Vaccination rates among adolescents increased significantly for hepatitis B vaccines; vaccines for varicella, tetanus, diphtheria, acellular pertussis (Td or Tdap); meningococcal conjugate vaccine (MenACWY); and human papilloma virus (HPV) vaccine, according to new data from the US Centers for Disease Control and Prevention (CDC).
The findings from the National Immunization Survey–Teen estimating vaccination coverage among more than 20,000 adolescents aged 13 to 17 years were published in the August 20 issue of the Morbidity and Mortality Weekly Report.
According to background information in the article, the CDC’s Advisory Committee for Immunization Practices recommends that adolescents routinely receive the following vaccines: MenACWY (1 dose), Tdap (1 dose), and (for girls) HPV (3 doses).
Among adolescents aged 13 to 17 years, administration of 1 or more dose of Td or Tdap vaccine after age 10 years increased from 72.2% to 76.2%. Coverage with 1 or more dose of Tdap increased from 40.8% to 55.6%, and coverage with 1 or more dose of MenACWY increased from 41.8% to 53.6%. Among adolescent girls, coverage with 1 or more dose of HPV increased from 37.2% to 44.3%, and coverage with 3 or more doses of HPV increased from 17.9% to 26.7%.
“Among vaccines either administered during childhood or as catch-up adolescent vaccinations, coverage with ≥2 doses of [measles, mumps, and rubella (MMR)] was similar to coverage during 2008 at 89.1%; coverage with ≥3 doses of HepB increased from 87.9% to 89.9%,” the authors note.
The Healthy People 2010 target aims for 90% vaccination coverage. Measured against this goal, the vaccination coverage for adolescents aged 13 to 15 years was
•89.0% (95% confidence interval [CI], 87.9% – 90.0%) for 2 or more doses of MMR vaccine,
•91.2% (95% CI, 90.3% – 92.1%) for 3 or more doses of hepatitis B vaccine,
•74.7% (95% CI, 73.3% – 76.0%) for 1 or more dose of Td/Tdap vaccine, and
•90.5% (95% CI, 89.1% – 91.7%) for 1 or more dose of varicella vaccine.
Despite the overall increase from 2008 to 2009, vaccination rates varied widely among states. According to an editorial, the variation among states might be explained, in part, by different vaccination-promoting initiatives, which include “communication campaigns, strong partnerships with local professional organizations, universal funding of adolescent vaccinations, and middle school entry vaccination requirements.”
According to the CDC, no racial/ethnic differences for initiation of the HPV vaccine were observed in 2009. However, more whites completed the 3-dose series compared with blacks and Hispanics. “Similar to 2008, a higher percentage of adolescent females living below the poverty level had initiated the HPV series than those living at or above poverty level,” the authors note. They add that education regarding HPV infection and the benefits of vaccination at the recommended age, before sexual activity begins, is “an important public health endeavor.”
In a related press release, Anne Schuchat, MD, director of CDC’s National Center for Immunization and Respiratory Diseases, notes that pertussis outbreaks in several states and an increase in pertussis-related infant deaths in California highlight how important it is for preteens to receive the Tdap booster. Although there was a significant 15-point rise in Tdap booster in this age group, the percentage receiving this particular vaccine still falls below the Healthy People 2010 goal. Dr. Schuchat sums up the results by saying that “this year’s data are mixed. We can see that more parents of adolescents are electing to protect their children from serious diseases such as pertussis, meningitis, and cervical cancer, but there is clear room for improvement in our system’s ability to reach this age group.
“It is important for teens and adults to get a one-time dose of Tdap to protect themselves and those around them from whooping cough. Young infants are most vulnerable to serious complications from pertussis and can be infected by older siblings, parents or other caretakers,” she notes.