Patterns of Use of Human Papillomavirus and Other Adolescent Vaccines in the United States

Nadja A. Vielot, Anne M. Butler, M. Alan Brookhart, Sylvia Becker-Dreps, Jennifer S. Smith

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Purpose The purpose of the study was to describe the patterns of use of universally recommended adolescent vaccines in the United States. Methods We identified 11-year-olds using the MarketScan insurance claims database (2009–2014). Human papillomavirus (HPV), tetanus-diphtheria-acellular pertussis (Tdap), and meningococcal (MenACWY) vaccination claims were identified using diagnosis and procedure codes. Generalized linear models estimated vaccination incidence rates and correlates of adolescent vaccination and timely vaccination. Results Among 1,691,223 adolescents, receipt of Tdap (52.1%) and MenACWY (45.8%) vaccinations exceeded receipt of HPV vaccination (18.4%). While both sexes had similar Tdap and MenACWY vaccination proportions, girls received HPV vaccination more frequently than boys (21.9% vs. 15.1%). Adolescents received HPV vaccination later (mean age: 11.8 years) than Tdap or MenACWY vaccination (mean age: 11.2 years for both). Half of vaccinated adolescents received Tdap and MenACWY vaccination only; however, coadministration with HPV vaccine increased with birth cohort. Western adolescents had the highest incidence rates of HPV vaccination, and Southern adolescents had the lowest. Rural adolescents were less likely than urban adolescents to receive each vaccination except in the Northeast, where they were more likely to receive HPV vaccination (incidence rate ratio: 1.09, 95% confidence interval: 1.2005–1.13). Timely HPV vaccination was associated with female sex, urbanicity, Western residence, and later birth cohort. Conclusions HPV vaccination occurred later than Tdap or MenACWY vaccination and was less frequent in boys and rural adolescents. Girls, Western and urban residents, and younger birth cohorts were more likely to receive timely HPV vaccination. Vaccine coadministration increased over time and may encourage timely and complete vaccination coverage.

Original languageEnglish
Pages (from-to)281-287
Number of pages7
JournalJournal of Adolescent Health
Issue number3
StatePublished - Sep 2017


  • Adolescents
  • Coadministration
  • Health care providers
  • Human papillomavirus
  • Meningococcal conjugate vaccine
  • Tetanus-diphtheria-acellular pertussis vaccine
  • Vaccination


Dive into the research topics of 'Patterns of Use of Human Papillomavirus and Other Adolescent Vaccines in the United States'. Together they form a unique fingerprint.

Cite this