You are here

IID-11.4 Data Details

Expand All

IID-11.4 Increase the percentage of female adolescents aged 13 through 15 years who receive 2 or 3 doses of human papillomavirus (HPV) vaccine as recommended

About the Data: National

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Immunization Survey-Teen (NIS-Teen); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
45.1 (2016)
Target: 
80.0
Target-Setting Method: 
Maintain consistency with national programs, regulations, policies, and laws.
Target-Setting Method Justification: 
High coverage rates for adolescents are important, but many of the adolescent vaccines are relatively recent additions to the ACIP recommendations. Additionally, vaccinating adolescents is more challenging than vaccinating young children (e.g., recommended vaccines for young children often coincide with well-child visits in the first years of life), and adolescents make fewer medical visits on average, compared with younger children. Thus, an 80 percent target for these adolescent vaccines is both ambitious and achievable. Varicella vaccine has been routinely recommended for many years for preschool-aged children, with catchup for older kids. The target for adolescent varicella is lower than kindergarten varicella because approximately two to three cohorts of children will have missed the kindergarten varicella vaccine requirement during the Healthy People 2020 reporting period.
Numerator: 

Number of females aged 13 to 15 years who receive 2 or 3 doses of the human papillomavirus (HPV) vaccine

Denominator: 

Number of females aged 13 to 15 years

Comparable Healthy People 2010 Objective: 
Not applicable
Data Collection Frequency: 
Annual
Methodology Notes: 

    The National Immunization Survey-Teen (NIS-Teen) collects vaccination information for adolescents aged 13–17 years in the 50 states, the District of Columbia, selected areas, and the U.S. Virgin Islands, using a random-digit-dialed sample of landline and, starting in 2011, cellular telephone numbers. Parent/guardian respondents provide vaccination and sociodemographic information on adolescents in their care. After the parent/guardian grants permission to contact their child's vaccination provider, a questionnaire is mailed to that provider to obtain a vaccination history from the medical record. Data for this measure were restricted to adolescents aged 13–15 and weighted to represent the population of adolescents age 13–15, with adjustments for households with multiple telephone lines and mixed telephone use (landline and cellular), household nonresponse, and exclusion of households without telephone service. A recent report outlining the methodology of the NIS Surveys is available at https://www.cdc.gov/vaccines/imz-managers/nis/methods.html.

    In December 2016, the ACIP updated the HPV vaccine recommendation to include a 2-dose schedule for immunocompetent adolescents initiating the vaccination series before their 15th birthday1. Three doses are still recommended for persons initiating the series at ages 15 through 26 years or who are immunocompromised1. To account for the revisions to the HPV vaccine recommendation, a new measure of being up to date with HPV vaccination was reported in the 2016 NIS-Teen MMWR article2. As measured by the NIS-Teen, an adolescent is considered up to date with the HPV vaccine series if they receive 3 or more doses of HPV vaccine, or if each of the following three conditions are met: 1) they receive 2 doses of HPV vaccine; 2) the first dose of HPV vaccine is received before their 15th birthday; and 3) the difference between dates of first and second doses is greater than or equal to 5 months minus 4 days–the absolute minimum interval between the first and second doses.

    This measure tracks the proportion of female adolescents aged 13–15 years who received 2 or 3 doses of the human papillomavirus (HPV) vaccine as recommended.

    References

    1. 1. Meites E, Kempe A, Markowitz LE. Use of a 2-dose schedule for human papillomavirus vaccination—updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep 2016;65:1405–8.
    2. 2. Walker TY, Elam-Evans LD, Singleton JA, Yankey D, Markowitz LE, Fredua B, Williams CL, Meyer SA, Stokley S. National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years – United States, 2016. MMWR. 2017 Aug 25;66 (33):874-82. DOI: http://dx.doi.org/10.15585/mmwr.mm6633a2.
Caveats and Limitations: 
Data for this revised HPV measure in 2016 will not be comparable to measures prior to 2016 because the definition changed.
Trend Issues: 
Data for this revised HPV measure in 2016 will not be comparable to measures prior to 2016 because the definition changed.

About the Data: State

Description of the data source, numerator, denominator, survey questions, and other relevant details about the state-level data.

Data Source: 
National Immunization Survey-Teen (NIS-Teen); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Measure: 
percent
Numerator: 

Number of females aged 13 to 15 years who receive 2 or 3 doses of the human papillomavirus (HPV) vaccine

Denominator: 

Number of females aged 13 to 15 years

Data Collection Frequency: 
Annual
Methodology Notes: 

      The National Immunization Survey-Teen (NIS-Teen) collects vaccination information for adolescents aged 13–17 years in the 50 states, the District of Columbia, selected areas, and the U.S. Virgin Islands, using a random-digit-dialed sample of landline and, starting in 2011, cellular telephone numbers. Parent/guardian respondents provide vaccination and sociodemographic information on adolescents in their care. After the parent/guardian grants permission to contact their child's vaccination provider, a questionnaire is mailed to that provider to obtain a vaccination history from the medical record. Data for this measure were restricted to adolescents aged 13–15 and weighted to represent the population of adolescents age 13–15, with adjustments for households with multiple telephone lines and mixed telephone use (landline and cellular), household nonresponse, and exclusion of households without telephone service. A recent report outlining the methodology of the NIS Surveys is available at https://www.cdc.gov/vaccines/imz-managers/nis/methods.html.

      In December 2016, the ACIP updated the HPV vaccine recommendation to include a 2-dose schedule for immunocompetent adolescents initiating the vaccination series before their 15th birthday1. Three doses are still recommended for persons initiating the series at ages 15 through 26 years or who are immunocompromised1. To account for the revisions to the HPV vaccine recommendation, a new measure of being up to date with HPV vaccination was reported in the 2016 NIS-Teen MMWR article2. As measured by the NIS-Teen, an adolescent is considered up to date with the HPV vaccine series if they receive 3 or more doses of HPV vaccine, or if each of the following three conditions are met: 1) they receive 2 doses of HPV vaccine; 2) the first dose of HPV vaccine is received before their 15th birthday; and 3) the difference between dates of first and second doses is greater than or equal to 5 months minus 4 days–the absolute minimum interval between the first and second doses.

      This measure tracks the proportion of female adolescents aged 13–15 years who received 2 or 3 doses of the human papillomavirus (HPV) vaccine as recommended.

      References

      1. 1. Meites E, Kempe A, Markowitz LE. Use of a 2-dose schedule for human papillomavirus vaccination—updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep 2016;65:1405–8.
      2. 2. Walker TY, Elam-Evans LD, Singleton JA, Yankey D, Markowitz LE, Fredua B, Williams CL, Meyer SA, Stokley S. National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years – United States, 2016. MMWR. 2017 Aug 25;66 (33):874-82. DOI: http://dx.doi.org/10.15585/mmwr.mm6633a2.
Caveats and Limitations: 
Data for this revised HPV measure in 2016 will not be comparable to measures prior to 2016 because the definition changed.
Trend Issues: 
Data for this revised HPV measure in 2016 will not be comparable to measures prior to 2016 because the definition changed.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2014, the data source name was revised to the “National Immunization Survey (NIS) – Teen” to distinguish this survey from the “National Immunization Survey (NIS),” which samples children between the ages of 19 and 35 months. Neither the data nor the target were revised. In 2015, the baseline year was revised from 2008 to 2012 due to expanding the sampling frame from landline phones only to a dual frame sample including landline and cell phones. The baseline statement was changed from "16.6 percent of females aged 13 to 15 years had received at least 3 doses of human papillomavirus (HPV) vaccine in 2008" to "28.1 percent of females aged 13 to 15 years had received at least 3 doses of human papillomavirus (HPV) vaccine in 2012." The target remains unchanged. In 2018, to reflect the updated Advisory Committee on Immunization Practices (ACIP) 2016 recommendation on HPV vaccination, the objective statement and the methodology were changed. The baseline was changed from "28.1 percent of females aged 13 to 15 years had received at least 3 doses of human papillomavirus (HPV) vaccine in 2012." to "45.1 percent of females aged 13 to 15 years had received 2 or 3 doses of human papillomavirus (HPV) vaccine in 2016." The target remains unchanged.

References

Additional resources about the objective

  1. Datasets for the National Immunization Survey - Teen [online]. Atlanta (GA): National Center for Immunization and Respiratory Diseases. c2013 – [cited 2013 June 6].