National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2019

Laurie D. Elam-Evans, PhD; David Yankey, PhD; James A. Singleton, PhD; Natalie Sterrett, MPH; Lauri E. Markowitz, MD; Charnetta L. Williams, MD; Benjamin Fredua, MS; Lucy McNamara, PhD; Shannon Stokley, DrPH

Disclosures

Morbidity and Mortality Weekly Report. 2020;69(33):1109-1116. 

In This Article

National Vaccination Coverage

In 2019, 71.5% of adolescents aged 13–17 years had received ≥1 dose of HPV vaccine, and 54.2% had completed the HPV vaccination series and were considered HPV UTD (Table 1, Figure). Increases from 2018 in ≥1 dose HPV vaccine coverage and HPV UTD status were observed for females and for males. Coverage with ≥1 dose of MenACWY increased by 2.3 percentage points to 88.9%. Coverage with ≥2 MenACWY doses among adolescents aged 17 years was 53.7%, similar to that in 2018 (50.8%). Coverage with ≥1 dose of MenB among adolescents aged 17 years increased from 17.2% in 2018 to 21.8% in 2019. Coverage with ≥1 dose of Tdap remained stable and high (90.2%). Coverage exceeded 90% for ≥2 doses measles, mumps, and rubella vaccine (MMR), ≥3 doses of hepatitis B vaccine, and ≥1 and ≥2 doses of varicella vaccine among adolescents without a history of varicella disease.†††

Figure.

Estimated vaccination coverage with selected vaccines and doses* among adolescents aged 13–17 years, by survey year and Advisory Committee on Immunization Practices (ACIP) recommendations — National Immunization Survey-Teen (NIS-Teen)§,¶ — United States, 2006–2019
Abbreviations: 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 age 16 years; 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 recommended for boys in 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 beginning the series between ages 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 from 2016–2019. 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.
§NIS-Teen revised the adequate provider definition (APD) in 2014 and retrospectively applied that definition to 2013 data. Estimates using different APD definitions might not be directly comparable.
NIS-Teen moved from a dual landline and cellular telephone sampling frame to a single cellular telephone sampling frame in 2018.

†††Hepatitis A, hepatitis B, varicella, and measles, mumps, and rubella vaccines are considered childhood vaccinations and are recommended for adolescents who are not up to date with these vaccinations. Estimates in this report include those who might have received vaccinations on-time or as catch-up.

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