Human papillomavirus (HPV) vaccination coverage among U.S. adolescents remained largely unchanged for a fourth consecutive year in 2025, according to surveillance findings published by the Centers for Disease Control and Prevention (CDC) in the Morbidity and Mortality Weekly Report (MMWR). Analyzing data from the 2025 National Immunization Survey-Teen (NIS-Teen) covering 18,692 adolescents aged 13 to 17 years, researchers observed that despite routine adolescent vaccines maintaining near 90% coverage, HPV immunization continues to plateau well below national public health targets. Vaccination Plateau Enters Fourth Consecutive Year as Routine Immunizations Remain High According to the report, 77.7% of adolescents aged 13 to 17 had received at least one dose of HPV vaccine in 2025, and 63.4% were up to date with the recommended vaccination series. Neither metric increased significantly from 2024, when coverage stood at 78.2% for at least one dose and 62.9% for series completion, marking a continuing plateau that has persisted since 2021. Gender stratification showed that approximately 64% of females and 63% of males were up to date on HPV vaccination.
School Mandates and Rural Gaps Drive HPV Disparities
In contrast, coverage with other routine adolescent vaccines remained substantially higher. Coverage with at least one dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) reached 88.8%, while coverage with at least one dose of quadrivalent meningococcal conjugate vaccine (MenACWY) was 89.0%. Although both vaccines recorded modest declines from 2024 levels of 91.3% and 90.1%, respectively, overall coverage remained consistent with ranges observed between 2019 and 2023. Investigators noted that minor coverage declines among adolescents 13 and 14 years of age warrant ongoing monitoring. Institutional Policy Gaps in School-Entry Mandates Drive Uptake Disparities Examining the persistent divergence between HPV vaccination and other routine immunizations, CDC investigators highlighted differences in school-entry policy requirements across jurisdictions. “The consistently lower HPV vaccination coverage compared with other routine adolescent vaccines might, in part, reflect differences in school entry requirements,” wrote the authors, from the Centers for Disease Control and Prevention (CDC). “Tdap is required for school entry in all states, and MenACWY is required in most states; however, few states require HPV vaccination.”
William Schaffner, MD, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center, noted that the absence of mandates places an artificial ceiling on community protection. “Over most of the country, HPV vaccination is topping out in the 60% range if you don't have obligations or requirements,” Dr. Schaffner, who was not involved with the research, told Infectious Disease Special Edition. “While this does not shock me, it disappoints me, because HPV vaccinations benefit both girls and boys in preventing a whole array of genital, anal, and head and neck cancers.” He emphasized: “This is our first explicitly anti-cancer vaccine.” Regarding subtle downward trends in routine immunizations, Dr. Schaffner added: “The acceptance of MenACWY vaccine and Tdap just drifting downwards a little bit may be a reflection of vaccine hesitancy. We have to keep our eye on that.” Pronounced Rural-Urban Divide and State-Level Polarization The survey demonstrated significant geographic disparities across the nation. Adolescents living in mostly rural areas experienced HPV first-dose coverage 12.0 percentage points lower than peers in mostly urban areas, while the proportion up to date with the full series was 14.2 percentage points lower. This rural-urban disparity persisted across all household income and poverty tiers, demonstrating that rural deficits are not driven by poverty alone.
HPV Coverage Trails Healthy People 2030 Target of 80%
State-by-state data revealed extreme jurisdictional polarization. First-dose HPV coverage ranged from 49.5% in Mississippi to 94.1% in Rhode Island, while series completion ranged from 30.9% in Mississippi to 84.5% in Rhode Island—a geographic gap exceeding 50 percentage points. Conversely, Tdap coverage exhibited much narrower geographic variation across jurisdictions, ranging from 80.5% in the District of Columbia to 94.6% in Vermont. Lagging Behind Healthy People 2030 Targets as Experts Call for Action National HPV vaccination coverage remains far below the federal Healthy People 2030 benchmark of 80% series completion. The 2025 national figure of 63.4%—and just 58.6% among adolescents aged 13 to 15 years—underscores substantial unmet preventive needs. Concurrently, coverage with two doses of measles, mumps, and rubella vaccine (MMR) was 92.5%, missing the 95% threshold required to maintain community herd immunity.
The American Academy of Pediatrics (AAP) recommends routine HPV vaccination for all adolescents starting between age 9 and 12 years. The CDC authors emphasized that clinicians must actively review vaccination histories, implement reminder and recall systems, and administer due vaccines during every clinical visit. Furthermore, public health specialists and pediatric advocates urge policymakers to integrate school-based immunization programs and structured institutional policies into national cancer prevention frameworks, ensuring equitable adolescent healthcare access and reducing preventable oncologic disease burden nationwide.
