Figure.

Trends in initiation of human papillomavirus (HPV) vaccine series and medical provider recommendations among adolescents aged 13-17, National Immunization Survey–Teen (NIS-Teen), Montana, 2013-2017. (A) Percentage of adolescents who initiated HPV vaccination series, by sex and rural or urban residence. NIS-Teen designates whether adolescents live in a metropolitan statistical area (MSA) principal city, an MSA nonprincipal city (ie, suburban), or a non-MSA. In this study, MSA principal city areas are considered urban and non-MSAs are considered rural. Montana does not have any MSA nonprincipal city areas. Data obtained from the Centers for Disease Control and Prevention’s TeenVaxView online tool.²⁰ (B) Percentage of parents or guardians who responded yes to the question, “Had or has doctor or other health care professional ever recommended that teen receive HPV shots?” Data obtained from NIS-Teen’s 2013-2017 public-use data files.¹⁹ Because of a change in how adequate provider data for immunization records were assessed starting with the 2014 NIS-Teen, vaccine series initiation rates from 2013 may not be directly comparable with rates from later years.¹⁶