News & Views: Teen Immunizations — An Update from The Recent NIS-Teen Survey

Each year the Centers for Disease Control and Prevention (CDC) completes the National Immunization Survey-Teen (NIS-Teen) to evaluate the country’s progress in protecting teens according to the recommended immunization schedule. The randomized telephone survey interviews parents or guardians of teens 13 to 17 years of age and then mails surveys to the providers of those teens to confirm vaccination history.

The 2015 NIS-Teen results were recently reported in Morbidity and Mortality Weekly (MMWR). Data from 21,000 teens were surveyed for the 2015 survey. Here are some highlights from the findings:

• While HPV vaccination is improving, we are not where we need to be to protect the nearly 31,000 men and women affected by HPV-related cancers every year in the U.S.; nor are we close to reaching the Healthy People 2020 targets for 80 percent HPV vaccination coverage with all three doses:
  • Completed three-dose series — Only 28 percent of males and 42 percent of females have received all three doses. Because the third dose is important for developing a protective memory immune response, these data are alarming. As a country, we are leaving more than half of our teens susceptible to cancer.
  • Received one or more doses — About 50 percent of males and 63 percent of females have started the vaccination series. We need to make sure these teens get at least one dose that is given six months after the first dose to ensure durable immunity in these teens.
  • The data examining one or more doses are slightly better than the 2014 survey data — about an 8 percent increase for males and a 3 percent increase for females, so we are moving in the right direction.
  • Interestingly, more black and Hispanic teens are getting HPV vaccine than white teens:
    • Black teens — 54 percent males; 67 percent females
    • Hispanic teens — 59 percent males; 68 percent females
    • White teens — 44 percent males; 59 percent females
  • Likewise, more teens living below the poverty level are getting HPV vaccine than those living at or above the poverty level:
    • Teens living below poverty level — 61 percent males; 70 percent females
    • Teens at or above the poverty level — 46 percent males; 60 percent females
  • State coverage levels are quite variable:
    • Males — 35 percent (Kentucky) to 81 percent (Rhode Island)
    • Females — 48 percent (Wyoming) to 88 percent (Rhode Island)
    • See how your state is doing: males and females
  • Parents and teens need to know that every 17 minutes someone in the U.S. is diagnosed with an HPV-related cancer — and we can prevent those cases with vaccination!
• About 86 percent of all teens are getting Tdap vaccine. This was slightly lower than found in 2014 (88 percent). State coverage ranged from 70 percent (Alaska) to 97 percent (Rhode Island).
• About 81 percent of all teens are getting Mening ACWY. This was slightly higher than found in 2014 (79 percent). State coverage ranged from 55 percent (Mississippi) to 98 percent (Rhode Island).
  • However, only about one-third of 17-year-olds who had received their first dose before 16 years of age had received the second dose.
• About 83 percent of all teens have had a second dose of chickenpox vaccine. This was slightly higher than in 2014 (81 percent). State coverage ranged from 66 percent (South Dakota) to 96 percent (Vermont).
• See all state coverage rates in Table 3 of the MMWR report.

These data provide a snapshot of the big picture, but we all know that the big picture is the result of many people working every day on the front lines. So, first, thank you for all that you are doing to keep teens in your community protected! Second, we are challenging you to compare your rates with those of the national and state picture and identify one or more goals to work on in your own clinical setting. If everyone on the front lines sets and achieves a goal, next year, these numbers will be even better!

Resources related to teen vaccines

Vaccine Education Center

• Q&A sheets
  • Meningococcus — English and Spanish
  • HPV — English and Spanish
  • Tdap — English and Spanish
• Vaccines and Teens: The Busy Social Years booklet — recently updated:
  • English
  • Spanish
• HPV videos
• Prevent-HPV.org — questions and answers about the disease and the vaccine
• Meningococcus videos
  • Dr. Offit discussing meningococcal B vaccine
  • Why college students need meningococcal vaccine

Immunization Action Coalition

• www.give2mcv4.org — in collaboration with Sanofi Pasteur, this website includes a variety of tools to “raise awareness of the low immunization rates for the meningococcal (MCV4) booster dose.”
• www.vaccineinformation.org/teens — this collection of resources addresses teen vaccines and includes videos, personal stories, and links to a variety of resources.

CDC

• Teen Vaccines

Family advocacy groups

• National Meningitis Association
• Meningitis Angels