TABLE 2. Estimated vaccination coverage with selected vaccines and doses among adolescents aged 13–17* years, by metropolitan statistical area (MSA)† and by poverty level — National Immunization Survey–Teen (NIS-Teen), United States, 2019.
| Vaccine | MSA |
Below poverty level |
At or above poverty level |
||||||
|---|---|---|---|---|---|---|---|---|---|
| % (95% CI)§ | |||||||||
| Non-MSA | MSA nonprincipal city | MSA principal city | Non-MSA | MSA nonprincipal city | MSA principal city | Non-MSA | MSA nonprincipal city | MSA principal city | |
| (n = 3,689) | (n = 7,745) | (n = 7,354) | (n = 607) | (n = 820) | (n = 1,376) | (n = 2,962) | (n = 6,676) | (n = 5,687) | |
| Tdap¶ ≥1 dose | 88.7 (86.7–90.5) | 90.5 (89.0–91.8) | 90.2 (88.5–91.7) | 92.2 (88.7–94.6) | 87.6 (80.3–92.4) | 88.9 (86.0–91.3) | 88.0 (85.6–90.1) | 90.9 (89.5–92.1) | 90.6 (88.4–92.4) |
| MenACWY** | |||||||||
| ≥1 dose | 83.5 (80.9–85.8)†† | 90.3 (89.1–91.4) | 88.6 (86.8–90.2) | 90.4 (87.0–93.0) | 92.4 (88.5–95.1) | 88.3 (84.6–91.1) | 82.2 (79.0–85.0)†† | 89.7 (88.4–90.9) | 88.8 (86.5–90.7) |
| ≥2 doses§§ | 46.6 (39.2–54.2) | 55.5 (49.9–61.0) | 53.3 (46.9–59.5) | 36.5 (23.5–51.8)†† | 51.5 (33.4–69.3) | 59.5 (47.9–70.2) | 48.8 (40.1–57.5) | 57.1 (51.6–62.4) | 50.8 (43.3–58.3) |
| HPV¶¶ vaccine | |||||||||
| All adolescents | |||||||||
| ≥1 dose | 64.2 (61.2–67.2)†† | 71.2 (69.2–73.1) | 73.8 (71.5–75.9) | 72.6 (66.8–77.7) | 75.2 (67.9–81.3) | 76.5 (71.4–81.0) | 62.6 (59.0–66.1)†† | 70.3 (68.3–72.2) | 72.4 (69.8–74.9) |
| HPV UTD*** | 47.3 (44.2–50.4)†† | 53.4 (51.2–55.7)†† | 57.1 (54.6–59.5) | 54.6 (48.4–60.7) | 58.8 (51.2–66.0) | 58.8 (53.5–63.9) | 45.4 (41.8–49.1)†† | 52.7 (50.3–55.0)†† | 56.5 (53.6–59.4) |
| Females | |||||||||
| ≥1 dose | 66.3 (61.7–70.7)†† | 72.3 (69.5–75.0) | 75.9 (72.9–78.7) | 76.2 (67.3–83.3) | 73.0 (61.2–82.2) | 78.4 (72.4–83.4) | 64.0 (58.5–69.2)†† | 72.2 (69.6–74.7) | 75.0 (71.3–78.4) |
| HPV UTD | 49.0 (44.6–53.5)†† | 56.1 (53.0–59.2) | 59.4 (55.7–63.1) | 60.1 (51.0–68.4) | 58.3 (47.3–68.4) | 60.2 (53.3–66.7) | 45.6 (40.6–50.7)†† | 55.3 (52.1–58.4) | 58.7 (54.2–63.1) |
| Males | |||||||||
| ≥1 dose | 62.4 (58.2–66.4)†† | 70.2 (67.4–72.9) | 71.4 (68.2–74.5) | 69.4 (61.5–76.4) | 77.5 (68.6–84.4) | 74.8 (66.5–81.6) | 61.3 (56.4–66.1)†† | 68.6 (65.6–71.5) | 69.6 (65.9–73.1) |
| HPV UTD | 45.7 (41.3–50.1)†† | 51.0 (47.7–54.3) | 54.6 (51.4–57.8) | 49.8 (41.4–58.3) | 59.4 (48.7–69.3) | 57.5 (49.6–65.1) | 45.2 (40.0–50.5)†† | 50.5 (47.0–53.9) | 54.1 (50.5–57.7) |
| MMR ≥2 doses | 91.7 (90.0–93.1) | 92.3 (91.0–93.3) | 91.4 (89.3–93.2) | 91.6 (87.6–94.4) | 93.7 (90.3–95.9) | 93.6 (91.6–95.1) | 91.9 (90.0–93.5) | 92.2 (90.8–93.4) | 91.0 (88.0–93.2) |
| Hepatitis A vaccine ≥2 doses††† | 67.4 (64.5–70.2)†† | 77.1 (75.1–78.9) | 79.8 (77.6–81.9) | 65.5 (59.0–71.4)†† | 82.2 (77.0–86.5) | 81.1 (77.1–84.5) | 68.1 (64.8–71.3)†† | 76.9 (74.9–78.9) | 79.6 (76.9–82.1) |
| Hepatitis B vaccine ≥3 doses | 92.5 (90.9–93.9) | 92.0 (90.6–93.2) | 90.9 (88.9–92.6) | 92.8 (89.4–95.1) | 92.6 (89.2–95.0) | 91.0 (88.1–93.2) | 92.7 (90.8–94.2) | 92.9 (91.6–93.9) | 91.4 (88.7–93.5) |
| Varicella | |||||||||
| History of varicella§§§ | 12.4 (10.3–15.0)†† | 8.3 (7.3– 9.3) | 9.3 (8.1–10.6) | 9.8 (7.1–13.4) | 8.2 (5.9–11.2)†† | 12.3 (9.5–15.6) | 13.0 (10.3–16.3)†† | 7.8 (6.8–8.9) | 8.2 (7.0–9.6) |
| No history of varicella disease | |||||||||
| ≥1 dose vaccine | 95.0 (93.4–96.2) | 95.6 (94.6–96.4) | 94.7 (92.9–96.1) | 95.7 (92.4–97.6) | 95.0 (91.9–97.0) | 95.2 (93.2–96.6) | 95.2 (93.4–96.5) | 95.6 (94.5–96.4) | 94.8 (92.3–96.6) |
| ≥2 doses vaccine | 90.9 (89.1–92.4) | 91.4 (90.2–92.6) | 89.6 (87.1–91.6) | 90.7 (86.2–93.9) | 93.0 (89.6–95.4) | 92.9 (90.7–94.6) | 91.3 (89.2–93.0) | 91.0 (89.6–92.3) | 89.1 (85.8–91.6) |
| Varicella disease or received ≥2 varicella vaccine doses | 92.0 (90.4–93.4) | 92.1 (91.0–93.2) | 90.5 (88.3–92.4) | 91.6 (87.6–94.5) | 93.6 (90.4–95.7) | 93.7 (91.8–95.2) | 92.4 (90.6–93.9) | 91.7 (90.4–92.9) | 90.0 (86.9–92.3) |
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 = 18,788) in the 2019 NIS-Teen were born January 2001 through February 2007.
† MSA status was determined by household-reported county 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/programs-surveys/metro-micro/about.html). Non-MSA areas include urban populations not located within an MSA and completely rural areas.
§ Estimates with 95% CIs >20 might not be reliable.
¶ Includes percentages receiving Tdap at age ≥10 years.
** Includes percentages receiving MenACWY and meningococcal-unknown type vaccine.
†† Statistically significant difference (p<0.05) in estimated vaccination coverage by MSA; referent group was adolescents living in MSA principal city areas.
§§ ≥2 doses of MenACWY or meningococcal-unknown type vaccine. Calculated only among adolescents aged 17 years at interview. Does not include adolescents who received 1 dose of MenACWY at age ≥16 years.
¶¶ HPV vaccine, nine-valent (9vHPV), quadrivalent (4vHPV), or bivalent (2vHPV).
*** HPV UTD includes those who’ve received ≥3 doses and those with 2 doses when the first HPV vaccine dose was initiated before age 15 years and there was at least 5 months minus 4 days between the first and second dose. This update to the HPV recommendation occurred in December of 2016.
††† In July 2020, ACIP revised recommendations for Hepatitis A vaccination to include catch-up vaccination for children and adolescents aged 2–18 years who have not previously received Hepatitis A vaccine at any age (http://dx.doi.org/10.15585/mmwr.rr6905a1).
§§§ By parent/guardian report or provider records.