evaluation of Vaccination Reminder/Recall Systems for Adolescent Patients

Although patient reminder/recall systems have been shown to be effective at improving
vaccination coverage levels for infants and younger children, little is known about the
effectiveness of such systems for increasing immunization rates in adolescent populations.
The process of reminder/recall in adolescents, and vaccination of adolescents overall,
presents particular challenges. Adolescents are less likely to routinely access health care
compared to younger children and adults. In addition, other obstacles such as lack of health
insurance, missed opportunities for vaccination during health care visits, and the
scattering of immunization records across multiple providers have posed major challenges in
the vaccination of adolescents. Issues of parental consent for vaccination can also be
problematic, given that adolescents may present for care without their parents accompanying
them. These and other barriers to immunization may reduce the effectiveness of
reminder/recall for adolescents. In the current research study, a study team with extensive
experience in immunization delivery research will investigate the ability of pediatricians
and family physicians in a number of different practice settings to implement a
reminder/recall system for their adolescent patient populations. In addition, we will be
able to examine the effectiveness of reminder/recall originating at public school-based
health centers, an innovative strategy that has not previously been reported. Randomized
controlled trials of reminder/recall for adolescents will be conducted at each type of site.
The study team will track important process measures during reminder/recall including the
percentage of the eligible population who actually received intervention; percentage with
incorrect addresses; percentage with incorrect or disconnected phones; percentage actually
up-to-date but incorrectly recalled; missed vaccination opportunities; and invalid doses of
vaccines administered. In this way, we will be able to not only determine the degree to
which reminder/recall was successful for adolescents, but also identify impediments to
success, which will provide a foundation for future efforts. Our study will also
investigate the cost of establishing and operating a reminder/recall system for adolescents
in each type of clinical setting.

Major Hypotheses

1. Reminder/recall of adolescents will result in an increased rate of receipt of
immunizations in private settings of approximately 10 percentage points

2. Reminder/recall will result in a greater rate of receipt of immunizations when patients
in public settings have access to a school-based health center (SBHC) compared to when
they do not have access to a SBHC

3. Reminder/recall originating at SBHC sites will result in the highest efficacy of
reminder/recall among all the types of clinical sites

Inclusion Criteria:

- children ages 11-18

- seen in practice in last 2 years

- not up-to-date on any or all shots (Tdap, HPV, meningococcal)

- parents agree to participate in Colorado Immunization and Information System registry

Exclusion Criteria:

- up-to-date on all vaccines

- under age 11 over age 18

- patients who have moved or gone elsewhere at each practice setting

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention

Outcome Measure:

1) the percentage receiving any vaccine after the baseline time point

Outcome Time Frame:

6 months after intervention

Safety Issue:


Principal Investigator

Allison Kempe, MD, MPH

Investigator Role:

Principal Investigator

Investigator Affiliation:

University of Colorado, Denver


United States: Federal Government

Study ID:




Start Date:

October 2007

Completion Date:

September 2010

Related Keywords:

  • Human Papilloma Virus (HPV)
  • Tetanus-diphtheria-acellular Pertussis (Tdap)
  • Meningococcal Infection
  • Varicella
  • adolescent reminder/recall
  • adolescent vaccines
  • Tdap
  • Meningococcal
  • HPV
  • Reminder cards
  • Recall messages
  • vaccine
  • conjugate
  • Chickenpox
  • Herpes Zoster
  • Diphtheria
  • Meningococcal Infections
  • Papilloma
  • Whooping Cough
  • Tetanus