Many Teens and Preteens Skip Crucial Immunizations

Published on in CHOP News

October 17, 2011 — This week at the annual meeting of the American Academy of Pediatrics, the Vaccine Education Center at The Children’s Hospital of Philadelphia (VEC) and the American Medical Association released an updated information guide called Vaccines and Teens [PDF, 874KB] for parents and physicians, detailing the most current recommendations and information about critical immunizations for older children.

Many adolescents and teens not protected from diseases

While vaccination rates are improving among children ages 11-19, many adolescents and teens are still not protected from diseases such as pertussis, meningococcal meningitis, and human papillomavirus (HPV), according to the Centers for Disease Control and Prevention (CDC).

“This age group is particularly susceptible to certain infections for a variety of reasons,” explained Paul A. Offit, MDdirector of the Vaccine Education Center and chief of Infectious Diseases at The Children’s Hospital of Philadelphia. “Immunity provided by some of those early childhood vaccinations is fading, and older children become susceptible again to diphtheria, tetanus and pertussis. Additionally, teens and adolescents are developing new social patterns. Sleepaway camps, dorm rooms, dating and night clubs are all exciting parts of growing up, but are also situations that increase the risk of potentially life-threatening infections like meningococcus and HPV.”

Results from a CDC national survey of 13- to 17-year-olds released in August 2011 show that approximately 30 to 50 percent of adolescents are still missing at least one of the recommended critical vaccines for ages 11-12, which include the meningococcal vaccine (MCV4); tetanus, diphtheria, and pertussis (Tdap) booster vaccine; and the three-dose human papillomavirus (HPV) vaccine, which is recommended for all girls, but available to both boys and girls. The influenza vaccine is also recommended annually for all children and adults older than six months.

“There’s good news and not so good news to report. Immunization rates against tetanus, diphtheria and pertussis [Tdap] were up 13 percent from the previous year, and up nine percent for the meningococcal vaccine. That means about two-thirds of kids are getting those recommended vaccines,” Offit said. “However, the news for the HPV vaccine was discouraging. Immunization rates for HPV increased only 4 percent from the previous year, meaning only about one-third of girls for whom this vaccine is recommended are getting it, placing them at unnecessary risk for cervical cancer, which accounts for 10,000 cases and 4,000 deaths every year.”

Reasons for lower vaccination rates among adolescents

One reason for lower vaccination rates among adolescents (60 percent of adolescents vs. 90 percent of younger children) is that many of recommendations are only a few years old. Additionally, teens and preteens see their doctors less often than any other age group, so physicians have fewer opportunities to counsel parents on the recommended immunizations for older children.

Commitment to increasing adolescent immunization rates in the U.S.

"The AMA is committed to improving adolescent immunization rates in the United States, and we are delighted to be able to collaborate with the Vaccine Education Center at The Children's Hospital of Philadelphia on this informative booklet,” said AMA President Peter W. Carmel, MD. “The AMA encourages physicians to use this booklet as a resource to help inform adolescents, teens and their parents about the importance of vaccines and their value in preventing disease.“

The Vaccines and Teens booklet is available in both English and Spanish on the Vaccine Education Center’s website, and provides details about each of the recommended vaccines for older children, their safety, and the diseases they prevent. The booklet also provides information about making teens comfortable during immunizations and locating vaccine records for colleges and employers. 

 The CDC, American Academy of Pediatrics, American Academy of Family Physicians, American Medical Association, and Society for Adolescent Health and Medicine all recommend a routine healthcare visit that includes vaccination at 11-12 years of age. Adolescents who are not vaccinated at this age should have their vaccines brought up-to-date as soon as possible. 

Get the Vaccines and Teens booklet

The Vaccines and Teens booklet as well as comprehensive vaccine and disease information is available at Parents Pack: Age Groups and Vaccines — Teenagers (13 to 20 years).

About The Vaccine Education Center

The Vaccine Education Center was formed in October 2000 to provide accurate, comprehensive and up-to-date information about vaccines and the diseases they prevent. The Vaccine Education Center is funded by endowed chairs from The Children’s Hospital of Philadelphia. The Center does not receive support from vaccine companies. 

About the American Medical Association

The American Medical Association helps doctors help patients by uniting physicians nationwide to work on the most important professional, public health and health policy issues. The nation's largest physician organization plays a leading role in shaping the future of medicine. For more information on the AMA, please visit