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

Disclosures

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

In This Article

Vaccination Coverage by Selected Characteristics

Coverage with ≥1 dose of HPV vaccine and HPV UTD status were higher among adolescents living below the federal poverty level (73.3% and 53.7%, respectively) than among those living at or above the poverty level (62.8% and 46.7%, respectively)¶¶ (Table 2). Coverage with ≥1 dose of HPV vaccine was 10.8 percentage points lower among adolescents living in non-MSAs and 7.0 percentage points lower among those living in MSA nonprincipal cities compared with those living in MSA principal cities (Table 2). These disparities remained after controlling for poverty level.*** HPV UTD status was 10.0 percentage points lower among adolescents living in non-MSAs and 5.5 percentage points lower among those living in MSA nonprincipal cities compared with those living in MSA principal cities (Table 2). After adjusting for poverty level, differences in HPV UTD status did not persist among adolescents living in MSA nonprincipal cities, but did among adolescents living in non-MSAs compared with those living in MSA principal cities.††† ≥1- and ≥2-dose MenACWY coverage rates among adolescents living in non-MSAs were 7.4 and 12.0 percentage points lower, respectively, than those among adolescents living in MSA principal cities (Table 2). This disparity remained after controlling for poverty level.§§§ Differences in HPV vaccination coverage by race/ethnicity in 2017 were similar to patterns observed in previous years (Supplementary Table 1, https://stacks.cdc.gov/view/cdc/58073).[4] Coverage with ≥1 dose of HPV vaccine and HPV UTD status were 8.8 and 6.6 percentage points higher, respectively, among adolescents enrolled in Medicaid than among those with private insurance only (Supplementary Table 2, https://stacks.cdc.gov/view/cdc/58074). HPV UTD status, ≥1-dose MenACWY, and ≥2-dose MenACWY coverage rates were 12.7, 5.0, and 22.6 percentage points lower, respectively, among uninsured adolescents than among those with private insurance (Supplementary Table 2).

¶¶Adolescents were classified as below the federal poverty level if their total family income was less than the federal poverty level specified for the applicable family size and number of children aged <18 years. All others were classified as at or above the poverty level. Poverty status was unknown for 779 adolescents. https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-thresholds.html.
***Among adolescents living below poverty level, ≥1-dose HPV vaccination coverage estimates stratified by MSA status were 63.7% (95% CI = 58.4%–68.7%) for adolescents living in non-MSAs, 70.4% (CI = 65.8%–74.7%) for adolescents living in MSA nonprincipal cities, and 78.0% (CI = 74.1%–81.5%) for adolescents living in MSA principal cities (reference group). Among adolescents living at or above poverty level, ≥1-dose HPV vaccination coverage estimates were 56.9% (CI = 53.8%–60.0%) for adolescents living in non-MSAs, 61.6% (CI = 59.6%–63.6%) for adolescents living in MSA nonprincipal cities, and 66.0% (CI = 63.7%–68.2%) for adolescents living in MSA principal cities (reference group).
†††Among adolescents living below poverty level, HPV UTD status estimates stratified by MSA status were 44.3% (CI = 39.1%–49.6%), 52.8% (CI = 47.8%–57.8%), and 57.0% (CI = 52.4%–61.5%) for adolescents living in non-MSAs, MSA nonprincipal cities, and MSA principal cities (reference group), respectively. Among adolescents living at or above poverty level, HPV UTD status estimates stratified by MSA status were 40.7% (CI = 37.6%–48.3%), 46.1% (CI = 44.0%–48.2%), and 49.3% (CI = 46.9%–51.7%) for adolescents living in non-MSAs, MSA nonprincipal cities, and MSA principal cities (reference group), respectively.
§§§Among adolescents living below poverty level, ≥1-dose MenACWY coverage estimates stratified by MSA status were 83.2% (CI = 79.3%–86.5%), 87.7% (CI = 84.0%–90.7%), and 85.1% (CI = 80.9%–88.5%) for adolescents living in non-MSAs, MSA nonprincipal cities, and MSA principal cities (reference group), respectively. Among adolescents living at or above poverty level, ≥1-dose MenACWY coverage estimates were 76.0% (CI = 73.1%–78.7%), 85.7% (CI = 84.0%–87.3%), and 86.0% (CI = 84.3%–87.5%) for adolescents living in non-MSAs, MSA nonprincipal cities, and MSA principal cities (reference group), respectively.

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