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Percentage of adolescents aged 13 to 17 years who have received 1 dose of Tdap since the age of 10 years, 1 dose of meningococcal conjugate vaccine, and 3 doses of HPV (females). (National Immunization Survey-Teen, 2012)

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Immunization - Adolescents

United States Immunization - Adolescents (2012-2014) see more
  • Percentage of adolescents aged 13 to 17 years who have received 1 dose of Tdap since the age of 10 years, 1 dose of meningococcal conjugate vaccine, and 3 doses of HPV (females). (National Immunization Survey-Teen, 2012)

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Immunization - Adolescents
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Immunization - Adolescents
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Immunization - Adolescents
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Overview

Public Health Impact

The Advisory Committee on Immunization Practices recommends adolescents receive 4 vaccines to protect from meningococcal, tetanus, diphtheria, pertussis, human papillomavirus, and influenza.[1] Immunity from the childhood vaccine DTaP diminishes as children age, and a Tdap booster is needed at age 11 or 12 years to maintain protection against tetanus, diphtheria, and pertussis. This booster provides protection for immunized teens and those they contact, which is important for infants and seniors. The meningococcal conjugate vaccine (MCV4) protects against some strains of Neisseria meningitidis that cause meningococcal disease, such as meningococcal meningitis and meningococcal septicemia. MCV4 is recommended at age 11 or 12 years, and a booster shot is recommended at age 16. HPV vaccination is also recommended at age 11 or 12 years for girls and boys, but far fewer teens receive the vaccine than Tdap and MCV4.[2] Genital HPV is the most common sexually transmitted infection, affecting nearly all sexually active men and women. HPV infection can cause genital warts and certain cancers including cervical cancer, other genital cancers (cancer of the vulva, vagina, penis, or anus), and oropharyngeal cancer (cancer in the back of throat, including the base of the tongue and tonsils). Yearly administration of the flu vaccine to preteens and teens is recommended to protect against seasonal influenza. The CDC offers a list of vaccine-preventable diseases and vaccines for teens and pre-teens.

The Tdap vaccine is the most cost-effective among all adolescent immunizations.[3] The HPV vaccine is most cost-effective in female and men-having-sex-with-men adolescent populations. The MCV4 vaccine is the least cost-effective of the adolescent vaccines due to a lower number of meningococcal disease cases and higher vaccine costs.[4] The cost-effectiveness of the flu vaccine depends on the circulating strains and the underlying co-morbidities of the adolescent population. Immunizations for adolescents are less cost-effective across the board than those for children. In addition, the determination of cost-effectiveness assumes a level of vaccine coverage high enough to achieve herd immunity, and it assumes the vaccine is administered at 11 to 12 years of age.[5]

Adolescent immunization rates for HPV and influenza are suboptimal compared with rates for Tdap and MCV4.[6] The Task Force on Community Preventive Services has recommended interventions to increase vaccination rates in adolescents such using an immunization-information system to track delivery of vaccinations and using health care provider prompts as a reminder to administer vaccinations. More research is needed to substantiate the effectiveness of these strategies in the adolescent population. Recent studies have provided evidence to support the effectiveness of automated texts, voice messages, and postcards to parents/guardians in improving vaccination rates in adolescents.[7] Increasing routine vaccination coverage levels for adolescents is a Healthy People 2020 objective.[8]



[1] Centers for Disease Control and Prevention. Preteen and teen vaccines. http://www.cdc.gov/vaccines/who/teens/for-preteens-teens.html. Updated June 11, 2012. Accessed October 21, 2013.

[2] Wharton M. Immunization rates low despite excellent effectiveness, safety profile. AAP News. 2013;34:4.

[3] Ortega-Sanchez IR, Lee GM, Jacobs J, et al. Projected cost-effectiveness of new vaccines for adolescents in the United States. Pediatrics 2008;121(1):563-578.

[4] Ortega-Sanchez IR, Lee GM, Jacobs J, et al. Projected cost-effectiveness of new vaccines for adolescents in the United States. Pediatrics 2008;121(1):563-578.

[5] Meltzer MI, Neuzil KM, Griffin MR, Fukuda K. An economic analysis of annual influenza vaccination of children. Vaccine 2005;23:1004-1014.

[6] Szilagyi PG, Serwint JR, Humiston SG, et al. Effect of provider prompts on adolescent immunization rates: a randomized trial. Academic Pediatrics. 2015;15(2):149-157.

[7] Szilagyi PG, Serwint JR, Humiston SG, et al. Effect of provider prompts on adolescent immunization rates: a randomized trial. Academic Pediatrics. 2015;15(2):149-157.

[8] Office of Disease Prevention and Health Promotion. Healthy People 2020. http://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives?topicId=23. Accessed May 20, 2015.