Abstract and Introduction
Introduction
The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of persons aged 11–12 years to protect against certain diseases, including human papillomavirus (HPV)–associated cancers, meningococcal disease, and pertussis.[1] A booster dose of quadrivalent meningococcal conjugate vaccine (MenACWY) is recommended at age 16 years, and serogroup B meningococcal vaccine (MenB) may be administered to persons aged 16–23 years.[1] To estimate vaccination coverage among adolescents in the United States, CDC analyzed data from the 2018 National Immunization Survey–Teen (NIS-Teen) which included 18,700 adolescents aged 13–17 years.* During 2017–2018, coverage with ≥1 dose of HPV vaccine increased from 65.5% to 68.1%, and the percentage of adolescents up-to-date† with the HPV vaccine series increased from 48.6% to 51.1%, although the increases were only observed among males. Vaccination coverage increases were also observed for ≥1 MenACWY dose (from 85.1% to 86.6%) and ≥2 MenACWY doses (from 44.3% to 50.8%). Coverage with tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap) remained stable at 89%. Disparities in coverage by metropolitan statistical area (MSA)§ and health insurance status identified in previous years persisted.[2] Coverage with ≥1 dose of HPV vaccine was higher among adolescents whose parents reported receiving a provider recommendation; however, prevalence of parents reporting receiving a recommendation for adolescent HPV vaccination varied by state (range = 60%–91%). Supporting providers to give strong recommendations and effectively address parental concerns remains a priority, especially in states and rural areas where provider recommendations were less commonly reported.
NIS-Teen is an annual survey that monitors vaccines received by adolescents aged 13–17 years in the 50 states, the District of Columbia, selected local areas, and U.S. territories.¶ NIS-Teen is conducted among parents and guardians of eligible adolescents identified using a random-digit–dialed sample of cell phone numbers.** During the telephone interview, information is obtained on the sociodemographic characteristics of the teen and household, and contact information and consent to contact the teen's vaccination providers are requested. Vaccination providers identified during the interview are mailed a questionnaire requesting the vaccination history from the teen's medical record.†† Vaccination coverage estimates are based on provider-reported vaccination histories. This report presents vaccination coverage estimates for 18,700 adolescents (8,928 [48%] females and 9,772 [52%] males) aged 13–17 years with adequate provider data.§§ The overall Council of American Survey Research Organizations response rate was 23.3%, and only 48.3% of adolescents with completed interviews had adequate provider data.
Previously described NIS-Teen methodology, including methods for weighting and synthesizing provider-reported vaccination histories (https://www.cdc.gov/vaccines/imz-managers/nis/downloads/NIS-TEEN-PUF17-DUG.pdf) was used. Beginning in 2018, NIS-Teen used a single-frame sample of cell phone lines. The landline telephone–sample frame that was used from 2006 through 2017 was dropped because of the declining number of landline-only households in the United States (https://www.cdc.gov/vaccines/imz-managers/coverage/teenvaxview/pubs-presentations/dual-to-single-frame-teen.html). Data were weighted and analyzed to account for the complex sampling design. T-tests were used to assess vaccination coverage differences by survey year (2018 compared with 2017) and between demographic subgroups. P-values <0.05 were considered statistically significant. SAS-callable SUDAAN (version 11; SAS Institute) was used to conduct all analyses.
Morbidity and Mortality Weekly Report. 2019;68(33):718-723. © 2019 Centers for Disease Control and Prevention (CDC)
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