Immunizations: Adolescents Tip Sheet

Incentives will be paid on an annual basis, following the end of Quarter 4. For additional information, refer to the 2021 and 2022 CBI Technical Specifications.

Members may be excluded from the measure if there is a contraindication to the vaccine or its components. Medical exemptions must be reported any time on or before the member’s 13th birthday.

Members meet the measure requirements when they have received all of the following:

Meningococcal Vaccine

• At least one vaccine administered with a date of service on or between the member’s 11th and 13th birthdays.
• Acceptable codes: 90619, 90733, 90734 (Menactra, Menveo, MenACWY, Menomune).

Tdap Vaccine

• At least one tetanus, diphtheria toxoids and acellular pertussis (Tdap) vaccine administered with a date of service on or between the member’s 10th and 13th birthdays.
• Acceptable codes: 90715 (Adacel, Boostrix).

HPV Vaccine

• At least two HPV vaccine with dates of service at least 146 days apart on or between the member’s 9th and 13th birthdays; o at least three HPV vaccines with different service dates on or between the member’s 9^th and 13^th
• HPV vaccination routinely recommended at age 11–12 years (can start at age 9 years if high risk).
• Acceptable codes: 90649, 90650, 90651.

Data for this measure will be collected using claims, immunization registries (CAIR & RIDE), DHCS Fee-for-Service encounter claims, Santa Cruz Health Information Exchange (SCHIE) and provider data submissions via the Data Submission Tool (DST) on the Portal del Proveedor. To find gaps in data:

• Run a report from your electronic health record (EHR) system; or.
• Manually compile patient data (Example: Download monthly adolescent immunizations quality report or your Care-Based Incentives Measure Details report on the Provider Portal and compare to EHR/paper charts).

This measure allows providers to submit immunization codes from the clinic EHR system or paper records to the Alliance by the DST contractual deadline. To submit, you may upload data files to the DST on the Portal del Proveedor. To be accepted, data must be submitted as a CSV file. Step-by-step instructions are available in the Data Submission Tool Guide on the Portal del Proveedor.

• Know your vaccination rates. Utilize the Alliance’s Portal del Proveedor reports to monitor your clinic’s vaccine rates.
• Voice your strong support of immunization. Confident recommendation and education by a health care professional is the main reason parents decide to vaccinate.
• Recommend the HPV vaccine the same day and the same way you recommend all other vaccines. For example, “Now that Miguel is 11, he is due for vaccinations to help protect against meningitis, HPV cancers and whooping cough. We’ll give those shots during today’s visit. Do you have any questions about these vaccines?”
• Motivate your team and encourage their immunization conversations with parents and to begin preparing teen parents/guardians for the vaccinations early.
• Empower staff to chart prep to review the schedule of immunizations and avoid any missed opportunities like providing a vaccine during a sick visit.
• Maintain strong doctor-patient relationships to help with challenging immunization conversations.
• Learn how to answer some of parents’ most common questions about the HPV vaccine and other vaccines. Review this HPV fact sheet published by the American Cancer Society:
  • HPV Provider Fact Sheet

• Use personal examples of how you choose to vaccinate children in your family.

• The Alliance’s Immunization Resources web page
• CDC Top 10 Tips for HPV Vaccination Success: Attain and Maintain High HPV Vaccination Rates
• CAIR Immunization Registry http://cairweb.org/.
• RIDE (Healthy Futures) Immunization Registry http://www.myhealthyfutures.org/.
• California Immunization Coalition.