Vaccines for Teens: Still Room for Improvement

Rates of HPV Shots Among Teens Lag Behind Other Recommended Vaccines

By Denise Mann
WebMD Health News

Reviewed by Laura J. Martin, MD

Aug. 25, 2011 -- More teens are getting their recommended vaccines, but there is still room for improvement. The numbers are especially low for human papillomavirus (HPV) or cervical cancer vaccines among U.S. girls, the CDC reports.

The recommended vaccines for all teens include:

Girls should also get three doses of an HPV vaccine to protect against genital warts, cervical cancer, and other cancers caused by HPV.

The flu vaccine is recommended annually for all people 6 months old and older.

Compared with 2009, vaccine rates among teens were up across the board in 2010.

  • Tdap rates increased from 55.6% to 68.7%
  • MenACWY rates increased from 53.6% to 62.7%.
  • Rates for one or more doses of HPV among females increased from 44.3% to 48.7%

The rate of increase in teen HPV vaccine rates was less than half of what was seen with the other vaccines.

Three doses of the HPV shot are needed to be fully effective. The shots should be given over a six-month period. Among females who had enough time to get all three, just 30.4% did. Teens who were black, Hispanic, and those who lived below the poverty line were among the least likely to get all three HPV shots.

About 20 million Americans are infected with HPV today. Each year, 12,000 women develop cervical cancer, the CDC states.

Bad News: Too Many Girls Not Getting HPV Shots

"U.S. girls are not getting the HPV vaccine that we know can prevent cervical cancer," the CDC's Melinda Wharton, MD, MPH, said during a teleconference. Wharton is deputy director for the National Center for Immunization and Respiratory Diseases.

This is "bad news" and "so very disappointing to us." But "the good news is that we can do better," Wharton says.

Cervical cancer is most often seen in women in their 30s and 40s. The HPV shot helps protect girls before they become infected with the types of genital warts linked to cervical cancer.

Why are rates of HPV trailing behind other teen vaccines?

Parents may not be aware of the HPV vaccine and what it does. They also may not be getting a strong enough recommendation from their daughter's pediatrician, Wharton says.

Also, HPV is given as three shots. "It is harder to get three doses in than one," Wharton says.

Some parents may have questions about their 11- or 12-year-old daughters getting a shot that prevents a sexually transmitted disease. But "this is a preventive vaccine, not a therapeutic one, and it won't work unless given prior to onset of sexual activity," Wharton says.

There was some pushback from parents in the early days of the vaccine because of potential side effects, but this vaccine is safe, Wharton says.

Jeff Levi, PhD, executive director of the Trust for America's Health, is also disheartened by the number of girls not getting HPV shots. "These rates are nothing short of tragic," he says in a written statement. "We could be sparing an entire generation from HPV, which can lead to a range of STDs, cervical cancer, and other cancers."

Boys may also get the HPV shot to prevent genital warts, but it's not part of the CDC's official vaccine recommendations. Just 1.4% of male teens got the HPV shot in 2010.

Teen Vaccine Rates Vary by State

Vaccine coverage rates also varied widely by states, the study showed.

Massachusetts, Rhode Island, and Virginia had the highest rates. More than 65% of teens got at least one dose of all three recommended teen vaccines in these states. These numbers still fall short of goals set by the government in its HealthyPeople 2020 campaign.

Overall, teen vaccine rates were lower for teens living in the Southeastern U.S. compared with other areas.

Teen vaccine rates based on the type of vaccine also varied by state -- sometimes by dozens of percentage points -- the study showed.

So why are some states doing so much better than others? School vaccination programs, reminders, and good communication between doctors and local public health officials may make a difference, the study suggests.

The CDC has tracked teen vaccine rates since 2006. The new findings appear in the CDC's Morbidity and Mortality Weekly Report.

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SOURCES: CDC teleconference, Aug. 25, 2011.Morbidity and Mortality Weekly Report, Aug. 26, 2011; vol 60: pp 1018-1023.Jeff Levi, PhD, executive director, Trust for America's Health.Melinda Wharton, MD, MPH, deputy director, CDC's National Center for Immunization and Respiratory Diseases, Atlanta. ©2011 WebMD, LLC. All Rights Reserved.

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