The US Department of Health and Human Services, Office of Disease Prevention and Health Promotion has created the Healthy People framework for identifying prominent public health priorities to improve health and well-being nationwide. Healthy People 2030 has outlined numerous public health objectives as part of their 10-year plan, including the need to increase vaccination rates. Ensuring high vaccination rates among adolescents and young adults is especially important for achieving this goal, as this not only protects both individual and community health, but also helps to curb the spread of infectious disease and protects vulnerable populations by establishing community immunity.
However, not all adolescents experience equal access to and availability of vaccinations. The World Health Organization (WHO) defines these barriers as social determinants of health (SDOH): the non-medical factors that influence an individual’s health outcomes, including conditions such as income, education, socioeconomic status, access to health coverage and language fluency. When examining the disparities that exist in adolescent health, these factors contribute directly to differences in vaccinations rates. Read on to learn more about some of the barriers that lead to vaccination disparities, and how you can play a role in supporting adolescent immunization equity.
Geographic Setting
Where adolescents live and how far they have to travel to see a healthcare provider impacts their health outcomes, including vaccination rates. Research suggests that rural patients travel further to receive medical care when compared to those living in urban settings. As a result, adolescents living in rural areas experience lower vaccination rates. Rural communities also face challenges such as the lack of resources to properly store vaccines and healthcare workers to administer them.
Pharmacies have become important locations for patients to receive vaccinations and are a trusted soure for care and advice. But with more than 7,000 pharmacies having closed since 2019, communities nationwide are experiencing a shortage of care options. This gap largely impacts Black and Latino neighborhoods where there are fewer pharmacies per capita than people who live in mostly white neighborhoods.
Health Literacy
Education level can also create a barrier to healthcare among adolescents. Research shows that vaccination coverage is lower among households with lower education. Because parents and teens may not be familiar with the recommended immunization schedule, this can contribute to missed opportunities for keeping adolescents up to date. Additionally, with an emphasis placed on vaccinations required for school, parents may not be aware of other recommended vaccines, such as HPV. In an article by the Rural Health Information Hub, Shannon Stokley, DrPH, shared that this is true particularly in rural settings and, “when it comes to vaccines that are not required by most states, like the HPV and meningococcal conjugate vaccines, rural vaccination rates are lower.”
Language Barriers
Communication between healthcare providers and their patients is essential in vaccination decision-making. Language barriers can pose challenges for healthcare providers in effectively communicating medical information to their patients. Along with language barriers, ineffective cross-cultural communication between provider and patient can lead to lower health literacy and understanding of vaccination information.
What can you do?
Healthcare Providers
- For parents and teens located in rural areas, utilize telehealth resources and online health systems to help answer questions and guide decision-making regarding vaccination. You can help patients locate nearby vaccination locations by directing them to state immunization resources or the HRSA Find a Health Center tool.
- It’s important to provide confident, consistent, and concise vaccination recommendations to parents and teens. Learn more about Unity’s 3Cs Training Videos and Resources to support effective communication skills between provider and patient.
- Work with your health system to provide vaccination resources in multiple languages. The CDC and Unity Consortium offer En Español pages to help you get started, in addition to the Vaccine Information Statement (VIS) translations available via Immunize.org.
- For providers looking to incorporate a more culturally competent approach in their vaccination conversations, check out the Department of Health and Human Services (HHS) Think Cultural Health CLAS Training Guide.
Parents and Teens
- Help keep your friends and family up to date on their recommended immunizations. Utilize resources from organizations such as Unity Consortium, Vaccinate Your Family, and VaccineInformation.org to share credible, fact-based vaccine information.
- Engage with organizations working to combat vaccine disparities. Parents and teens can join Unity’s Mom Advisory Council and Teen Advisory Council to share their experiences with barriers to vaccination.
- Students, you can support your peers by starting conversations about the importance of vaccination. Talk to your school about opportunities to share information about recommended immunizations, how you can learn more about vaccines and the importance of immunization and share resources with your peers to help them access their vaccination records.
Addressing SDOH is essential for improving health outcomes among adolescents and young adults, as these factors profoundly impact access to healthcare services, vaccine uptake, and overall community health and well-being. We all have a crucial role to play in improving vaccine equity by addressing systemic inequalities. Together, we can help ensure that all adolescents and young adults receive the life-saving vaccinations they need to stay healthy.