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## Complete Summary

#### TITLE

Immunizations: percentage of adolescents who are on time with
recommended immunizations (Hep B, Hep A, HPV, MMR, MCV4, Tdap, VZV).

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Immunizations.
Bloomington (MN): Institute for Clinical Systems Improvement (ICSI);
2007 Oct. 67 p. \[77 references\]

### Measure Domain

#### PRIMARY MEASURE DOMAIN

Process

The validity of measures depends on how they are built. By examining the
key building blocks of a measure, you can assess its validity for your
purpose. For more information, visit the [Measure
Validity](http://www.qualitymeasures.ahrq.gov/resources/measure_domains.aspx)
page.

#### SECONDARY MEASURE DOMAIN

Does not apply to this measure

### Brief Abstract

#### DESCRIPTION

This measure is used to assess the percentage of adolescents who are on
time with recommended immunizations (Hep B, Hep A, HPV (for females),
MMR, MCV4, Tdap, VZV (for patients without evidence of immunity).

#### RATIONALE

The priority aim addressed by this measure is to increase the rate of
people on time with recommended immunizations.

#### PRIMARY CLINICAL COMPONENT

Immunization; hepatitis B (Hep B); hepatitis A (Hep A); human
papillomavirus (HPV); measles, mumps and rubella (MMR); meningococcal
(MCV4); tetanus, diphtheria toxoids and acellular pertussis vaccine
(Tdap); varicella vaccine (VZV)

#### DENOMINATOR DESCRIPTION

All adolescents age 12 to 17 with continuous enrollment who presented
for a primary care visit in the specified quarter

#### NUMERATOR DESCRIPTION

Number of adolescents in denominator who are on time with recommended
immunizations (see the related \"Numerator Inclusions/Exclusions\" field
the Complete Summary)

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE CRITERION OF QUALITY

-   A clinical practice guideline or other peer-reviewed synthesis of
    the clinical evidence

#### NATIONAL GUIDELINE CLEARINGHOUSE LINK

-   [1) Immunizations. 2) Immunization
    update.](http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=12093)

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Unspecified

### State of Use of the Measure

#### STATE OF USE

Current routine use

#### CURRENT USE

Internal quality improvement

### Application of Measure in its Current Use

#### CARE SETTING

Physician Group Practices/Clinics

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Group Clinical Practices

#### TARGET POPULATION AGE

Age 12 to 17 years

#### TARGET POPULATION GENDER

Either male or female

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

Unspecified

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Staying Healthy

#### IOM DOMAIN

Effectiveness

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

Adolescents ages 12 to 17

This measure should be collected through:

-   Identifying eligible adolescents who presented in the target quarter
    for a primary care visit who have maintained continuous enrollment
    for 18 months.

-   Reviewing the record to determine if all recommended doses were
    given within the recommended time frames.

The suggested time period for data collection is quarterly.

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
All adolescents age 12 to 17 with continuous enrollment who presented
for a primary care visit in the specified quarter

**Exclusions**\
Unspecified

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

All cases in the denominator are equally eligible to appear in the
numerator

#### DENOMINATOR (INDEX) EVENT 

Encounter\
Patient Characteristic

#### DENOMINATOR TIME WINDOW

Time window is a single point in time

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Number of adolescents in denominator who are on time with recommended
immunizations\*

\*An adolescent is on time with recommended immunizations if he/she has
received:

-   Hep B -- hepatitis B vaccine

-   Hep A -- hepatitis A vaccine

-   HPV -- human papillomavirus vaccine (for females)

-   MMR - measles, mumps and rubella

-   MCV4 - meningococcal

-   Tdap - tetanus, diphtheria toxoids and acellular pertussis vaccine

-   VZV - varicella vaccine (for patients without evidence of immunity)

**Note**: Dosing schedule is subject to change, depending on
manufacturer\'s recommendations. Refer to the Immunization table and
corresponding annotations in the original measure documentation for
specific administration criteria.

Adolescents (age 11 to 15 years) can be immunized with Recombivax® HB
per an alternative two-dose schedule of 10 micrograms intramuscularly
(IM) given 4 to 6 months apart. Be aware, however, that the introduction
of this alternate dosing schedule does increase operational complexity
for immunization administration in a clinic serving multiple ages of
children and will therefore increase resultant risk of error.

**Exclusions**\
Unspecified

#### MEASURE RESULTS UNDER CONTROL OF HEALTH CARE PROFESSIONALS, ORGANIZATIONS AND/OR POLICYMAKERS

The measure results are somewhat or substantially under the control of
the health care professionals, organizations and/or policymakers to whom
the measure applies.

#### NUMERATOR TIME WINDOW

Fixed time period

#### DATA SOURCE

Medical record

#### LEVEL OF DETERMINATION OF QUALITY

Individual Case

#### PRE-EXISTING INSTRUMENT USED

Unspecified

### Computation of the Measure

#### SCORING

Rate

#### INTERPRETATION OF SCORE

Better quality is associated with a higher score

#### ALLOWANCE FOR PATIENT FACTORS

Unspecified

#### STANDARD OF COMPARISON

Internal time comparison

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

Unspecified

### Identifying Information

#### ORIGINAL TITLE

Percentage of adolescents who are on time with recommended
immunizations.

-   Hep B -- Hepatitis B vaccine

-   Hep A -- Hepatitis A vaccine

-   HPV -- Human papillomavirus vaccine (for females)

-   MMR - Measles, mumps and rubella

-   MCV4 - Meningococcal

-   Tdap - Tetanus, diphtheria toxoids and acellular pertussis vaccine

-   VZV - Varicella vaccine (for patients without evidence of immunity)

#### MEASURE COLLECTION

[Immunizations
Measures](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=26&doc=4470)

#### DEVELOPER

Institute for Clinical Systems Improvement

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

2003 Jul

#### REVISION DATE

2007 Oct

#### MEASURE STATUS

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems
Improvement (ICSI). Immunizations. Bloomington (MN): Institute for
Clinical Systems Improvement (ICSI); 2006 Jun. 61 p.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Immunizations.
Bloomington (MN): Institute for Clinical Systems Improvement (ICSI);
2007 Oct. 67 p. \[77 references\]

#### MEASURE AVAILABILITY

The individual measure, \"Percentage of adolescents who are on time with
recommended immunizations (Hep B, Hep A, HPV, MMR, MCV4, Tdap, VZV),\"
is published in \"Health Care Guideline: Immunizations.\" This document
is available from the [Institute for Clinical Systems Improvement (ICSI)
Web
site](http://www.icsi.org/guidelines_and_more/guidelines__order_sets___protocols/).

For more information, contact ICSI at, 8009 34th Avenue South, Suite
1200, Bloomington, MN 55425; phone: 952-814-7060; fax: 952-858-9675; Web
site: [www.icsi.org](http://www.icsi.org/); e-mail:
<icsi.info@icsi.org>.

#### NQMC STATUS

This NQMC summary was completed by ECRI on April 19, 2004. This NQMC
summary was updated by ECRI Institute on October 11, 2004, August 11,
2005, July 17, 2006 and again on December 26, 2007.

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/10/2008