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Teen Vaccination Coverage

2012 National Immunization Survey (NIS) - Teen


Summary of Main Points

The Advisory Committee on Immunization Practices (ACIP) recommends that preteens get Tdap, MCV4*, and the first HPV vaccine dose during a single visit. However, the National Immunization Survey-Teen (NIS-Teen) vaccination coverage data collected in 2012 show that too many boys and girls are not being vaccinated with HPV and meningococcal vaccines when they receive Tdap vaccine. Without these life-saving vaccines, preteens and teens are at risk of infections with HPV and vaccine-preventable bacterial meningitis.

Since 2009, the yearly national vaccination coverage estimate among teens for one dose of meningococcal conjugate vaccine has been lower than the estimate for one dose of Tdap vaccine, and the difference in coverage between the two vaccines is widening. Among females, vaccination coverage estimates for HPV vaccination remained low and did not increase at all from 2011 to 2012.

2012 HPV Vaccination Coverage for Girls

2012 HPV Vaccination Coverage for Girls.

The newest data showing coverage rates of HPV vaccine for girls 13-17 years of age were published July 25, 2013 in MMWR.

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From 2011 to 2012, vaccination coverage among U.S. adolescents between the ages of 13 and 17 years increased to about 85% for at least one dose of Tdap vaccine, 74% for at least one dose of MCV4 vaccine, and, among males, to about 21% for at least one dose of HPV vaccine. In 2012, vaccination coverage for at least one dose of HPV vaccine among females approached 54%, remaining statistically unchanged since 2011. Only one-third of female teens received all 3 recommended doses of the HPV vaccine series in 2012.

Increased Tdap coverage might be due to state school vaccination requirements (40 states required Tdap vaccination for entry into nonresidential middle schools during the 2012-2013 school year), as well as other factors, including providers’ and parents’ awareness that in recent years most states have reported increased cases or outbreaks of pertussis. Increased coverage for meningococcal vaccine might be due partly to state school vaccination requirements; 13 states required MCV4 vaccination for entry into nonresidential middle schools during the 2012-2013 school year.

Large and increasing coverage differences between Tdap and other vaccines recommended for adolescents show that many valuable opportunities are being missed to vaccinate boys and girls, especially against HPV infection. Providers should administer recommended HPV and meningococcal vaccinations to boys and girls during the same visits when Tdap is given. Providers, parents, and adolescents also should use every healthcare visit as an opportunity to review adolescents’ immunization histories and ensure that every adolescent is fully vaccinated.

*Please note that meningococcal conjugate vaccine is commonly abbreviated as MCV4; the MMWR article containing the 2012 NIS-Teen data references the vaccine as MenACWY.

 

Survey Data – Coverage among Adolescents 13 through 17 Years of Age

HPV Vaccine

  • For girls who received at least one dose of HPV vaccine, coverage remained similar to the estimate for 2011 (53.0% in 2011 vs. 53.8% in 2012). This means that just over half of the girls between the ages of 13 and 17 years had started the series that they should have completed by their 13th birthdays, according to national recommendations.
    • Receipt of the recommended three doses remained statistically unchanged from 2011 to 2012 (34.8% in 2011 compared to 33.4% in 2012). This means that only about one-third of girls between the ages of 13 and 17 years had completed the series that they all should have completed by their 13th birthdays, according to national recommendations and national vaccination coverage targets.
    • Among girls who received one or two doses of HPV vaccine, coverage rates were higher for Hispanics than for whites.
    • Overall, coverage for one or two doses was higher for those living below poverty level; however, no differences by poverty level were observed for three doses.
  • For boys who received at least one dose of HPV vaccine, coverage increased significantly from 8.3% in 2011 to 20.8% in 2012, the first year after HPV vaccine was routinely recommended for boys.
    • Only 6.8% of boys aged 13-17 years received all three recommended doses of HPV vaccine (an increase from 1.3% in 2011).
    • Coverage for one or two doses of HPV vaccine was greater among blacks and Hispanics compared to whites.
    • Overall, coverage was greater among those living below the poverty level compared to those living at or above the poverty level.

Meningococcal Conjugate Vaccine (MCV4)

  • MCV4 vaccination increased by only 3.5 percentage points from 2011 to 2012, (70.5% in 2011 vs. 74.0% in 2012).
  • Coverage for one dose of MCV4 was similar across poverty levels, but lower among whites than other racial/ethnic groups.

Tdap Vaccine

  • Nationally, Tdap vaccination increased by 6.4 percentage points from 2011 to 2012 (78.2% in 2011 vs. 84.6% in 2012).
  • Tdap coverage was similar across poverty levels, age groups, and racial/ethnic groups.

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NIS-Teen Vaccination Coverage Data Tables


Background on the NIS-Teen

  • The National Immunization Survey on teen immunization coverage rates (also called NIS-Teen) provides a "report card" to let us know how well we are doing in protecting our nation's teens against vaccine-preventable diseases.
  • The NIS-Teen is a random-digit-dialed survey of parents and guardians of teens 13–17 years old and in 2012, included data for more than 19,000 adolescents. The telephone survey is followed by verification of records with health care professionals.
  • The NIS-Teen includes immunization coverage estimates for three vaccines that are recommended at 11 through 12 years of age. These vaccines include Tdap to protect against tetanus, diphtheria, and pertussis, MCV4 to protect against meningococcal disease, and HPV vaccines to protect against infection with HPV and HPV-related diseases, including cancers.
  • NIS-Teen immunization coverage estimates are based on a sample of adolescents identified from both land-line and cell phone sampling frames. Before 2011, only land-line sampling frames were used. Including cell phones is intended to help keep a nationally representative sample, since an increasing number of families have moved to using only cell phones and no longer have land-line telephones.
  • The report also includes coverage on some vaccines recommended for adolescents if not previously given in childhood.

Also see Archived Teen Vaccination Coverage.

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