Six in ten teens now have had at least one dose of the human papillomavirus (HPV) vaccine, but many still are not receiving the second dose, according to 2016 data on vaccination coverage among adolescents published in the Morbidity and Mortality Weekly Report.

Researchers analyzed data from 20,475 adolescents aged 13-17 years in the 2016 National Immunization Survey–Teen, which showed that coverage for at least one dose of the HPV vaccine had increased from 56% in 2015 to 60% in 2016. However only 43% of adolescents – 50% of females and 38% of males – were up to date with the full two-dose vaccination series, in accordance with the updated vaccine recommendations (MMWR. 2017 Aug 25;66:874-82).

Vaccinations rates were similar between females and males aged 13 years, but among those aged 17 years, coverage was 14-23 percentage points higher in females than in males.

“Since HPV vaccine was introduced for females in 2006 and for males in 2011, coverage has increased gradu­ally among females and more rapidly among males,” wrote Tanja Y. Walker and her colleagues from the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention, Atlanta. “Coverage with 1 or more doses HPV vaccine among males continues to approach that among females, particularly for adolescents aged 13 years, suggesting that HPV vaccination of both female and male adolescents has been integrated into vaccination practices.”

HPV vaccine coverage with at least one dose was highest in central cities (66%) and lowest among adolescents in nonmetropolitan areas (50%). However, HPV coverage also was higher among adolescents living below the federal poverty line, compared with those living at or above the poverty line.

There was also significant geographic variation in HPV vaccine coverage, ranging from coverage with at least one dose among 90% of females and 88% of males in Rhode Island, to just 37% of males in Indiana and Wyoming and 48% of females in Mississippi. New York City showed the greatest average annual increase in coverage of one or more doses of the HPV vaccine from 2015 to 2016 (7.7 percentage point).

The analysis also looked at coverage for the Tdap vaccine, which increased for one or more doses from 86% to 88% from 2015 to 2016, respectively, while coverage with two or more doses of the meningococcal conjugate vaccine among 17-year-olds increased from 33% to 39%, respectively.

The authors pointed out that coverage for HPV immunization was still 22-28 percentage points below coverage for Tdap and the meningococcal conjugate vaccine, suggesting there was substantial opportunity for improvement.

“Potential contributing factors might include dif­ferences in parental acceptance of certain vaccines and provider participation in, and adolescents’ eligibility for, the Vaccines for Children program,” Ms. Walker and her colleagues said.

No conflicts of interest were declared.


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