Simultaneous Administration Among Females of HPV4 Vaccine and Other Vaccines Recommended for Adolescents— Immunization Information System Sentinel Sites, United States, 2008–2009

Background: CDC’s Advisory Committee on Immunization Practices (ACIP) recommends simultaneous administration of all age-appropriate vaccine doses to children without specific contraindications. ACIP’s 2006 quadrivalent human papillomavirus (HPV4) vaccine recommendations acknowledged the benefits of administering HPV4 simultaneously with other recommended vaccines, including tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine and meningococcal conjugate (MCV4) vaccine. Studies are needed to characterize simultaneous administration of these vaccines. In 2008, the National Immunization Survey–Teen coverage estimate for ≥1 HPV4 dose among females aged 13–17 years was 37.2%.

Objectives: To describe patterns of simultaneous administration of HPV4 vaccine with Tdap, MCV4, or tetravalent meningococcal polysaccharide (MPSV4) vaccines among adolescent females.

Methods: We examined aggregate quarterly data from six Immunization Information Systems (IIS) participating in CDC’s IIS Sentinel Site Project from 2008–2012. Using unweighted averages of each site’s data, we examined simultaneous administration of any HPV4 dose with other vaccines recommended for females aged 11–18 years.

Results: Among 630,204 females aged 11–18 years, an average of 30.8% received ≥1 HPV4 dose through September 2009. Of these, approximately 76% received ≥1 other vaccine during that same visit. This occurred more often among 11–12 year olds compared with 13–18 year olds (86.4% vs. 74.0%). Among females receiving an HPV4 dose and another vaccine simultaneously, 54.7% received Tdap, and 69.9% received either MCV4 or MPSV4; only 34.0% simultaneously received Tdap, HPV4, and meningococcal vaccines. While simultaneous administration of these vaccines among females remains low (8.3%), it has increased over time.

Conclusions: Receipt of ≥1 HPV4 dose remains low in adolescent females. Results suggest opportunities for simultaneous administration with other recommended vaccines are being missed. Adherence to simultaneous vaccination recommendations is needed to achieve higher vaccination rates among adolescents. Education targeting adolescents, parents, and vaccination providers might increase simultaneous vaccination.