CDC: Teen Vaccine Coverage Improves, but More Provider Recommendations Needed

Ensuring adolescents have received all recommended vaccines is important for maintaining good health, especially as students are going back to school. A recent CDC study found that teen vaccine coverage has improved, but more education and provider recommendations are needed to boost immunization rates for human papillomavirus (HPV).¹

The Advisory Committee on Immunization Practices (ACIP) recommends the HPV vaccine for all adolescents age 11-12 years—it can start at age 9 years— and it can be administered as a 2-dose series if it is started at age 9-14 years.² If the HPV initial vaccine series is started at age 15 years or older, it is administered as a 3-dose series.

In addition, individuals should receive 1 dose of the tetanus, diphtheria, and pertussis (Tdap) vaccine at age 11-12 years. Teens should receive a booster dose of the meningococcal conjugate vaccine (MenACWY) at age 16 years, and the meningococcal serogroup B vaccine (MenB) may be administered to individuals age 16-23 years with certain risk factors.²

The CDC analyzed data from the 2018 National Immunization Survey-Teen (NIS-Teen) to estimate vaccine coverage among adolescents aged 13-17 years, which included 18,700 teens.² Additionally, NIS-Teen is an annual survey that monitors vaccines received by adolescents aged 13-17 years in all 50 states, the District of Columbia, selected local areas, and in United States territories, and it is conducted among parents and guardians of eligible teens. Vaccine providers identified during the interview were mailed a questionnaire requesting the teen’s immunization history. The overall survey response rate was 23.3%, and 48.3% of teens with completed interviews had adequate provider data.¹

The study revealed that from 2017-2018, coverage with at least 1-dose of HPV vaccine increased from 65.5%-68.1%, and the percentage of teens up-to-date with the HPV vaccine series increased from 48.6%-51.1%.¹ However, the increases in HPV vaccine coverage were only observed among males.

According to the CDC analysis, 77.5% of parents reported receiving a provider recommendation for the HPV vaccine. Teens receiving at least 1-dose of HPV vaccine were higher when parents received a provider recommendation (74.7%) than those without a provider recommendation (46.7%).¹

Coverage with at least 1-dose of MenACWY increased by 6.5 percentage points to 50.8%, and coverage with at least 1-dose of MenB among individuals 17 years was 17.2%. Vaccine coverage with Tdap stayed stable at 89%.

Limitations to the study include that the response rate was low, and less than half of the completed interviews had sufficient provider data. Survey results may also exhibit bias since the information is self-reported. However, important information about vaccine coverage was revealed in this study.

Pharmacists can play an important role by educating patients and administering vaccines. More education efforts are needed to increase HPV vaccination rates, especially among females. Important talking points include that the HPV vaccine is safe and effective, and protects against cervical cancer, precancerous lesions, and genital warts.

References

• 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, 2018. MMWR Mortal Wkly Rep 2019;68:718-723. DOI: http://dx.doi.org/10.15585/mmwr.mm6833a2.
• Robinson CL, Bernstein H, Romero JR, Szilagyi P. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger — United States, 2019. MMWR Morb Mortal Wkly Rep 2019;68:112—114. DOI: http://dx.doi.org/10.15585/mmwr.mm6805a4.