National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2016

Abstract

The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents routinely receive tetanus, diphtheria, and acellular pertussis vaccine (Tdap), meningococcal conjugate vaccine (MenACWY), and human papillomavirus (HPV) vaccine (1) at age 11-12 years. ACIP also recommends catch-up vaccination with hepatitis B vaccine, measles, mumps, and rubella (MMR) vaccine, and varicella vaccine for adolescents who are not up to date with childhood vaccinations. ACIP recommends a booster dose of MenACWY at age 16 years (1). In December 2016, ACIP updated HPV vaccine recommendations to include a 2-dose schedule for immunocompetent adolescents initiating the vaccination series before their 15th birthday (2). To estimate adolescent vaccination coverage in the United States, CDC analyzed data from the 2016 National Immunization Survey-Teen (NIS-Teen) for 20,475 adolescents aged 13-17 years.* During 2015-2016, coverage increased for ≥1 dose of Tdap (from 86.4% to 88.0%) and for each HPV vaccine dose (from 56.1% to 60.4% for ≥1 dose). Among adolescents aged 17 years, coverage with ≥2 doses of MenACWY increased from 33.3% to 39.1%. In 2016, 43.4% of adolescents (49.5% of females; 37.5% of males) were up to date with the HPV vaccination series, applying the updated HPV vaccine recommendations retrospectively.^† Coverage with ≥1 HPV vaccine dose varied by metropolitan statistical area (MSA) status and was lowest (50.4%) among adolescents living in non-MSA areas and highest (65.9%) among those living in MSA central cities.^§ Adolescent vaccination coverage continues to improve overall; however, substantial opportunities exist to further increase HPV-associated cancer prevention.

FIGURE 1

Estimated vaccination coverage with selected vaccines and doses among adolescents aged 13–17 years, by survey year — National Immunization Survey–Teen (NIS-Teen), United States, 2006–2016 Abbreviations: ACIP = Advisory Committee on Immunization Practices; APD = adequate provider data; HPV = human papillomavirus; MenACWY = quadrivalent meningococcal conjugate vaccine; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine. ≥1 dose Tdap at or after age 10 years; MenACWY: ≥2 doses MenACWY or meningococcal-unknown type vaccine, calculated only among adolescents aged 17 years at time of interview. Does not include adolescents who received their first and only dose of MenACWY at or after age 16 years; HPV vaccine, nine-valent (9vHPV), quadrivalent (4vHPV) or bivalent (2vHPV). ACIP recommends 9vHPV, 4vHPV or 2vHPV for females and 9vHPV or 4vHPV for males. The routine ACIP recommendation was made for females in 2006 and for males in 2011. ^† NIS-Teen implemented a revised APD definition in 2014, and retrospectively applied the revised APD definition to 2013 data. Estimates using different APD definitions might not be directly comparable.

FIGURE 2

Estimated vaccination coverage of ≥1 dose of human papillomavirus vaccine among female adolescents aged 13–17 years^, —National Immunization Survey–Teen, United States, 2016 Abbreviation: DC = District of Columbia. * National coverage = 65%. ^† The Advisory Committee on Immunization Practices recommends nine-valent, quadrivalent, or bivalent HPV vaccine for females. ^§ Sample size = 9,661. ^¶ Includes female adolescents born during January 1998–February 2004.

FIGURE 3

Estimated vaccination coverage of ≥1 dose of human papillomavirus vaccine among male adolescents aged 13–17 years^, — National Immunization Survey–Teen, United States, 2016 Abbreviation: DC = District of Columbia. *National coverage = 56%. ^† The Advisory Committee on Immunization Practices recommends nine-valent or quadrivalent HPV vaccine for males. ^§ Sample size = 10,814. ^¶ Includes male adolescents born during January 1998–February 2004.