Keep Adolescents on Track With Immunizations

Back-to-school season will bring more opportunities to help adolescents catch up on routine vaccinations.

Only about 60% of adolescents are current with immunizations...and things worsened during the pandemic.

Keep in mind, the “milestone” age is 11 to 12 years old.

HPV. Recommend Gardasil 9 for all kids at age 11 or 12...or as young as 9. Give 2 doses separated by 6 to 12 months for most patients who start the series before age 15.

Continue to give 3 doses if starting the series at age 15 or up...or for some immunocompromised kids or adults (cancer, HIV, etc).

Clarify that HPV vaccination reduces risk of certain cancers (cervical, throat, etc) and genital warts.

Explain that it’s best to get vaccinated early...long before exposure. And dispel myths that Gardasil 9 promotes sexual activity.

Meningococcal. Recommend a dose of Menactra, MenQuadfi, or Menveo at age 11 or 12 to cover serogroups A, C, W, and a booster at age 16.

Expect Menactra to be phased out this year. It’s okay to switch products for the booster.

Add a meningococcal B vaccine series (Bexsero, Trumenba) for some adolescents age 10 and up at high risk...asplenia, sickle cell, etc.

Also explain that any 16- to 23-year-old can get MenB vaccine. Risk goes up with close contact...such as living in a college dorm. Point out that colleges may require both MenB and quad vaccines.

Use the same product for all MenB doses.

Tdap. Give one dose of Adacel or Boostrix at age 11 or a booster to the DTaP series for infants and young kids.

Administration. Identify other needed vaccines...COVID-19, flu, hep A and hep B, etc...and give all at the same visit. Administer any late vaccine doses ASAP. There’s no need to restart a series.

Continue to have patients sit for vaccination, then monitor for 15 min. Fainting after vaccination seems more common in adolescents.

See our Immunization Resource Hub for tools to start discussions, address hesitancy, and prevent vaccine-related injury.

Key References

  • JAMA Pediatr. 2022 Jan 1;176(1):68-77
  • (7-28-22)
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