National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2017

Tanja Y. Walker, MPH; Laurie D. Elam-Evans, PhD; David Yankey, PhD; Lauri E. Markowitz, MD; Charnetta L. Williams, MD; Sarah A. Mbaeyi, MD; Benjamin Fredua, MS; Shannon Stokley, DrPH


Morbidity and Mortality Weekly Report. 2018;67(33):909-917. 

In This Article

National Vaccination Coverage

In 2017, coverage with ≥1 dose of HPV vaccine was 65.5% among teens, an increase of 5.1 percentage points compared with 2016; 48.6% were HPV UTD with the recommended vaccination series, an increase of 5.2 percentage points from 2016 (Table 1) (Figure). Among adolescents surveyed during 2016–2017, HPV vaccination initiation by age 13 years increased an average of 5.9 percentage points for each birth year, from 19.6% (1998 birth cohort) to 56.3% (2004 birth cohort) (Supplementary Figure 1, HPV UTD status by age 13 years increased an average of 3.6 percentage points for each birth year, from 7.7% (1998 birth cohort) to 29.8% (2004 birth cohort). Coverage with ≥1 and ≥2 MenACWY doses, ≥2 MMR doses, and ≥2 VAR doses also increased (Table 1). Coverage with ≥1 dose of MenB among persons aged 17 years was 14.5% (95% confidence interval [CI] = 12.3%–17.1%).


Estimated coverage with selected vaccines and doses* among adolescents aged 13–17 years, by survey year and ACIP recommendations — National Immunization Survey-Teen, United States, 2006–2017§
Abbreviations: ACIP = Advisory Committee on Immunization Practices; HPV = human papillomavirus; MenACWY = quadrivalent meningococcal conjugate vaccine; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine; UTD = up to date.
*≥1 dose Tdap at or after age 10 years; ≥1 dose MenACWY or meningococcal-unknown type vaccine; ≥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 16 years of age; HPV vaccine, nine-valent (9vHPV), quadrivalent (4vHPV), or bivalent (2vHPV). The routine ACIP recommendation for HPV vaccination was made for females in 2006 and for males in 2011. Because HPV vaccination was not recommended for males until 2011, coverage for all adolescents was not measured before that year; HPV UTD includes those with ≥3 doses and those with 2 doses when the first HPV vaccine dose was initiated before age 15 years and at least 5 months minus 4 days elapsed between the first and second dose.
ACIP revised the recommended HPV vaccination schedule in late 2016. The recommendation changed from a 3-dose to 2-dose series with appropriate spacing between receipt of the first and second dose for immunocompetent adolescents initiating the series before the 15th birthday. Three doses are still recommended for adolescents initiating the series between the ages of 15 and 26 years. Because of the change in recommendation, the graph includes estimates for ≥3 doses HPV from 2011 to 2015 and the HPV UTD estimate for 2016 and 2017. Because HPV vaccination was recommended for boys in 2011, coverage for all adolescents was not measured before that year.
§NIS-Teen implemented a revised adequate provider data definition (APD) in 2014, and retrospectively applied the revised APD definition to 2013 data. Estimates using different APD definitions may not be directly comparable.