Each year CDC's National Immunization Survey-Teen (NIS-Teen) measures how many U.S. adolescents aged 13–17 have their recommended vaccines. The 2025 survey covered 18,692 teens.
What's recommended
The 2025 CDC Child and Adolescent Immunization Schedule (updated July 2, 2025) recommended routine vaccination at ages 11–12 with:
| Vaccine | Protects against |
|---|---|
| Tdap | tetanus, diphtheria and pertussis |
| MenACWY | four meningococcal groups — with a booster at 16 |
| HPV | human papillomavirus — can start at age 9 |
At 16, teens may also get a two-dose MenB series through shared clinical decision-making; a pentavalent MenABCWY vaccine can be used when both MenACWY and MenB are due. Flu vaccination is recommended every year, and COVID-19 vaccination may be given through shared decision-making. Teens can also catch up on missed childhood vaccines.
National coverage, 2025
| Vaccine | 2024 | 2025 |
|---|---|---|
| ≥1 dose Tdap | 91.3% | 88.8% |
| ≥1 dose MenACWY | 90.1% | 89.0% |
| ≥1 dose HPV | 77.7% | |
| Up to date with HPV series | 63.4% | |
| ≥2 doses MenB | 15.9% | 12.5% |
| ≥2 doses hepatitis A (catch-up) | 87.1% | 88.6% |
- Tdap and MenACWY dipped but stayed around 90%, in line with 2019–2023. The dips roughly offset the gains of 2024 and may be normal year-to-year variation — but declines among 13- and 14-year-olds (13-year-olds' Tdap fell from 89.4% to 86.0%) could be an early warning.
- HPV coverage has now failed to rise for four straight years, and still trails Tdap and MenACWY. One likely reason: every state requires Tdap for school and most require MenACWY, but few require HPV.
Healthy People 2030 targets missed
| 2025 | Target | |
|---|---|---|
| HPV series complete, ages 13–15 | 58.6% | 80% |
| ≥2 doses MMR, ages 13–17 | 92.5% | 95% (the level needed to prevent measles outbreaks) |
Rural teens fall behind
Compared with teens in mostly urban areas, those in mostly rural areas had:
| Gap | |
|---|---|
| ≥1 dose HPV | 12.0 points lower |
| Up to date with HPV | 14.2 points lower |
| ≥1 dose MenACWY | 3.0 points lower |
Suburban teens were 2.9 points lower than urban teens for ≥1 HPV dose; Tdap was similar everywhere.
The HPV gap held at every income level — so poverty doesn't explain it. Other studies point to lower acceptance of HPV vaccine in rural communities, and rural teens are less likely to attend an 11- or 12-year well-child visit or to get a provider's recommendation. The MenACWY gap, by contrast, appeared only among teens below the poverty line, hinting at economic or access barriers.
State by state
| Vaccine | Lowest | Highest |
|---|---|---|
| ≥1 dose Tdap | District of Columbia, 80.5% | Vermont, 94.6% |
| ≥1 dose MenACWY | Mississippi, 61.2% | Rhode Island, 96.5% |
| ≥1 dose HPV | Mississippi, 49.5% | Rhode Island, 94.1% |
| Up to date with HPV | Mississippi, 30.9% | Rhode Island, 84.5% |
HPV coverage was generally highest in New England and along the West Coast. Since 2024, five jurisdictions rose and six fell on one or more routine teen vaccines.
What providers can do
- review teens' vaccination records for needed doses
- use reminder and recall systems to tell families when vaccines are due or overdue
- discuss recommended vaccines with families
- give every vaccine that's due at every visit
Broader efforts — better access to preventive care, clearer provider recommendations and stronger vaccine confidence — could close the gaps, especially for HPV.
Limits
Only 21.4% of households responded, and just 42.0% of teens had adequate provider records; weighting may not remove all bias. A bias check suggests part of the Tdap and MenACWY dip may come from teens with several providers whose records weren't all returned, so those decreases should be read with caution. NIS-Teen tends to underestimate coverage — most for being up to date with HPV (by 5.4 points in 2024).
Sources
Based on Cassandra Pingali, David Yankey, Laurie D. Elam-Evans and colleagues, "Vaccination Coverage Among Adolescents Aged 13–17 Years — National Immunization Survey-Teen, United States, 2025," MMWR, volume 75, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The report's discussion puts both rural HPV gaps at about 10 points; its results give 12.0 and 14.2, which are used here.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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