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Compared with children, adolescents are underimmunized. Investigators used data from electronic medical records to examine the frequency of missed opportunities for administration of recommended tetanus-diphtheria (Td) vaccine among nearly 24,000 adolescents who received care at a large medical practice in Massachusetts between 1997 and 2004. A missed opportunity was defined as a healthcare visit with a patient aged 11 to 17 years who needed Td immunization but did not receive the vaccine within 14 days of the visit.
Among the nearly 104,000 outpatient visits, missed opportunities occurred in 84% overall and in 96% of non–preventive-care visits, 71% of vaccine-only visits (presumably for other vaccines), and 47% of preventive-care visits. Am…