TABLE 2. Estimated vaccination coverage with selected vaccines and doses among adolescents aged 13–17* years, by metropolitan statistical area† and by poverty level — National Immunization Survey–Teen, United States, 2020.
| Vaccine | MSA, % (95% CI)§ |
Below poverty level, % (95% CI)§ |
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 = 3,678) | (n = 8,409) | (n = 8,076) | (n = 631) | (n = 865) | (n = 1,352) | (n = 2,938) | (n = 7,246) | (n = 6,420) | |
|
Tdap¶ ≥1 dose
|
90.7 (88.7–92.3) |
90.6 (89.3–91.8) |
89.3 (87.7–90.7) |
93.1 (89.7–95.5) |
89.0 (84.7–92.1) |
89.6 (86.3–92.2) |
89.8 (87.4–91.9) |
91.1 (89.7–92.3) |
89.2 (87.3–90.9) |
|
MenACWY**
| |||||||||
| ≥1 dose |
85.7 (83.7–87.5)†† |
89.4 (87.9–90.7) |
90.2 (88.7–91.5) |
86.1 (81.8–89.5)†† |
87.2 (82.6–90.6) |
91.6 (88.8–93.7) |
85.6 (83.2–87.7)†† |
90.2 (88.6–91.5) |
89.4 (87.5–91.0) |
| ≥2 doses§§ |
50.1 (43.4–56.9) |
58.5 (54.0–62.8)†† |
50.6 (45.2–56.1) |
47.4 (33.5–61.7) |
47.6 (33.0–62.7) |
48.6 (35.8–61.7) |
50.2 (42.3–58.0) |
61.2 (56.6–65.6)†† |
50.2 (44.1–56.4) |
|
HPV¶¶ vaccine
| |||||||||
|
All adolescents
| |||||||||
| ≥1 dose |
68.0 (65.3–70.6)†† |
74.2 (72.5–75.9)†† |
77.8 (75.8–79.6) |
73.6 (67.8–78.7)†† |
83.6 (79.5–87.0) |
85.7 (82.0–88.7) |
64.9 (61.7–67.9)†† |
73.1 (71.3–74.9)†† |
76.2 (74.0–78.3) |
| HPV UTD*** |
49.2 (46.3–52.1)†† |
59.1 (57.2–61.0) |
60.4 (58.2–62.6) |
56.7 (50.3–62.9) |
63.8 (58.1–69.2) |
64.4 (59.2–69.3) |
46.0 (42.9–49.3)†† |
58.4 (56.4–60.4) |
59.8 (57.4–62.2) |
|
Females
| |||||||||
| ≥1 dose |
67.8 (63.7–71.7) †† |
76.7 (74.5–78.8) |
79.8 (76.9–82.4) |
75.2 (66.4–82.2)†† |
84.4 (78.9–88.6) |
87.2 (82.0–91.0) |
63.6 (58.6–68.2)†† |
75.7 (73.3–78.0) |
78.8 (75.7–81.7) |
| HPV UTD |
50.3 (46.0–54.6)†† |
62.2 (59.6–64.7) |
63.2 (59.9–66.4) |
56.9 (47.6–65.8) |
65.3 (56.8–72.9) |
66.0 (58.2–73.0) |
46.8 (42.0–51.6)†† |
61.9 (59.1–64.5) |
63.5 (60.0–67.0) |
|
Males
| |||||||||
| ≥1 dose |
68.1 (64.6–71.5)†† |
71.9 (69.3–74.4)†† |
75.8 (73.2–78.3) |
71.6 (63.7–78.4)†† |
82.9 (76.5–87.8) |
84.3 (78.8–88.6) |
66.1 (61.9–70.0)†† |
70.7 (68.0–73.3) |
73.7 (70.5–76.6) |
| HPV UTD |
48.1 (44.3–52.0)†† |
56.2 (53.4–58.9) |
57.8 (54.8–60.7) |
56.4 (47.8–64.7) |
62.5 (54.5–69.8) |
62.9 (55.8–69.4) |
45.4 (41.2–49.7)†† |
55.2 (52.2–58.1) |
56.2 (52.8–59.5) |
|
MMR ≥2 doses
|
92.8 (91.0–94.2) |
92.4 (91.2–93.5) |
92.3 (90.9–93.5) |
93.6 (89.4–96.2) |
89.5 (83.8–93.3) |
90.8 (86.2–94.0) |
92.3 (90.2–94.0) |
92.9 (91.6–93.9) |
92.4 (90.9–93.6) |
|
Hepatitis A vaccine ≥2 doses†††
|
76.2 (73.7–78.5)†† |
82.0 (80.6–83.4) |
83.6 (81.9–85.2) |
80.4 (75.0–84.9) |
82.1 (77.1–86.3) |
83.0 (78.1–87.0) |
74.4 (71.5–77.0)†† |
81.8 (80.2–83.3) |
83.6 (81.7–85.3) |
|
Hepatitis B vaccine ≥3 doses
|
92.4 (90.6–93.9) |
92.9 (91.7–93.9) |
92.3 (90.9–93.5) |
92.8 (89.0–95.4) |
91.0 (86.3–94.2) |
89.9 (85.5–93.2) |
92.0 (89.8–93.8) |
93.1 (91.9–94.1) |
92.9 (91.5–94.1) |
|
Varicella
| |||||||||
| History of varicella§§§ |
10.1 (8.6–11.8) |
8.2 (7.2–9.4) |
8.0 (6.9–9.4) |
9.8 (6.9–13.6) |
13.3 (9.4–18.5) |
9.3 (6.4–13.3) |
10.3 (8.6–12.3)†† |
7.2 (6.2–8.4) |
7.8 (6.5–9.3) |
|
No history of varicella disease
| |||||||||
| ≥1 dose vaccine |
96.1 (94.6–97.1) |
95.8 (94.8–96.6) |
95.3 (94.1–96.2) |
95.9 (91.9–97.9) |
96.9 (94.6–98.2) |
94.0 (90.0–96.4) |
96.1 (94.4–97.3) |
95.5 (94.3–96.4) |
95.5 (94.2–96.5) |
| ≥2 doses vaccine |
92.5 (90.7–94.0) |
92.0 (90.6–93.2) |
91.6 (90.1–92.9) |
94.2 (90.1–96.6) |
87.9 (81.2–92.4) |
90.7 (85.7–94.0) |
91.7 (89.4–93.5) |
92.4 (91.0–93.5) |
91.6 (90.0–93.0) |
| History of varicella or received ≥2 doses VAR | 93.2 (91.6–94.6) | 92.7 (91.4–93.8) | 92.3 (90.9–93.5) | 94.7 (91.0–97.0) | 89.5 (83.6–93.4) | 91.5 (87.0–94.6) | 92.5 (90.5–94.1) | 92.9 (91.6–94.0) | 92.2 (90.7–93.5) |
Abbreviations: CI = confidence interval; HPV = human papillomavirus; MenACWY = quadrivalent meningococcal conjugate vaccine; MMR = measles, mumps, and rubella vaccine; MSA = metropolitan statistical area; NIS-Teen = National Immunization Survey–Teen; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine; UTD = up to date; VAR = varicella vaccine.
* Adolescents (20,163) in the 2020 NIS-Teen were born during January 2002–January 2008.
† MSA status was determined based on 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.html). Non-MSA areas include urban populations not located within an MSA as well as completely rural areas.
§ Estimates with 95% CI widths >20 might not be reliable.
¶ Includes percentages receiving Tdap vaccine at age ≥10 years.
** Includes percentages receiving MenACWY and meningococcal-unknown type vaccine.
†† Statistically significant difference (p<0.05) in estimated vaccination coverage by metropolitan statistical area; referent group was adolescents living in MSA principal city areas.
§§ ≥2 doses of MenACWY or meningococcal-unknown type vaccine. Calculated only among adolescents who were aged 17 years at interview. Does not include adolescents who received 1 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 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 2016.
††† In July 2020, ACIP revised recommendations for HepA vaccination to include catch-up vaccination for children and adolescents aged 2–18 years who have not previously received HepA vaccine at any age. https://www.cdc.gov/mmwr/volumes/69/rr/rr6905a1.htm?s_cid=rr6905a1
§§§ By parent or guardian report or provider records.