title: Adolescent vaccination-coverage levels in the United States: 2006-2009.
abstract: BACKGROUND
  From 2005 through 2007, 3 vaccines were added to the adolescent vaccination schedule: tetanus-diphtheria-acellular pertussis (TdaP); meningococcal conjugate (MenACWY); and human papillomavirus (HPV) for girls.
  
  
  OBJECTIVE
  To assess implementation of new adolescent vaccination recommendations.
  
  
  METHODS
  Data from the 2006-2009 National Immunization Survey-Teen, an annual provider-verified random-digit-dial survey of vaccination coverage in US adolescents aged 13 to 17 years, were analyzed. Main outcome measures included percentage of adolescents who received each vaccine according to survey year; potential coverage if all vaccines were administered during the same vaccination visit; and, among unvaccinated adolescents, the reasons for not receiving vaccine.
  
  
  RESULTS
  Between 2006 and 2009, ≥1 TdaP and ≥1 MenACWY coverage increased from 11% to 56% and 12% to 54%, respectively. Between 2007 and 2009, ≥1 HPV coverage among girls increased from 25% to 44%; between 2008 and 2009, ≥3 HPV coverage increased from 18% to 27%. In 2009, vaccination coverage could have been >80% for Td/TdaP and MenACWY and as high as 74% for the first HPV dose if providers had administered all recommended vaccines during the same vaccination visit. For all years, the top reported reasons for not vaccinating were no knowledge about the vaccine, provider did not recommend, and vaccine is not needed/necessary (for TdaP and MenACWY) and adolescent is not sexually active, no knowledge about the vaccine, and vaccine is not needed/necessary (for HPV).
  
  
  CONCLUSIONS
  Adolescent vaccination coverage is increasing but could be improved. Strategies are needed to increase parental knowledge about adolescent vaccines and improve provider recommendation and administration of all vaccines during the same visit.
authors.affiliation: Centers forDisease Control and Prevention, Atlanta, GA 30333, USA. sstokley@cdc.gov
authors.forename: Shannon
authors.initials: S
authors.lastname: Stokley
authors.forename: Amanda
authors.initials: A
authors.lastname: Cohn
authors.forename: Christina
authors.initials: C
authors.lastname: Dorell
authors.forename: Susan
authors.initials: S
authors.lastname: Hariri
authors.forename: David
authors.initials: D
authors.lastname: Yankey
authors.forename: Nancy
authors.initials: N
authors.lastname: Messonnier
authors.forename: Pascale M
authors.initials: PM
authors.lastname: Wortley
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D013997:Time Factors; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*