Vaccination Coverage Among Adolescents Aged 13–17 Years

National Immunization Survey -- Teen, United States, 2022

Cassandra Pingali, MPH, MS; David Yankey, PhD; Laurie D. Elam-Evans, PhD; Lauri E. Markowitz, MD; Madeleine R. Valier, MPH; Benjamin Fredua, MS; Samuel J. Crowe, PhD; Carla L. DeSisto, PhD; Shannon Stokley, DrPH; James A. Singleton, PhD


Morbidity and Mortality Weekly Report. 2023;72(34):912-919. 

In This Article

Abstract and Introduction


Three vaccines are routinely recommended for adolescents to prevent pertussis, meningococcal disease, and cancers caused by human papillomavirus (HPV). CDC analyzed data from the 2022 National Immunization Survey–Teen for 16,043 adolescents aged 13–17 years to assess vaccination coverage. Birth cohort analyses were conducted to assess trends in vaccination coverage by age 13 years (i.e., before the 13th birthday) and by age 14 years (i.e., before the 14th birthday) among adolescents who were due for routine vaccination before and during the COVID-19 pandemic. Cross-sectional analysis was used to assess coverage estimates among adolescents aged 13–17 years. In 2022, vaccination coverage by age 14 years among adolescents born in 2008 continued to lag that of earlier birth cohorts and varied by sociodemographic factors and access to health care compared with coverage among earlier birth cohorts. Vaccination coverage by age 13 years among adolescents born in 2009 was similar to coverage estimates obtained before the COVID-19 pandemic. Among all adolescents aged 13–17 years, 2022 vaccination coverage levels did not differ from 2021 levels; however, initiation of the HPV vaccination series decreased among those who were insured by Medicaid. Coverage with ≥1 dose of tetanus, diphtheria, and acellular pertussis vaccine and ≥1 dose meningococcal conjugate vaccine was high and stable (around 90%). Providers should review adolescent vaccination records, especially among those born in 2008 and those in populations eligible for the Vaccines for Children program, to ensure adolescents are up to date with all recommended vaccines.


In the United States, the Advisory Committee on Immunization Practices (ACIP) recommends that children aged 11–12 years receive tetanus, diphtheria, and acellular pertussis vaccine (Tdap), meningococcal conjugate vaccine (MenACWY), and human papillomavirus (HPV) vaccine (HPV vaccine can be started at age 9 years). A booster dose of MenACWY is recommended at age 16 years, and using shared clinical decision-making, adolescents and young adults aged 16–23 years may also receive serogroup B meningococcal vaccine (MenB). ACIP also recommends that adolescents stay up to date with COVID-19 vaccines,* acquire any missed childhood vaccines (catch-up vaccination), and receive an annual influenza vaccine.[1] Results from 2021 National Immunization Survey–Teen (NIS-Teen) revealed declines in MenACWY§ and Tdap coverage among adolescents born in 2008; these persons were due for their routine adolescent vaccines in 2020, during the height of the COVID-19 pandemic.[2] Ongoing assessment of adolescent vaccination coverage can help guide progress in implementation of ACIP recommendations and identify populations and areas with low coverage.

*COVID-19 vaccination is recommended for all persons aged ≥6 months ( Estimates of COVID-19 vaccination coverage are available at and
Influenza vaccination is recommended for all persons aged ≥6 months. Influenza vaccination coverage estimates are available at
§Meningococcal conjugate vaccination coverage represents coverage with the quadrivalent meningococcal conjugate vaccine or meningococcal-unknown type vaccine.
Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine coverage represents coverage with ≥1 Tdap dose at age ≥10 years.