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Teen Vaccination Coverage

2014 National Immunization Survey-Teen (NIS-Teen)


Summary of Main Points

Despite increases, coverage estimates for human papillomavirus (HPV) vaccine remained low in 2014 and continue to lag behind rates for the Tdap and quadrivalent meningococcal conjugate vaccines. Four out of ten adolescent girls and six out of ten adolescent boys haven’t started the HPV vaccine series, and are vulnerable to cancers caused by HPV infections.

While there was only a 3 percentage point overall increase nationally, a handful of diverse state and local areas made large increases. Some of the promising strategies that have been effective in combination at increasing HPV vaccine uptake for these state and local areas include:

HPV Vaccine Coverage Maps

HPV Vaccine Coverage Map
  • joint initiatives with cancer prevention and immunization stakeholders (including clinical professional organizations like AAP),
  • incorporating HPV vaccination in the jurisdiction’s cancer control plans,
  • comprehensive public communication campaigns,
  • immunization information system (IIS)-based reminder/recall,
  • assessment and feedback (AFIX) activities (including clinician-to-clinician educational sessions emphasizing how to provide strong recommendations for vaccination at ages 11 or 12 years),
  • practice-focused strategies to educate key clinical and administrative staff about the importance of timely routine HPV vaccination, and
  • using all opportunities to educate clinicians and parents about the importance of on-time HPV vaccination.

2014 HPV Vaccination Coverage for Adolescents

2012 HPV Vaccination Coverage for Girls.

The newest data showing coverage rates of HPV vaccine for adolescents 13-17 years of age were published July 31, 2015 in MMWR.

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The Advisory Committee on Immunization Practices (ACIP) recommends that preteens (ages 11 or 12) get one dose of quadrivalent meningococcal conjugate vaccine, one dose of HPV vaccine, and one dose of Tdap vaccine during a single visit. A persistent gap in coverage between HPV vaccination and other vaccinations recommended for adolescents is a sign of missed opportunities to protect adolescents from cancers caused by HPV infections. Since 2008, the yearly national vaccination coverage estimate among female adolescents for one dose of HPV vaccine has been lower than the estimate for one dose of Tdap vaccine, and the difference in coverage between the two vaccines remains large. The difference between Tdap and HPV vaccine shows we are missing crucial opportunities to vaccinate boys and girls, leaving them at greater risk of HPV infections that can lead to cancer.


 

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

HPV Vaccine

  • For girls ages 13-17, coverage with at least one dose of HPV vaccine increased by 3.3 percentage points from 2013 to 2014 (56.7% in 2013 vs. 60.0% in 2014).
    • Receipt of the recommended three doses increased from 2013 to 2014, but still remained low (36.8% in 2013 vs. 39.7% in 2014).
    • Coverage with each HPV vaccine dose was higher among Hispanic girls than among white girls; coverage with one and two doses of HPV vaccine was higher among black girls than among white girls.
    • Coverage with each HPV vaccine dose was higher among girls living below the poverty level compared with those living at or above the poverty level.
  • For boys ages 13-17, coverage with at least one dose of HPV vaccine increased by 8.1 percentage points from 2013 to 2014 (33.6% in 2013 vs 41.7% in 2014).
    • Receipt of the recommended three doses increased from 2013 to 2014, but still remained low (13.4% in 2013 vs. 21.6% in 2014).
    • Coverage with each HPV vaccine dose was higher among Hispanic boys than among white boys; and coverage with one dose of HPV vaccine was higher among black boys than among white boys.
    • Coverage with each HPV vaccine dose was higher among boys living below the poverty level compared with those living at or above the poverty level.
  • There was wide variation in HPV vaccination coverage at the state level.
    • For girls, state-level coverage with at least one dose of HPV vaccine ranged from 38.3% in Kansas to 76.0% in Rhode Island.
    • For boys, state-level coverage with at least one dose of HPV vaccine coverage ranged from 23.2% in Indiana to 69.0% in Rhode Island.

Quadrivalent Meningococcal Conjugate Vaccine

  • Nationally, quadrivalent meningococcal conjugate vaccination coverage increased by 2.7 percentage points from 2013 to 2014 (76.6% in 2013 vs. 79.3% in 2014) among 13-17 year olds.

Tdap Vaccine

  • Nationally, Tdap vaccination coverage increased by 2.9 percentage points from 2013 to 2014 (84.7% in 2013 vs. 87.6% in 2013) among 13-17 year olds.

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NIS-Teen Vaccination Coverage Data Tables

 

Background on the NIS-Teen

  • The National Immunization Survey on adolescent 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 or guardians of teens 13-17 years old and in 2014, included data for more than 20,000 adolescents. The telephone survey is followed by a mailed questionnaire to vaccination providers to obtain the teen’s vaccination history.
  • The NIS-Teen includes coverage estimates for vaccines that are routinely recommended for adolescents.  These vaccines include Tdap to protect against tetanus, diphtheria, and pertussis, quadrivalent meningococcal conjugate vaccine to protect against meningococcal disease, and HPV vaccine to protect against HPV cancers.
  • NIS-Teen immunization coverage estimates are based on a sample of households identified from both landline and cell phone sampling frames.  Before 2011, only landline sampling frames were used. Including cell phones helps maintain a nationally representative sample as an increasing number of families have moved to using only cell phones and no longer have landline telephones.

Also see Archived Teen Vaccination Coverage.

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