183 - Medical Dental Integration to Increase Adolescent Vaccinations for Children Ages 9-17.

Poster Number: 183
Publication Number: 183.142

Jessica Jack, Denver Health and Hospital Authority/University of Colorado School of Medicine, Denver, CO, United States; Christine E. Krentz, University of Colorado School of Medicine, Denver, CO, United States; Aaron Buban, University of Colorado School of Dental Medicine, Denver, CO, United States; Mark T. Durniak, University of Colorado School of Medicine, Erie, CO, United States; Kojo Danso, Denver Health and Hospital, Denver, CO, United States; Scott Hamilton, Denver Health, denver, CO, United States

Background: Dentists are key players in preventative health who routinely screen for oral cancer and counsel on HPV prevention. Children older than 9 years old typically see the dentist more often than their primary care providers . This highlights an opportunity for dentistry and medicine to collaborate to identify and vaccinate adolescents who are overdue for immunizations during dental visits.

Objective: The purpose of this project was to create a collaborative process between dentistry and medicine to increase vaccination rates of adolescent vaccinations (Tdap, MCV4, and HPV9) by 5% in patients ages 9-17 through vaccination during dental visits or assisted follow-up scheduling.

Design/Methods: The project was conducted at a large Federally Qualified Healthcare Center with three pilot dental clinics that were co-located within medical clinics. Data was collected from 5/24/21-11/12/21. Reports were run daily to identify patients ages 9-17 who were overdue for vaccinations. PDSA cycles were performed which included provider training, vaccine reminders that were added to the electronic medical record, flags that were placed in patient charts as a visual cue for providers, and individual provider feedback. Patients who were identified as overdue for vaccines were offered same-day vaccines or if they declined were given the opportunity to schedule a follow-up visit with their medical clinic. Chart review was conducted to determine same-day efficacy and if vaccines were administered within 30-days of the dental visit. Vaccination rates for adolescents were then compared to 2020.

Results: Compared to 2020, across all clinics during the 6-month period, there was a 5% (Nf119) increase in vaccinations due to medical-dental integration in 2021 (MDI) (Fig 1). Montbello Clinic was particularly successful, with a 14% increase in vaccinations during the 6-month period due to MDI (Fig 2). Same-day vaccine administration efficacy was 12% overall and 19 % at the Montbello Clinic (Fig 3).Conclusion(s): Patients were receptive to discussing and receiving vaccinations during dental visits. Factors for success were buy-in from clinic staff, visual cues in charts and in the office, and presence of an MDI champion. Limitations were dental and medical staff shortages that led to an inability to coordinate same day vaccinations. This highlights the benefits of MDI and that dental providers can play an influential role in pediatric disease prevention by actively participating in vaccination.
Figure 1Overall Vaccinations (HPV9, Tdap, or MCV4)
Figure 2Montbello Vaccinations (HPV9, Tdap, or MCV4)