Immunizations for Adolescents (IMA)

Healthcare Effectiveness Data Information Set^® (HEDIS) is a widely used set of performance measures developed and maintained by NCQA.
These are used to drive improvement efforts surrounding best practices.

Measure description: This HEDIS measure represents the percentage of children who turned 13 years of age during the measurement year and had the following vaccinations on or by their thirteenth birthday:

• One dose of meningococcal vaccine
• One tetanus, diphtheria toxoids and one acellular pertussis vaccine (Tdap): and
• Completed the human papillomavirus (HPV) series.

Meningococcal Serogroups A, C, W, Y:

• At least one meningococcal serogroups A, C, W, Y vaccine, with a date of service on or between the member’s eleventh and 13th birthdays
• Anaphylaxis due to the meningococcal vaccine any time on or before the member’s 13th birthday meets criteria.
• Do not count meningococcal recombinant (serogroup B) (MenB) vaccines. Immunizations documented under a generic header or meningococcal and generic documentation that meningococcal vaccine, meningococcal conjugate vaccine or meningococcal polysaccharide vaccine were administered meet criteria.

Tdap:

• At least one tetanus, diphtheria toxoids and acellular pertussis (Tdap) vaccine, with a date of service on or between the member’s tenth and 13th birthdays.
• Anaphylaxis due to tetanus, diphtheria, or pertussis vaccine any time on or before the member’s thirteenth birthday meets criteria. Encephalitis due to the tetanus, diphtheria, or pertussis vaccine any time on or before the member’s thirteenth birthday. Immunizations documented using a generic header of Tdap/Td can be counted as evidence of Tdap.

HPV:

• At least two HPV vaccines on or between the member’s ninth and 13th birthdays and with dates of service at least 146 days apart. For example, if the service date for the first vaccine was March 1, then the service date for the second vaccine must be on or after July 25.
• Or at least three HPV vaccines, with different dates of service on or between the member’s ninth and 13th birthdays.
• Anaphylaxis due to the HPV vaccine any time on or before the member’s 13th birthday meets criteria.

Numerator codes for Immunizations for Adolescents (IMA):

Documentation required

Acceptable:

• A note indicating the name of the specific antigen and the date of the immunization
• A certificate of immunization prepared by an authorized health care provider or agency, including the specific dates and types of immunizations administered

Nonacceptable:

• A note that says the member is up to date with all immunizations but does not list the dates and names of immunizations
• Meningococcal recombinant (serogroup B) (MenB) vaccines

Strategies for improvement:

• Educate staff to reach out to patients to schedule well-care visits and vaccines between the ages of nine and 12.
• Use appointment reminders for well-care visits and vaccines.
• Consider offering drop-in hours, after-hours, or weekend appointments for member convenience.
• Create alerts within your electronic health record (EHR) to indicate when the vaccines are due.
• Implement standing orders for adolescent vaccines so that patients may complete vaccines through a nurse visit.
• Educate families on the importance of these vaccines (use of motivational interviewing).
• Address vaccine hesitancy in parents by answering their questions and using fact-based educational materials.
• Document and submit claims in a timely manner and with the correct codes.
• Document all vaccines given with the date of service.
• Missing HPV vaccines are the primary reason for noncompliance. Provide enhanced and consistent provider/clinic recommendation of HPV vaccine.
• Ensure administration of the HPV vaccine when Tdap and meningococcal are given and during subsequent well-care and sick visits.
• Schedule the second HPV appointment when giving the first HPV vaccine.
• HPV rates are now reported for both females and males.
• Bill exclusionary diagnosis codes and dates given when applicable.
• Complete CDC's You Call the Shots interactive web-based immunization training course by visiting https://cdc.gov/vaccines/ed/YouCalltheShots (receive continuing education credit upon completion).

Resources:

• NCQA: ncqa.org
• You call the shots: https://cdc.gov/vaccines/ed/YouCalltheShots