June 2, 2025
As children grow into adolescents, yearly preventive care visits for exams and scheduled immunizations can help them on the path to wellness. The Centers for Disease Control and Prevention encourages health care providers to remind families about scheduling routine vaccines and visits.
To help our members close any care gaps, we track the following Healthcare Effectiveness Data and Information Set (HEDIS®) measures developed by the National Committee for Quality Assurance for children and adolescents:
Immunizations for Adolescents tracks the percentage of 13-year-olds who received the following vaccines by their 13th birthday:
- One dose of meningococcal vaccine
- One tetanus, diphtheria and pertussis
- The complete human papillomavirus vaccine series
Child and Adolescent Well-Care Visits tracks the percentage of members ages 3 to 21 who received at least one well-care visit with a primary care provider or OB/GYN during the measurement year.
For an immunization schedule and more details, see our preventive care guidelines and Children’s Wellness Guidelines.
Tips to consider
- Identify members who have missed vaccines or well-child visits. Contact their caregivers to schedule appointments.
- Check at each visit for any missing immunizations. Address common misconceptions about vaccines.
- Remind our members that it’s important to get a flu shot every year because new strains of flu virus appear each year. The CDC recommends that most people 6 months and older should get a flu vaccine every year.
- To document well-child visits, note that the visit was with a PCP and include in the medical record:
- Date of visit
- Health history
- Physical and mental development history
- Physical exam
- Height, weight and body mass index percentile
- Health education or anticipatory guidance, including physical activity, diet and nutrition
- We collect immunization data through claims and chart review. To document immunizations, you may include in the medical record any of the following:
- Certificates of immunizations
- Diagnostic reports
- Subjective, objective, assessment and plan notes
- Office or progress notes
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
HEDIS is a registered trademark of NCQA.