Vaccination coverage increased among adolescents in the US in 2024 compared to the prior year, according to findings from the annual National Immunization Survey-Teen, described in the CDC's Morbidity and Mortality Weekly Report (MMWR).1 "This trend is encouraging, particularly in light of the declines in routine vaccination coverage among adolescents that occurred during the COVID-19 pandemic," CDC spokesperson Paul Prince told Contagion.
"Additionally, the Vaccines for Children (VFC) program has been instrumental in ensuring that children and adolescents, particularly those from low-income families, have access to recommended vaccines at no cost. Together, these initiatives enhance access to vaccines, build confidence in vaccination, and address barriers to immunization," Prince said.
The 2024 survey found that recommended coverage with ≥1 dose of Tdap, ≥1 dose of meningococcal B vaccine, ≥ 3 doses of hepatitis B vaccine, and ≥2 doses of measles, mumps, and rubella (MMR) vaccine all increased from 2023. Coverage with ≥1 dose of HPV was the exception, however, without increasing since 2022.
"HPV vaccination coverage has not increased for the third consecutive year and continues to show significant variation by state and local area," Prince remarked. "Over the past nine years (2016-2024), we have observed that HPV vaccination coverage remains lower among adolescents in predominantly rural areas compared to those in urban areas."
The annual survey is conducted in two phases: a random-digit-dialed mobile telephone survey of parents or guardians in household with eligible adolescents; followed, with parental/guardian permission, by mailed survey to their healthcare providers and pharmacies. The 2024 survey comprised 16,325 adolescents aged 13-17 years, from a household response rate of 21.0%. Adequate provider data were received for 42.8% of the adolescents with completed survey response.
Cassandra Pingali, MPH, MS, Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, and colleagues reported increases in vaccination coverage in adolescents in 2024 compared to 2023 of 2.3% (to 91.3% coverage) for Tdap, and by 1.7% (to 90.1% coverage) for MenACWY. MenB vaccination increased by 4.5%; and MMR as well as HepB increased by 1.3%.In 2024, ≥90% of adolescents received ≥1 dose of Tdap in 39 states and ≥1 dose of MenACWY in 30 states.
What You Need to Know
Adolescent vaccination rates improved in 2024 for Tdap, MenACWY, MenB, MMR, and HepB compared to 2023, with most states reaching ≥90% coverage for Tdap and MenACWY.
HPV vaccination coverage stalled, showing no gains for the third year in a row, with wide variation by state, lower rates in rural areas, and stronger uptake when providers recommended it.
Access and provider influence remain critical, with the Vaccines for Children program and strong provider recommendations playing key roles in improving vaccine confidence and coverage.
The receipt of at least one dose of HPV by 78.2% of adolescents, however, and completion of the series by 62.9% was similar in 2024 and 2023 (76.8% and 61.4%, respectively). Coverage varied by regions and was lower in rural than urban areas.The lowest HPV coverage in 2024 was 39.1% in Mississippi and the highest of 79.8% in Massachusetts.
The investigators also found that rates of HPV coverage were substantially lower among adolescents when they or their parents did not receive recommendation of HPV vaccination from their provider. Coverage among adolescents receiving a recommendation from their provider ranged from 77.2 to 86%, while coverage for those who did not receive that recommendation ranged from 57.2% to 68.4%.
"These finding highlight the influence of provider recommendations and the potential for strong provider recommendations to improve vaccination coverage," Pingali and colleagues indicate."Ongoing conversations with families can emphasize the role of the HPV vaccine in cancer prevention and the importance of other vaccines recommended for adolescents."
The investigators also encourage state, local and territorial health departments to make use of the NIS-Teen findings, "by evaluating local vaccination data sources, such as immunization information system data, to identify geographic areas with low coverage to gain a more comprehensive understanding of vaccination coverage in their jurisdiction."
Reference
1. Pingali C, Yankey D, Elam-Evans LD, et al. Vaccination coverage among adolescents aged 13-17 years—National Immunization Survey-Teen.Doi: http://dx.doi.org/10.15585/mmwr.mm7430a1.
