Between 2005 and 2007 vaccination against tetanus-diphtheria-acellular pertussis (TdaP), meningococcal conjugate (MenACWY), and (in girls) human papillomavirus (HPV) were added to the vaccination schedule for adolescents. Using data from the National Immunization Survey-Teen (a survey of adolescents ages 13 to 17 years) from 2006 through 2009, researchers sought to determine how well the administration of these vaccines was progressing.

The overall rate of vaccination with the three vaccines increased from 10% in 2006 to 42% in 2009. Specifically, the proportion of adolescents whose TdaP vaccinations were up to date increased from 11% to 56%. Similarly, MenACWY vaccination rose consistently, from 12% to 54% of adolescents being up to date from 2006 to 2009. Although receipt of at least one HPV-vaccine dose increased from 25% in 2007 to 44% in 2009, only 18% of girls received the recommended three doses in 2008 and only 27% did in 2009. The data showed wide variance in vaccination rates across states.

The authors also used the number of visits that reported the injection of any vaccine to calculate the vaccination coverage that could have been possible. They determined that by 2009, 76% of children could have been up to date with these new vaccinations-34% more than the proportion who were actually vaccinated. The reasons most often cited for not vaccinating children against TdaP or MenACWY were a lack of knowledge about the vaccine, the health care provider not recommending vaccination, and not believing that the vaccine was necessary. Similarly, reasons given for girls not receiving the HPV vaccine included a lack of knowledge about the vaccine and not believing that the vaccine was necessary but also an assertion that the adolescent wasn't sexually active.

The authors conclude that although vaccination rates are increasing, they're not as high as they could be. They recommend evaluating regional policies and identifying strategies to increase vaccination, such as promoting parents' understanding of the vaccines and increasing health care providers' recommendations to vaccinate adolescents; in particular, providers can administer several vaccines during a single office visit, a practice that is recommended.-SDSJ

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