Immunizations: Adolescents Tip Sheet

Incentives are paid to the linked primary care provider (PCP) on an annual basis, following the end of quarter four. For additional information, refer to the CBI Technical Specifications.

• Administrative members on date of 13^th
• Dual coverage members.
• Members in hospice, receiving hospice services, or who died during the measurement year.

Providers must document each member’s need for Advisory Committee on Immunization Practices (ACIP) recommended immunizations as part of all regular health visits, including, but not limited to, the following types of encounters:

• Illness, care management, or follow-up appointments
• Initial Health Appointments (IHAs)
• Pre-travel visits
• Sports and school physicals
• Visits to local health departments
• Well-patient checkups

All California healthcare providers who administer vaccines must also enter immunization information for each patient into the local immunization registry within 14 calendar days, in accordance with state and federal laws.

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

• Meningococcal serogroups A,C,W,Y Vaccine
  • At least one meningococcal vaccine administered with a date of service on or between the member’s 11th and 13th birthdays or anaphylaxis due to the meningococcal vaccine any time on or before the member’s 13th birthday.
  • Acceptable codes: 90619, 90733, 90734 (Menactra, Menveo, MenACWY, Menomune); 428301000124106 (Anaphylaxis due to MCV vaccine).
• Tdap Vaccine
  • At least one Tdap vaccine administered with a date of service on or between the member’s 10th and 13th birthdays or anaphylaxis or encephalitis due to tetanus, diphtheria or pertussis vaccine any time on or before the member’s 13th birthday.
  • Acceptable codes: 90715 (Adacel, Boostrix); 428281000124107, 428291000124105 (Anaphylaxis due to Diphtheria, Tetanus or Pertussis Vaccine); 192710009, 192711008, 192712001 (Encephalitis due to Diphtheria, Tetanus or Pertussis Vaccine).
• HPV Vaccine: Any of the following meet criteria:
  • At least two HPV vaccines with dates of service at least 146 days apart on or between the member’s 9th and 13th birthdays.
  • At least three HPV doses with different service dates on or between the member’s 9^th and 13^th birthdays.
  • Anaphylaxis due to the HPV vaccine any time on or before the members 13th birthday.
  • Acceptable codes: 90649, 90650, 90651; 428241000124101 (Anaphylaxis due to HPV vaccine).

Note: SNOMED codes indicating anaphylaxis or encephalitis from vaccines need to be submitted via the Alliance Data Submission Tool (DST).

Data for this measure is collected using claims, immunization registries (CAIR & RIDE), DHCS Fee-For-Service encounter claims, and provider data submissions via the Data Submission Tool (DST) on the Provider Portal. To find gaps in data:

• Run a report from your Electronic Health Record (EHR) system; or
• Manually compile patient data. For example, download your monthly Adolescent Immunizations Quality report from the Provider Portal and compare it to your 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 Provider Portal. 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 Provider Portal.

• Build the member’s trust and confidence by addressing concerns and misconceptions proactively and confidently.
  • That's a common concern, but research has shown that receiving the HPV vaccine does not increase sexual activity or lead to earlier sexual debut among adolescents.
• HPV vaccination is recommended starting at age 9.
• Review charts prior to members’ visits, incorporate and review standing orders to ensure vaccines are available during all visits and train staff accordingly.
• Implement reminder and recall systems.
• Provide extended clinic hours, weekend appointments, or walk-in vaccination services.
• Provide clear, age-appropriate educational materials about the importance, safety, and benefits of vaccines.
• Use the Alliance Provider Portal reports and immunization registry (CAIR or RIDE) to identify patients due for a vaccine.
• Keep staff up to date on current recommendations and communication tools, such as Vaccines for Your Children – CDC.
• Share performance data with providers and staff to identify areas that need improvement, then reward individuals or teams who achieve higher rates.
• Ensure staff has current accounts with your local immunization registry and is trained to enter both administered vaccines and vaccines from health records into the registry. Providers are required to enter vaccine information into the immunization registry within 14 days of vaccine administration.
• Route after-hours calls from the Alliance members to the Nurse Advice Line: 844-971-8907.

• Alliance Cultural and Linguistic Services are available to network providers.
  • Language Assistance Services – request materials at 800-700-3874, ext. 5504.
  • Telephonic Interpreter Services – available to assist in scheduling members.
  • Face-to-Face Interpreter Services – can be requested for the appointment with the member.
  • For information about the Cultural and Linguistic Services Program, call the Alliance Health Education Line at 800-700-3874, ext. 5580 or email us at [email protected].
• Alliance Transportation Services for patients with transportation challenges.
  • Non-emergency medical transportation (NEMT), call 800-700-3874, ext. 5640 (TTY: Dial 711).
  • Non-medical transportation (NMT), call 800-700-3874, ext. 5577 (TTY: Dial 711).
• California Immunization Registry (CAIR).
• Healthy Futures Public Health information system.
• Start at 9 Toolkit - National HPV Vaccination Roundtable.
• Strategies for Improving Vaccine Communication and Uptake – American Academy of Pediatrics.