Human papillomavirus vaccine coverage is up slightly, but 40% of girls and 58% of boys aged 13-17 years have not begun the series, according to survey data from the Centers for Disease Control and Prevention.

“Despite overall progress in vaccination coverage among adolescents, HPV vaccination coverage continues to lag behind Tdap and meningococcal conjugate vaccine coverage at state and national levels,” said Dr. Sarah Reagan-Steiner and her associates at the CDC, who analyzed data from the 2014 National Immunization Survey–Teen. “Differences in coverage estimates by vaccine indicate missed opportunities for administering HPV vaccine at visits when Tdap or meningococcal conjugate vaccines are given. Routinely recommending HPV vaccine at ages 11-12 years, during the same visit and with the same emphasis used for other vaccines, is critical.”

The 2014 NIS-Teen assessed vaccination coverage for 20,827 U.S. adolescents aged 13-17 years, the investigators said. The survey involved random-digit dialing the landlines and cell phones of parents to collect demographic data, and mailing follow-up surveys to their children’s clinicians to gather vaccination data ( MMWR . 2015 Jul 31;64[29]:784-92.)

From 2013 to 2014, vaccination coverage rose for all routinely recommended vaccines for adolescents, the researchers reported. Coverage for at least one Tdap dose ranged from almost 95% in Connecticut to 71% in Idaho and Mississippi, and coverage for at least one dose of meningococcal conjugate vaccine ranged from 95% in Pennsylvania to 46% in Mississippi. First-dose HPV coverage among adolescent girls rose by 3.3% overall, but ranged from only 38% in Kansas to 76% in Rhode Island.

Rates of HPV vaccination were much larger in several jurisdictions, including two cities (Chicago and Washington) and two states (Georgia and Utah) that received funding to increase HPV vaccination coverage, the researchers said. Strategies that helped increase HPV vaccine coverage included adding HPV vaccination to cancer control plans, partnering with cancer prevention stakeholders, and holding clinician-to-clinician information sessions to stress the need to make strong vaccine recommendations when patients reach 11-12 years of age.

Study limitations included household response rates (60% for landline surveys and 31% for cell phone surveys, and 52%-57% of surveys gathering adequate data from clinicians), Dr. Reagan-Steiner and her associates noted. They reported no conflicts of interest.


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