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Local, National Vaccine Coverage of US Adolescents

MMWR; 2018 Aug 24; Walker, Elam-Evans, et al

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of persons aged 11–12 years with human papillomavirus (HPV) vaccine, quadrivalent meningococcal conjugate vaccine (MenACWY), and tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap). A booster dose of MenACWY is recommended at age 16 years, and catch-up vaccination is recommended for hepatitis B vaccine (HepB), measles, mumps, and rubella vaccine (MMR), and varicella vaccine (VAR) for adolescents whose childhood vaccinations are not up to date (UTD). ACIP also recommends that clinicians administer a serogroup B meningococcal vaccine (MenB) series to adolescents and young adults aged 16–23 years, with a preferred age of 16–18 years.

In order to estimate US adolescent vaccination coverage, The Centers for Disease Control and Prevention (CDC) analyzed data from the 2017 National Immunization Survey–Teen (NIS-Teen) for 20,949 adolescents aged 13–17 years. They found:

  • During 2016–2017, coverage increased for ≥1 dose of HPV vaccine (from 60.4% to 65.5%), ≥1 dose of MenACWY (82.2% to 85.1%), and ≥2 doses of MenACWY (39.1% to 44.3%).
  • Coverage with Tdap remained stable at 88.7%.
  • In 2017, 48.6% of adolescents were UTD with the HPV vaccine series (HPV UTD) compared with 43.4% in 2016.
  • On-time vaccination (receipt of ≥2 or ≥3 doses of HPV vaccine by age 13 years) also increased.
  • Although HPV vaccination initiation remains lower than coverage with MenACWY and Tdap, HPV vaccination coverage has increased an average of 5.1 percentage points annually since 2013, indicating that continued efforts to target unvaccinated teens and eliminate missed vaccination opportunities might lead to HPV vaccination coverage levels comparable to those of other routinely recommended adolescent vaccines.

Citation:

Walker TY, Elam-Evans LD, Yankey D, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 Years—United States, 2017.MMWR. 2018;67(33);909–917. doi:10.15585/mmwr.mm6733a1.

Commentary:

This large study looked at vaccination rates for adolescents around the US. There are encouraging data that show slow but sustained improvement in vaccine coverage nationwide. A steady average of 5% improvement annually in HPV coverage of adolescents since 2013 is good news, although up-to-date HPV vaccination rates nationwide are still not at 50% of the population. This contrasts with Tdap which has very high and stable coverage (88.7%) nationwide over time. Geographic disparities are identified with higher vaccine coverage in urban areas, and lower coverage in rural areas. Finally, this study identifies areas of opportunity to investigate and improve adolescent vaccine coverage.—Sarah Rawstron, MB, BS, FAAP, FIDSA; Pediatric Residency Program Director, The Brooklyn Hospital Center, NY; Clinical Associate Professor, Icahn School of Medicine, Mount Sinai, NY.