Why aren’t teens getting immunized?

Receiving immunizations is as important during the adolescent years as it is during early childhood. Just like vaccines given to younger children, teen vaccines prevent serious and life-threatening infections. Unfortunately, teenagers have lower rates of completion of recommended vaccines than younger children. Less than half of U.S. teens have received all the recommended vaccines as of August 2015, according to the Centers for Disease Control and Prevention. The American Academy of Pediatrics has an interactive map that shows variation in the vaccination rates of teen vaccines by state.

What are the teen vaccines?

Tdap. This vaccine prevents three bacterial infections: tetanus, diphtheria and pertussis. Pertussis, also called whooping cough, can present in teens and adults as a nagging cough without the typical cough spells and “whooping” seen in young children. Children get vaccinated with five doses but by the time they turn 11, the immunity wanes and a booster dose is required. If teens catch this, they may spread it to younger children that are at risk of dying from pertussis.

HPV. This vaccine prevents HPV or human papilloma virus infection, a sexually transmitted virus that infects the genitals and may lead to cervical, anal cancer, or head and neck cancer after a long period of dormancy (or being hidden in the body).

Meningitis. This vaccine protects against certain bacteria that infects the brain coverings or meningitis. Infections with these bacteria are most common between ages 11 and 21.

A single dose of the flu vaccine given yearly.

Why are some teens not getting these vaccines as recommended?

Doctors and health care providers are not doing a good job in recommending them. A 2015 survey showed that 27 percent of doctors do not strongly recommend the HPV vaccines to their patients. Some doctors may find discussing a vaccine that protects against a cancer caused by an STD a bit uncomfortable!

Parents often have misconceptions about the usefulness, efficacy and side effects of teen vaccines. A parent survey published in 2010 revealed that some of the concerns were:

  1. They believe that their child was at low risk for infections.
  2. The risks for adverse effects were “too great.”
  3. There was not enough research on the vaccine.
  4. The vaccine had not been on the market “long enough.”

In fact, these vaccines protect from serious and common infections. HPV causes almost 40,000 cancers every year! Serious side effects from the vaccine have not been seen despite monitoring of millions of recipients. The only known side effects are mild, such as soreness, swelling, or redness at the site of injection and low-grade fever. The benefits of the HPV vaccine clearly outweigh its minor risks.

Teens do not come to the doctor regularly. As children get older, urgent visits to the doctor such as for colds and minor illnesses decrease. Also, there are fewer school requirements for yearly school forms and immunization records seventh grade entry does require Tdap and meningococcal vaccines in Pennsylvania, but this requirement can be delayed for up to eight months!

What can be done to overcome this poor teen vaccination situation?

Pediatricians can address parents’ vaccine hesitancy more effectively. The American Academy of Pediatrics recently published recommendations on helpful strategies to tackle vaccine hesitancy.

Reducing missed opportunities to get teen vaccines. Teens could be vaccinated at any health care visit including emergency room, sick visits, and other non-scheduled visits to the doctor.

Using technology. Electronic medical records systems can provide reminders to doctors if vaccines are due. In addition, patients can receive reminders in their inbox if they sign up for a practice website portal. Doctors can view a patient’s vaccine record even if the teen changes providers. This can be achieved with an inter-connection of different records systems called “health care exchange”.

School vaccinations. Teens have a better chance of getting their vaccines if schools have a strategy to provide them. Schools already provide dental exams, eye exams, and STD screening so getting vaccines at school is not a stretch. The CDC has developed some helpful forms and guidelines for schools to administer vaccines.

Teen vaccines are extremely important to prevent outbreaks. Teens can be sources of outbreaks as they move around and have extensive social networks. Barriers to vaccinations include not only parents’ hesitancy, but doctors also are to blame because of less than adequate efforts. Fortunately, this realization has led to renewed efforts in recent years to improve rates of teen vaccinations and educate parents, and doctors, on the benefits of preventing serious and life-threatening infections.


Have a question for the Healthy Kids panel? Ask it here. Read more from the Healthy Kids blog »