TABLE 2. Estimated vaccination coverage with selected vaccines and doses among adolescents aged 13–17 years,* by poverty level^† and metropolitan statistical area^§ — National Immunization Survey–Teen (NIS-Teen), United States, 2017.

Vaccine	Poverty status % (95% CI)¶			Metropolitan statistical area (MSA) % (95% CI)¶
	Below poverty level (n = 3,579)	At or above poverty level (n = 16,591)	Difference (n = 20,170)	Non-MSA (n = 4,123)	MSA nonprincipal city (n = 8,282)	MSA principal city (n = 8,544)	Difference between non-MSA and MSA principal city (n = 12,667)	Difference between MSA nonprincipal city and principal city (n = 16,826)
Tdap** ≥1 dose	88.2 (85.7 to 90.4)	88.8 (87.7 to 89.7)	-0.6 (-3.0 to 2.0)	88.0 (86.0 to 89.8)	88.9 (87.5 to 90.1)	88.8 (87.2 90.1)	-0.8 (-3.1 to 1.6)	0.1 (-1.8 to 2.1)
MenACWY††
≥1 dose	85.7 (83.2 to 87.8)	84.8 (83.7 to 85.8)	0.9 (-1.7 to 3.4)	78.6 (76.3 to 80.7)§§	86.1 (84.6 to 87.4)	86.0 (84.4 to 87.4)	-7.4 (-10.0 to 4.7)§§	0.1 (-81.2 to 83.2)
≥2 doses¶¶	46.2 (38.6 to 54.0)	42.8 (39.7 to 45.9)	3.4 (-4.9 to 11.7)	35.0 (29.6 to 40.8)§§	44.3 (40.2 to 48.5)	47.0 (42.2 to 51.9)	-12.0 (-19.5 to 4.6)§§	-2.7 (-9.1 to 3.7)
HPV***
≥1 dose	73.3 (70.7 to 75.8)§§	62.8 (61.4 to 64.1)	10.5 (7.6 to 13.5)§§	59.3 (56.6 to 61.9)§§	63.1 (61.3 to 64.8)§§	70.1 (68.2 to 71.9)	-10.8 (-14.0 to 7.6)§§	-7.0 (-9.6 to 4.4)§§
UTD†††	53.7 (50.7 to 56.6)§§	46.7 (45.3 to 48.2)	7.0 (3.6 to 10.3)§§	42.4 (39.8 to 45.1)§§	46.9 (45.0 to 48.8)§§	52.4 (50.3 to 54.4)	-10.0 (-13.3 to 6.6)§§	-5.5 (-8.3 to 2.6)§§
≥2 MMR doses	90.6 (88.4 to 92.5)	92.4 (91.5 to 93.1)	-1.8 (-3.9 to 0.5)	92.0 (90.6 to 93.3)	92.1 (90.9 to 93.1)	92.1 (90.7 to 93.3)	-0.1 (-1.9 to 1.8)	0.0 (-1.7 to 1.7)
≥3 Hepatitis B doses	89.9 (87.6 to 91.8)§§	92.5 (91.7 to 93.3)	-2.6 (-4.8 to 0.3) §§	91.3 (89.6 to 92.7)	92.0 (90.9 to 93.0)	92.0 (90.6 to 93.1)	-0.7 (-2.7 to 1.3)	0.0 (-1.6 to 1.7)
Varicella
History of varicella disease§§§	13.8 (12.1 to 15.6)	12.6 (11.6 to 13.6)	1.2 (-0.8 to 3.2)	16.1 (14.2 to 18.2)	12.2 (11.0 to 13.5)	13.6 (12.1 to 15.2)	2.5 (0.0 to 5.1)	-1.4 (-3.4 to 0.6)
No history of varicella disease
≥1 varicella vaccine dose	94.4 (91.9 to 96.1)	95.7 (95.0 to 96.4)	-1.3 (-3.5 to 0.8)	95.4 (94.1 to 96.5)	95.6 (94.6 to 96.5)	95.4 (94.0 to 96.4)	0.0 (-1.6 to 1.7)	0.2 (-1.3 to 1.8)
≥2 varicella vaccine doses	88.2 (85.5 to 90.4)	88.6 (87.6 to 89.6)	-0.4 (-3.1 to 2.2)	87.3 (85.4 to 89.1)	88.8 (87.4 to 90.1)	88.7 (87.0 to 90.2)	-1.4 (−3.8 to 1.1)	0.1 (-1.9 to 2.3)
History of varicella or receipt of ≥2 doses varicella vaccine	89.8 (87.5 to 91.7)	90.1 (89.1 to 90.9)	-0.3 (-2.6 to 2.0)	89.4 (87.7 to 90.8)	90.2 (88.9 to 91.3)	90.2 (88.7 to 91.5)	-0.8 (-2.9 to 1.3)	0.0 (-1.8 to 1.9)

Abbreviations: CI = confidence interval; HPV = human papillomavirus; MenACWY = quadrivalent meningococcal conjugate vaccine; MMR = measles, mumps, and rubella vaccine; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine; UTD = up-to-date.

* Adolescents (N = 20,949) in the 2017 NIS-Teen were born January 1999 through February 2005.

^† Adolescents were classified as below poverty level if their total family income was less than the federal poverty level specified for the applicable family size and number of children aged <18 years. All others were classified as at or above the poverty level. Additional information available at https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-thresholds.html. Poverty status was unknown for 779 adolescents.

^§ MSA status was determined based on household-reported county and city of residence, and was grouped into three categories: MSA principal city, MSA nonprincipal city, and non-MSA. MSA and principal city were as defined by the U.S. Census Bureau (https://www.census.gov/geo/reference/gtc/gtc_cbsa.html). Non-MSA areas include urban populations not located within an MSA as well as completely rural areas.

^¶ Estimates with 95% CIs >20 might be unreliable.

** Includes percentages receiving Tdap vaccine at age ≥10 years.

^†† Includes percentages receiving MenACWY and meningococcal vaccine of unknown type.

^§§ Statistically significant difference (p<0.05) in estimated vaccination coverage by poverty level or metropolitan statistical area; the referent groups were adolescents living at or above poverty level and MSA principal city respectively.

^¶¶ ≥2 doses of MenACWY or meningococcal vaccine of unknown type vaccine. Calculated only among adolescents aged 17 years at interview. Does not include adolescents who received one dose of MenACWY vaccine at age ≥16 years.

*** HPV vaccine, nine-valent (9vHPV), quadrivalent (4vHPV), or bivalent (2vHPV) in females and males combined.

^††† HPV UTD includes those with ≥3 doses and those with 2 doses when the first HPV vaccine dose was initiated at age <15 years and at least 5 months minus 4 days elapsed between the first and second dose. This update to the HPV recommendation occurred in December of 2016.

^§§§ By parent/guardian report or provider records.