America's Health Rankings, United Health Foundation Logo

Immunizations-Adolescents, 2017 Annual Report
Measure: Immunizations - Adolescents, 2017 Annual Report

Why does this matter?

Immunizations are a safe and effective means of protecting people from potentially life-threatening preventable diseases. Preteens and teens are recommended to receive vaccines to protect them from meningococcal disease, tetanus, diphtheria, pertussis, human papillomavirus and influenza. Vaccinations have led to a 95 percent decrease in vaccine-preventable diseases in the past 50 years, leading the Centers for Disease Control and Prevention (CDC) to call vaccines one of the 10 greatest public health achievements of the 20th century.

Meningococcal disease

The meningococcal conjugate vaccine (MenACWY) protects against four of the five most common types of Neisseria meningitidis in the United States. MenACWY vaccination is recommended for children ages 11 or 12, with a booster shot at age 16. Meningococcal disease is spread person-to-person when people have close contact with the saliva of a person infected with the bacteria. This disease can become fatal if left untreated. Even with treatment, 10 to 15 percent of people who become infected will die, and another 10 to 20 percent will have lasting injury or disability.

Tetanus, diphtheria and pertussis (Tdap)

Immunity from the childhood vaccine diphtheria, tetanus and pertussis (DTaP) diminishes as children age, and a Tdap booster is recommended at ages 11 or 12 to maintain immunity to these diseases. The booster provides primary protection from pertussis for immunized teens and secondary protection for those they are in contact with, most importantly, infants and older adults. The Tdap vaccine is the most cost-effective among all adolescent immunizations. Since vaccination began in the U.S., tetanus and diphtheria have dropped by roughly 99 percent and pertussis by close to 80 percent.

Human papillomavirus (HPV)

HPV vaccination is recommended for boys and girls at ages 11 or 12, but far fewer teens receive this vaccine than Tdap and MenACWY. 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, vaginal, vulvar, penile, anal and throat cancer. Benefits of the vaccine decrease with age, and currently is not routinely recommended after age 26.

Source:
  • America's Health Rankings composite measure, 2017



HPV Females, 2017 Annual Report
Measure: HPV Immunization - Females, 2017 Annual Report

Why does this matter?

Human papillomavirus (HPV) is the most common sexually transmitted infection, affecting nearly all sexually active men and women in the United States. Almost 80 million Americans, or about one in four, are infected with HPV, and about 14 million people become newly infected each year. HPV can spread even if the infected person has no signs or symptoms. HPV infections can cause different types of cancer as well as genital warts. In fact, most cases of cervical cancer, cancers of the anus, cancers of the throat, cancers of the vagina and vulva and cases of genital warts are associated with HPV infection.

The HPV vaccine is the first vaccine ever developed against cancer. Three HPV vaccines have been approved by the U.S. Food and Drug Administration (FDA) for use in the United States since 2006. Recent studies, however, have shown the newest FDA-approved vaccine, 9-valent human HPV vaccine, to be more cost effective than previous HPV vaccines and therefore it is now the only vaccine available in the United States. HPV-associated diseases cause the United States an estimated $8 billion (2010 dollars) in annual direct medical costs for prevention and treatment of all HPV types.

Source:
  • CDC, National Immunization Survey-Teen, 2016



HPV Males, 2017 Annual Report
Measure: HPV Immunization - Males, 2017 Annual Report

Why does this matter?

Human papillomavirus (HPV) is the most common sexually transmitted infection, affecting nearly all sexually active men and women in the United States. Almost 80 million Americans, or about one in four, are infected with HPV, and about 14 million people become newly infected each year. HPV can spread even if the infected person has no signs or symptoms. HPV infections can cause different types of cancer as well as genital warts. In fact, most cases of cervical cancer, cancers of the anus, cancers of the throat, cancers of the vagina and vulva and cases of genital warts are associated with HPV infection.

The HPV vaccine is the first vaccine ever developed against cancer. Three HPV vaccines have been approved by the U.S. Food and Drug Administration (FDA) for use in the United States since 2006. Recent studies, however, have shown the newest FDA-approved vaccine, 9-valent human HPV vaccine, to be more cost effective than previous HPV vaccines and therefore it is now the only vaccine available in the United States. HPV-associated diseases cause the United States. an estimated $8 billion (2010 dollars) in annual direct medical costs for prevention and treatment of all HPV types.

Initial HPV vaccine trials were conducted on females, resulting in a three-year delay between when boys were first offered the vaccine versus girls. Adolescent boys have a lower prevalence of being up to date on the HPV vaccine than adolescent girls. It is important for boys to get vaccinated. Every year in the United States, more than 13,000 men will get cancers caused by HPV infections.

Source:
  • CDC, National Immunization Survey-Teen, 2016



Meningococcal, 2017 Annual Report
Measure: Meningococcal Immunizations, 2017 Annual Report

Why does this matter?

Meningococcal disease is a potentially life-threatening illness caused by the bacterium Neisseria meningitidis. It is a leading cause of bacterial meningitis in the United States. At any given time, about 10 percent of the U.S. population are carriers of N. meningitidis, meaning the bacteria are living in the nose and throat without causing disease. The bacteria can spread when people have close or lengthy contact with another person’s respiratory secretions, such as through kissing, coughing or living in the same household.

Five serogroups (A, B, C, W and Y) cause most meningococcal disease cases in the United States. Preventing the disease remains a priority because of the potentially serious outcomes and risk of outbreaks. There were around 350 cases reported in 2017, with the highest incidence occurring among infants.

The Centers for Disease Control and Prevention recommends that all preteens ages 11 and 12 get the meningococcal conjugate vaccine (covers the A, C, W and Y serogroups), with a booster at age 16. Teens may also get the optional serogroup B meningococcal disease for further protection. An analysis of the effectiveness of adolescent meningococcal vaccination found that getting one dose of the vaccine at age 11 and a booster at age 16 was cost-effective and prevented the most numbers of disease cases and deaths.

Source:
  • CDC, National Immunization Survey-Teen, 2016



Tdap, 2017 Annual Report
Measure: Tdap Immunizations, 2017 Annual Report

Why does this matter?

Tetanus, diphtheria and pertussis are serious illnesses that are caused by bacteria. Vaccination is the most effective defense against illness and death from these diseases.

  • Tetanus (lockjaw) causes painful muscle tightening, stiffness and difficulty breathing.
  • Diphtheria can cause a thick coating to form in the throat, making it hard to breathe and swallow. It can also cause heart failure, paralysis and death
  • Pertussis (whooping cough) is an acute respiratory infection causing severe and prolonged coughing, potentially progressing to pneumonia or even death

Diphtheria and pertussis are spread through person-to-person contact, mainly via respiratory and throat secretions. Tetanus is non-communicable and enters the body through cuts, scratches and wounds.

The childhood vaccine for these diseases is called DTaP (diphtheria and tetanus toxoids and acellular pertussis vaccine) and the booster vaccine for adolescents and adults is called Tdap (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine). The Tdap vaccine is recommended for:

  • Adolescents ages 11-18 (preferably at age 11 or 12) who have completed the recommended childhood DTaP series
  • Adults aged 19 and older who have not previously received a dose of Tdap 
  • Anyone who has close contact with infants or has not previously received Tdap
  • Pregnant women, in order to protect newborns from pertussis — infants are most at risk for severe, life-threatening illness from pertussis

Since vaccination began in the United States, reported tetanus and diphtheria cases have dropped 99 percent, and reported pertussis cases dropped 80 percent. In 2017, there were 18,975 reported cases of pertussis in the United States.

A recent literature review found that pertussis vaccination among adolescents is cost-effective. Tdap vaccination during pregnancy has also been found to be a highly cost-effective intervention that provides infants with protection against pertussis.

Source:
  • CDC, National Immunization Survey-Teen, 2016



Immunizations-Children, 2017 Annual Report
Measure: Immunizations - Children, 2017 Annual Report

Why does this matter?

Early childhood immunization is a safe and cost-effective way of protecting infants and children from potentially life-threatening preventable diseases early in life when they are most vulnerable. Infants receiving recommended immunizations by age 2 are protected from 14 diseases. Vaccinations have led to a 95% decrease in vaccine-preventable diseases in the past 50 years, leading the Centers for Disease Control and Prevention (CDC) to call vaccines one of the 10 greatest public health achievements of the 20th century.

After implementation of the Vaccines For Children Program in 1994, modeling estimated that among all children born between 1994 and 2013, childhood vaccinations would prevent 322 million cases of disease and 21 million hospitalizations over their lifetimes, and prevent 732,000 premature deaths due to vaccine preventable diseases. These estimates translate to net savings of $295 billion in direct costs and $1.38 trillion in total societal costs.

Source:
  • CDC, National Immunization Survey-Child, 2016



Public Health Funding, 2017 Annual Report
Measure: Public Health Funding, 2017 Annual Report

Why does this matter?

Public health systems are important to keeping Americans safe and healthy through prevention, preparedness and surveillance programs and serve as the first line of defense against disease epidemics. The public health response to the COVID-19 pandemic was weakened by chronic underfunding of these systems at the state and national levels. Increased spending on public health programs is associated with a decrease in mortality from preventable causes such as cardiovascular disease, diabetes, stroke and cancer.

Public health program spending represents just around 10% of all health care spending in most countries, yet its impact can be substantial. An investment of $10 per person per year in evidence-based community health programs could save the country more than $16 billion annually. That is a potential savings of $5.60 for every $1 invested.

Source:
  • CDC, HRSA and Trust for America's Health, 2015-2016



Uninsured, 2017 Annual Report
Measure: Uninsured, 2017 Annual Report

Why does this matter?

Health insurance is critical in helping people receive the preventive and medical care they need to achieve and maintain good health. The nation’s uninsurance rate dropped significantly after the Affordable Care Act was enacted, yet nearly 29.6 million people were still uninsured in 2019. In 2016, an analysis found that 74% of uninsured adults reported that they were uninsured because they could not afford health insurance.

Compared with insured adults, uninsured adults have more health disadvantages, including: 

One study estimated that after Medicaid expansion, three states experienced a 6% decline in all-cause mortality in adults ages 20 to 64 compared with adults living in demographically and economically similar states that did not expand Medicaid. This decline was largely from medical conditions that respond well to medical management such as HIV, heart disease and diabetes.

Source:
  • U.S. Census Bureau, Health Insurance Coverage in the United States, 2015-2016

Please tell us a little more about you

We appreciate you taking the time to help America’s Health Rankings better understand our audiences. Your feedback will allow us to optimize our website and provide you with additional resources in the future. Thank you.

Please select one option which best describes your profession or field of expertise

Journalist or media professional
Health Policy Professional
Public health professional (state, local, or community level)
Health care provider or administrator
Member of an advocacy group or trade organization
Academic, student, or researcher
Government administrator, legislator, or staffer
Concerned citizen
Other
Don't show me this again
Please take a quick survey.