Improving Immunization Rates for Adolescents Phase 2 (IIRA2) Measures Grid

Monitoring and measuring office processes and outcomes is a critical part of quality improvement work. Overall outcomes, such as improved vaccine coverage rates, are important to measure, but process measures, such as the rate of missed opportunities to vaccinate, can provide much needed information on whether interventions are being implemented consistently and reliably.

The measures set that was developed in the Improving Immunization Rates for Adolescents Phase 2 (IIRA2) is included in Appendix B for reference, adaptation and use in your practice.

IIRA2 Measures Grid

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Measures Name	Measures Definition	Measure Source	Measure Source	Measure Exclusion	Benchmark
1. HPV Vaccination Rate	The percentage of patients 16-18 years old who are up-to-date on human papillomavirus (HPV) vaccines (series completion)	Chart review, EMR, or IIS	Numerator: Number of patients 16-18 years old who are upto-date (completed series) on human papillomavirus (HPV) vaccines Denominator: Number of patients 16-18 years old	None	80%
2. Tdap Vaccination Rate	The percentage of patients 16-18 years old who are up-to-date on the tetanus, diphtheria and acellular pertussis (Tdap) vaccine	Chart review, EMR, or IIS	Numerator: Number of patients 16-18 years old who are upto-date on the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine Denominator: Number of patients 16-18 years old	None	80%
3. MenACWY Vaccination Rate	The percentage of patients 16-18 years old who are up-to-date on quadrivalent meningococcal conjugate (MenACWY) vaccines (series completion)	Chart review, EMR, or IIS	Numerator: Number of patients 16-18 years old who are upto-date (completed series) on quadrivalent meningococcal conjugate (MenACWY) vaccines Denominator: Number of patients 16-18 years old	None	80%
4. HepA Vaccination Rate	The percentage of patients 16-18 years old who are up-to-date on hepatitis A (HepA) vaccines (series completion)	Chart review, EMR, or IIS	Numerator: Number of patients 16-18 years old who are upto-date (completed series) on hepatitis A (HepA) vaccines Denominator: Number of patients 16-18 years old	None	None
5. Influenza Vaccination Rate	The percentage of patients 16-18 years old who received the 2021- 2022 flu vaccine	Chart review, EMR, or IIS	Numerator: Number of patients 16-18 years old who received the 2021-2022 flu vaccine Denominator: Number of patients 16-18 years old	None	80%
6. MenB Vaccination Rate (optional)	The percentage of patients 16-18 years old who have received the meningitis B (MenB) vaccine (series initiation)	Chart review, EMR, or IIS	Numerator: Number of patients 16-18 years old who have received the meningitis B (MenB) vaccine (initiated series) Denominator: Number of patients 16-18 years old	None	None
7. MenB Education Rate	The percentage of patients 16-18 years old who received education regarding the meningitis B (MenB) vaccine	Chart review, EMR, or IIS	Numerator: Number of patients 16-18 years old who received education regarding the meningitis B (MenB) vaccine at the current office visit or a previous office visit Denominator: Number of patients 16-18 years old who were eligible to initiate the meningitis B (MenB) vaccine series when they presented in the office	None	None
8. Missed Opportunity Rate	The percentage of patients 16-18 years old who do not receive all eligible doses of HPV, Tdap, MenACWY, and HepA when they present in the office	Chart review, EMR	Numerator: Number of patients 16-18 years old who did not receive all eligible doses of HPV, Tdap, MenACWY, and HepA when they presented in the office Denominator: Number of patients 16-18 years old who were eligible to receive HPV, Tdap, MenACWY, or HepA when they presented in the office	Documented, true contraindications, vaccines contraindicated due to Covid-19 vaccine interval	None
9. Missed Opportunities due to Postponement by Provider (optional)	The percentage of missed opportunities that were due to a provider postponing a vaccine to a later date	Chart review, EMR	Numerator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office because a vaccine was postponed to a later date by a provider Denominator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office	None	None
10. Missed Opportunities due to Postponement by Patient or Caregiver (optional)	The percentage of missed opportunities that were due to a patient or caregiver postponing a vaccine to a later date	Chart review, EMR	Numerator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office because a vaccine was postponed to a later date by the patient or caregiver Denominator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office	None	None
11. Missed Opportunities due to Refusal (optional)	The percentage of missed opportunities that were due to a patient or caregiver refusing or declining a vaccine	Chart review, EMR	Numerator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office because a vaccine was refused or declined by the patient or caregiver Denominator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office	None	None
12. Missed Opportunities due to Stock or Supply Issues	The percentage of missed opportunities that were due to stock or supply issues	Chart review, EMR	Numerator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office because of vaccine stock or supply issues Denominator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office	None	None
13. Missed Opportunities Without Reason Documented (optional)	The percentage of missed opportunities that did not have a documented reason	Chart review, EMR	Numerator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office and without documentation of the reason Denominator: Number of patients 16-18 years old who did not receive all eligible vaccines (HPV, Tdap, MenACWY, HepA) when they presented in the office	None	None
14. Missed Opportunities for Other Reasons (optional)	The percentage of missed opportunities due to other reasons	Chart review, EMR	Numerator: Number of patients 16-18 years old who did not receive all eligible vaccines (HPV, Tdap, MenACWY, HepA) when they presented in the office for reasons other than postponement, refusal, contraindication, or reason not documented. Denominator: Number of patients 16-18 years old who did not receive all eligible vaccine doses (HPV, Tdap, MenACWY, HepA) when they presented in the office	None	None
15. Ineligibility for vaccination due to COVID-19 vaccine (optional)	The number of patients who did not receive a vaccine due to a contraindicated COVID-19 vaccine	Chart review, EMR	Count of patients who met the following criteria: -16-18 years old -Seen for a visit during the data collection month -Not up-to-date on HPV (series completion), Tdap, MenACWY (series completion), or HepA (series completion) at the time of the visit -Ineligible to receive vaccines at the time of the visit due to a contraindicated Covid-19 vaccine interval	None	None

Last Updated

02/06/2023

Source

American Academy of Pediatrics