NIS-Teen: Revised Definition of Adequate Provider Data (APD)

Morbidity Mortality Weekly Report published the 2014 NIS-Teen vaccination coverage estimates. All coverage estimates are based on provider-reported vaccination histories from adolescents with adequate provider data (APD). The definition of adequate provider data used for 2014 NIS-Teen estimates changed from previous years. This revised adequate provider data definition affects vaccination coverage estimates. This report describes the impact of this definition change on vaccination coverage estimates. To measure this impact, the revised adequate provider data definition was applied to 20062013 NIS-Teen data. Revised vaccination coverage estimates were calculated and compared to published estimates that used the previous adequate provider data definition.

Key Findings of the APD Report:

Starting in 2014, the NIS-Teen defined an adolescent’s vaccination record as having adequate provider data if that adolescent had vaccination history data from one or more of the named vaccination providers or if the parent reported that the adolescent was completely unvaccinated. Prior to 2014, the adequate provider data definition had more criteria, and it was based on a comparison of provider report of vaccination history to parental report of vaccination history, either by shot card report or recall.

  • A shorter NIS-Teen questionnaire resulted in a revised adequate provider data definition which impacted NIS-Teen vaccination coverage estimates.
  • The 2013 NIS-Teen vaccination coverage estimates using the revised adequate provider data definition were different and generally lower than original 2013 NIS-Teen estimates which used the previous definition.
  • Coverage estimates for vaccines routinely recommended in childhood (e.g., MMR, hepatitis B vaccines) decreased more than some of the vaccines routinely recommended in adolescence (e.g., HPV vaccine).
  • Some states and local areas had larger percentage point decreases in vaccination coverage estimates than others. However, most of these changes were not significant.
  • In general, the change in APD definition does not impact overall vaccination coverage trends.
  • Beginning in 2014, NIS-Teen vaccination coverage estimates will use the revised definition and cannot be directly compared to previously published 2006-2013 NIS-Teen survey vaccination coverage estimates.