What to know
Supplementary vaccination coverage data from the NIS-Teen are included below. The first 2 tables show vaccination coverage for selected vaccines by race/ethnicity and by health insurance status. The final table shows change in estimates for bridging cohorts (2021 vs. 2021).
Supplemental Table 1. Estimated vaccination coverage with selected vaccines and doses among adolescents aged 13–17* years, by Race and Ethnicity— National Immunization Survey–Teen (NIS-Teen), United States, 2021.
Vaccines | Race and Ethnicity†, % (95% CI)§ | |||||
---|---|---|---|---|---|---|
White only, non-Hispanic
(n = 11,256)
|
Black only, non-Hispanic
(n = 1,799)
|
Hispanic
(n = 3,028)
|
American Indian/Alaska Native only, non-Hispanic
(n = 211)
|
Asian, non-Hispanic
(n = 779)
|
Multiracial, non-Hispanic
(n = 1,214)
|
|
Tdap¶ ≥ 1 dose | 90.1 ( 89.0 to 91.1) | 90.6 ( 88.0 to 92.6) | 87.4 ( 84.4 to 89.9) | 96.0 ( 90.9 to 98.3) ** | 91.5 ( 86.9 to 94.5) | 90.5 ( 87.5 to 92.9) |
MenACWY†† | ||||||
≥1 dose | 89.2 ( 88.2 to 90.2) | 90.2 ( 87.4 to 92.4) | 86.5 ( 83.0 to 89.5) | 93.4 ( 87.3 to 96.6) | 95.6 ( 93.5 to 97.0) ** | 88.1 ( 84.2 to 91.2) |
≥2 doses§§ | 61.3 ( 57.3 to 65.1) | 61.7 ( 51.7 to 70.8) | 50.6 ( 41.6 to 59.6) ** | 63.8 ( 36.9 to 84.1) | 78.8 ( 65.5 to 88.0) ** | 57.5 ( 43.6 to 70.4) |
HPV¶¶ vaccine | ||||||
All Adolescents | ||||||
≥1 dose | 74.4 ( 72.8 to 75.9) | 81.7 ( 78.2 to 84.7) ** | 77.8 ( 74.2 to 81.1) | 86.1 ( 78.4 to 91.4) ** | 82.8 ( 77.4 to 87.1) ** | 76.3 ( 69.4 to 82.1) |
HPV UTD*** | 59.8 ( 58.1 to 61.4) | 65.0 ( 61.0 to 68.8) ** | 61.7 ( 57.6 to 65.6) | 75.4 ( 66.1 to 82.9) ** | 72.3 ( 66.0 to 77.9) ** | 58.1 ( 51.3 to 64.6) |
FEMALES | ||||||
≥1 dose | 77.4 ( 75.3 to 79.4) | 82.3 ( 77.1 to 86.6) | 76.2 ( 70.4 to 81.1) | 89.5 ( 81.3 to 94.3) ** | 83.1 ( 74.6 to 89.1) | 82.3 ( 76.4 to 86.9) |
HPV UTD | 63.1 ( 60.7 to 65.5) | 66.9 ( 61.0 to 72.2) | 60.5 ( 54.5 to 66.2) | 80.0 ( 67.9 to 88.3) ** | 74.4 ( 65.1 to 81.9) ** | 61.4 ( 52.9 to 69.3) |
MALES | ||||||
≥1 dose | 71.7 ( 69.4 to 73.9) | 81.1 ( 76.3 to 85.1) ** | 79.5 ( 74.7 to 83.5) ** | 81.8 ( 67.2 to 90.7) | 82.4 ( 75.6 to 87.6) ** | 70.8 ( 59.1 to 80.2) |
HPV UTD | 56.7 ( 54.3 to 59.1) | 63.2 ( 57.5 to 68.5) ** | 62.9 ( 57.3 to 68.1) ** | 69.5 ( 54.9 to 81.0) | 69.5 ( 60.8 to 77.1) ** | 55.0 ( 44.8 to 64.8) |
MMR ≥2 doses | 93.5 ( 92.5 to 94.3) | 92.1 ( 89.1 to 94.3) | 89.9 ( 87.0 to 92.3) ** | 98.8 ( 96.2 to 99.7) ** | 96.0 ( 93.8 to 97.4) ** | 88.2 ( 80.1 to 93.2) |
Hepatitis A vaccine ≥2 doses††† | 83.8 ( 82.5 to 85.1) | 83.2 ( 79.8 to 86.2) | 86.6 ( 83.4 to 89.3) | 95.6 ( 88.7 to 98.4) ** | 92.8 ( 90.0 to 94.9) ** | 82.7 ( 74.9 to 88.5) |
Hepatitis B vaccine ≥3 doses | 92.9 ( 92.0 to 93.8) | 92.2 ( 89.7 to 94.2) | 90.1 ( 86.9 to 92.5) | 98.5 ( 94.2 to 99.6) ** | 95.4 ( 93.3 to 96.9) ** | 92.6 ( 89.2 to 95.0) |
Varicella | ||||||
History of varicella§§§ | 7.5 ( 6.6 to 8.5) | 4.8 ( 3.3 to 6.7) ** | 7.1 ( 5.2 to 9.5) | NA | NA | 8.8 ( 5.8 to 13.3) |
No history of varicella disease | ||||||
≥1 dose vaccine | 96.0 ( 95.2 to 96.6) | 95.9 ( 94.1 to 97.2) | 93.0 ( 90.3 to 95.0) ** | 97.9 ( 89.6 to 99.6) | 97.1 ( 95.1 to 98.3) | 90.3 ( 80.7 to 95.4) |
≥2 doses vaccine | 92.8 ( 91.8 to 93.7) | 91.3 ( 88.3 to 93.6) | 89.7 ( 86.6 to 92.1) ** | 93.9 ( 87.2 to 97.2) | 94.2 ( 90.6 to 96.5) | 86.7 ( 78.0 to 92.3) |
History of varicella or received ≥2 doses varicella vaccine | 93.4 ( 92.4 to 94.2) | 91.7 ( 88.8 to 93.9) | 90.4 ( 87.6 to 92.7) ** | 95.1 ( 89.5 to 97.8) | 94.8 ( 91.5 to 96.9) | 87.9 ( 79.8 to 93.0) |
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 = 18,002) in the 2021 NIS-Teen were born January 2003 through January 2009.
† Adolescent's race/ethnicity was reported by their parent or guardian. Adolescents identified in this report as white, black, Asian, American Indian/Alaska Native, or multiracial were reported by the parent or guardian as non-Hispanic. Adolescents identified as multiracial had more than one race category selected. Adolescents identified as Hispanic might be of any race.
§ Estimates with 95% confidence intervals > 20 may not be reliable.
¶Includes percentages receiving Tdap vaccine at age ≥10 years.
** Statistically significant difference (p<0.05) in estimated vaccination coverage by race/ethnicity; referent group was adolescents non-Hispanic whites.
†† Includes percentages receiving MenACWY and meningococcal-unknown type vaccine.
§§ ≥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 (https://www.cdc.gov/vaccines/programs/iis/cdsi.html). 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. MMWR Recomm Rep 2020;69(No. RR-5):1–38.
§§§ By parent/guardian report or provider records.
Supplemental Table 2. Estimated vaccination coverage with selected vaccines and doses among adolescents aged 13–17* years, by Health Insurance Status— National Immunization Survey–Teen (NIS-Teen), United States, 2021.
Vaccines | Health Insurance Status†, % (95% CI)§ | |||
---|---|---|---|---|
Private Insurance Only
(n = 11,378)
|
Any-Medicaid
(n = 5,269)
|
Other Insurance
(n = 1,312)
|
Uninsured
(n = 419)
|
|
Tdap¶ ≥ 1 dose | 90.2 ( 88.9 to 91.3) | 89.6 ( 88.0 to 91.0) | 87.4 ( 80.5 to 92.1) | 84.7 ( 76.6 to 90.3) |
MenACWY†† | ||||
≥1 dose | 90.2 ( 88.8 to 91.4) | 88.8 ( 86.9 to 90.4) | 85.5 ( 78.7 to 90.4) | 77.5 ( 67.8 to 84.9)** |
≥2 doses§§ | 61.7 ( 57.3 to 65.9) | 60.7 ( 54.7 to 66.4) | 56.6 ( 45.1 to 67.5) | NA |
HPV¶¶ vaccine | ||||
All Adolescents | ||||
≥1 dose | 75.9 ( 74.1 to 77.6) | 80.5 ( 78.2 to 82.5)** | 73.1 ( 66.8 to 78.5) | 64.4 ( 54.3 to 73.4)** |
HPV UTD*** | 62.1 ( 60.2 to 64.0) | 64.1 ( 61.3 to 66.7) | 56.2 ( 50.1 to 62.1) | 39.6 ( 30.4 to 49.6)** |
FEMALES | ||||
≥1 dose | 78.0 ( 75.4 to 80.4) | 82.3 ( 79.4 to 84.9)** | 71.7 ( 61.0 to 80.5) | 61.6 ( 45.5 to 75.5)** |
HPV UTD | 64.3 ( 61.5 to 67.1) | 66.2 ( 62.3 to 70.0) | 58.9 ( 49.5 to 67.8) | 35.0 ( 21.7 to 51.0)** |
MALES | ||||
≥1 dose | 73.8 ( 71.2 to 76.2) | 78.8 ( 75.4 to 81.8)** | 74.5 ( 68.3 to 79.8) | 66.9 ( 54.2 to 77.5) |
HPV UTD | 59.9 ( 57.2 to 62.5) | 62.1 ( 58.2 to 65.9) | 53.3 ( 45.4 to 61.0) | 43.6 ( 31.6 to 56.4)** |
MMR ≥2 doses | 93.2 ( 92.1 to 94.2) | 91.2 ( 89.0 to 93.0) | 92.9 ( 90.3 to 94.8) | 84.9 ( 75.5 to 91.1)** |
Hepatitis A vaccine ≥2 doses††† | 85.6 ( 84.2 to 87.0) | 84.8 ( 82.5 to 86.9) | 86.7 ( 83.2 to 89.5) | 71.1 ( 61.0 to 79.5)** |
Hepatitis B vaccine ≥3 doses | 93.6 ( 92.6 to 94.5) | 91.3 ( 89.4 to 92.9)** | 88.8 ( 81.6 to 93.4) | 87.1 ( 78.5 to 92.6) |
Varicella | ||||
History of varicella§§§ | 6.4 ( 5.3 to 7.8) | 8.5 ( 7.2 to 10.0)** | 6.1 ( 4.4 to 8.3) | 12.9 ( 8.1 to 19.9)** |
No history of varicella disease | ||||
≥1 dose vaccine | 95.9 ( 95.1 to 96.6) | 93.6 ( 91.3 to 95.4)** | 96.0 ( 93.9 to 97.4) | 88.9 ( 78.7 to 94.5) |
≥2 doses vaccine | 92.6 ( 91.3 to 93.6) | 90.5 ( 88.1 to 92.5) | 91.8 ( 88.8 to 94.0) | 83.5 ( 73.8 to 90.1)** |
History of varicella or received ≥2 doses varicella vaccine | 93.0 ( 91.9 to 94.0) | 91.3 ( 89.1 to 93.1) | 92.3 ( 89.5 to 94.4) | 85.6 ( 77.0 to 91.4)** |
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 = 18,002) in the 2021 NIS-Teen were born January 2003 through January 2009.
† Adolescents' health insurance status was reported by parent or guardian. "Other insurance" includes the Children's Health Insurance Program (CHIP), military insurance, Indian Health Service, and any other type of health insurance not mentioned elsewhere.
§ Estimates with 95% confidence intervals > 20 may not be reliable.
¶ Includes percentages receiving Tdap vaccine at age ≥10 years.
** Statistically significant difference (p<0.05) in estimated vaccination coverage by health insurance status; referent group was adolescents with private insurance.
†† Includes percentages receiving MenACWY and meningococcal-unknown type vaccine.
§§ ≥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 (https://www.cdc.gov/vaccines/programs/iis/cdsi.html). 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. MMWR Recomm Rep 2020;69(No. RR-5):1–38.
§§§ By parent/guardian report or provider records.
Supplemental Table 3. Change in Estimates* for Bridging Birth Cohort†, 2021 vs. 2020 National Immunization Survey – Teen
2021 Adequate Provider Data Definition¶ | ||||||||
---|---|---|---|---|---|---|---|---|
2020 | 2021 | Difference | P-value for Test of No Difference |
|||||
Variable | Description | Estimate | Std Err |
Estimate | Std Err |
Estimate | Std Err |
|
P_U13TD | 1+ Td/Tdap by 13 years | 89.2 | 0.56 | 89.2 | 0.54 | 0.0 | 0.78 | 0.949 |
P_U13TDAP | 1+ Tdap since age 10 by 13 years | 86.0 | 0.63 | 85.5 | 0.60 | -0.5 | 0.87 | 0.585 |
P_U13MEN | 1+ MenACWY by 13 years | 82.9 | 0.72 | 83.1 | 0.67 | 0.2 | 0.98 | 0.801 |
P_U13HPV | 1+ HPV by 13 years | 58.8 | 0.89 | 60.2 | 0.82 | 1.4 | 1.21 | 0.236 |
P_U13HPV3 | 3+ HPV by 13 years | 8.8 | 0.41 | 9.4 | 0.53 | 0.6 | 0.67 | 0.370 |
P_U13HEPA | 2+ Hepatitis A by 13 years | 79.6 | 0.63 | 78.4 | 0.71 | -1.2 | 0.95 | 0.214 |
P_U13HEPB | 2+ or 3+ Hepatitis B depending on type by 13 years | 91.8 | 0.67 | 91.2 | 0.56 | -0.6 | 0.87 | 0.498 |
P_U13MCV | 2+ Measles-containing by 13 years | 92.1 | 0.45 | 91.3 | 0.55 | -0.8 | 0.71 | 0.284 |
P_U13MMR | 2+ MMR-containing by 13 years | 91.6 | 0.46 | 91.0 | 0.55 | -0.6 | 0.72 | 0.412 |
P_U13VRC | 1+ Varicella by 13 years | 94.1 | 0.38 | 93.2 | 0.47 | -0.8 | 0.60 | 0.180 |
P_U13VRC2 | 2+ Varicella by 13 years | 88.8 | 0.52 | 87.8 | 0.63 | -1.0 | 0.81 | 0.219 |
Abbreviations: HPV = human papillomavirus; MenACWY = quadrivalent meningococcal conjugate vaccine; Tdap = tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine.
*National-level estimates computed among children with adequate provider data, excluding children from U.S. territories.
† The bridging birth cohort used for this analysis for the 2020 and 2021 NIS-Teen is children born between January 2003 and December 2007. Final provider-phase weights for 2020 were ratio-adjusted within each monthly birth cohort such that their sum within monthly birth cohort equals the sum of the final provider-phase weights for 2021 within the corresponding monthly birth cohort.
¶ An adolescent was considered to have adequate provider data if the adolescent had any non-COVID vaccination indicated by any PRC return (or was designated a zero-shot teen).