National Immunization Survey-Teen (NIS-Teen) 2020, Texas

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National Immunization Survey-Teen (NIS-Teen) 2020, Texas

Immunization Coverage Among Texas Teens 13-17 Years Old

Source: CDC NIS-Teen Report

About the National Immunization Survey-Teen (NIS-Teen)

The NIS-Teen is a national survey conducted every year by the Centers for Disease Control and Prevention (CDC) to assess vaccination coverage levels, or the percentage of people vaccinated, among adolescents 13-17 years of age. This study collects data by interviewing households in all 50 states, the District of Columbia, and smaller selected areas. The interviews are conducted by telephone, with households selected at random. To ensure the accuracy of vaccination coverage estimates, participant vaccination records are collected from healthcare providers by mail after the interview. The parents and guardians of eligible teens are asked during the telephone interview for consent to contact the adolescents’ vaccination providers to verify their records.

The NIS-Teen was established to provide an ongoing and consistent data set for analyzing vaccination coverage levels among adolescents in the United States and to share this information with interested public health partners. The NIS-Teen provides national and statewide estimates of vaccination coverage, including new vaccines as they are licensed and recommended for use. It also helps track progress towards the Healthy People 2030 goals.

Survey Sample

The survey assessed the vaccination histories of approximately 20,000 U.S. adolescents aged 13-17 years between January 2020 and February 2021. These adolescents were born between January 2002 and February 2008.  A total of 1,141 Texas teens were interviewed as part of this study, with estimated vaccination coverage levels for the state of Texas and two local Texas areas – the City of Houston and Bexar County.   

Vaccines Included

The following vaccine doses routinely recommended for adolescents starting at 11-12 years of age, were measured in the 2020 NIS-Teen:

  • ≥1 dose of Tetanus-diphtheria-pertussis (Tdap) vaccine
  • ≥1 dose of Quadrivalent Meningococcal Conjugate (MenACWY) vaccine
  • ≥1 dose of human papillomavirus (HPV) vaccine
  • HPV vaccine, Up-to-Date, either two or three doses dependent on age of initiation
  • Hepatitis A (HepA) vaccination, newly added to the NIS-Teen survey for 2020. In July 2020, Advisory Committee on Immunization Practices (ACIP) revised recommendations for HepA vaccination to include catch-up vaccination for children and adolescents aged 2–18 years who have not previously received HepA vaccine.

Vaccination Coverage Levels

 NIS-Teen Immunization Coverage Estimates in the U.S and Texas, 2019-2020        
Vaccine U.S.  2020Texas 2019Texas 2020

2019 to 2020 Texas Percentage Point Change

≥1 dose of tetanus-diphtheria-acellular pertussis (Tdap90.1%  84.8%   84%c   -0.8%   
≥1 dose of meningococcal conjugate (MenACWY89.3%   85.9%   91.2%   5.3%b   
≥1 dose of human papillomavirus (HPV75.1%   65.1%   72.8%%   7.7% b  
HPV Up-To-Date (HPV UTD58.6%   48.4%54.9%   6.5% b  
≥1 dose of HPV, females77.1%64.2% 76.1% 11.9%b
HPV UTD, females61.4%50.6% 57.0% 6.4%
≥1 of HPV, males73.1%65.9% 69.6% 3.8% 
HPV UTD, males56.0% 46.3% 52.9% 6.6% 
≥2 doses of measles, mumps, rubella (MMR)92.4% 84.2% 85.9% c1.7% 
≥2 doses of varicella (VAR)91.9% 81.6% 86.7%c 5.1% b
≥2 HepA 82.1% 81.4% 87.1%a 5.7% b

a Significantly greater (p<.0.05) than the U.S. estimate
Statistically significant difference (p<0.05) between years
Significantly lower (p<0.05) than the U.S. estimate


See accessible data table of chart below:

 NIS-Teen Immunization Coverage Estimates for Tdap and MenACWY by Jurisdiction, 2020            
Vaccine US Texas  City of Houston  Bexar County 
≥1 Tdap 90.1% 84% 87.6% 87.2%
≥1 MenACWY 89.3%91.2% 89.2% 90.6%

See accessible data table of chart below:

 NIS-Teen Immunization Coverage Estimates for HPV by Gender and Jurisdiction, 2020             
Vaccine US Texas  City of Houston  Bexar County 
≥1 HPV, females 77.1% 76.1% 87.6% 77.2%
HPV UTD, females 61.4%  57% 72.5% 62.1% 
≥1 HPV, males 71.3%69.6% 67% 74.2%
HPV UTD, males 56.%52.9% 49.8% 59.4%


The same methodology was not used for all years.

See accessible data table of chart below:

 NIS-Teen One-Dose HPV Immunization Coverage Estimates by Gender, U.S. and Texas, 2011-2020a                      
  2011  2012  2013  2014  2015  2016  2017  2018  2019 2020
U.S, Female 53.0% 53.8% 56.7% 60.0% 62.8% 65.1% 68.6% 69.9%  73.2% 77.1%
Texas, Female  48.8% 51.2% 55.5% 50.7% 60.1% 54.5% 60.4% 64.6%  64.2% 73.1%
U.S, Male  8.3% 20.8% 33.6% 41.7% 49.8% 56.0% 62.6% 66.3%  69.8% 73.1%
Texas, Male  10.4% 24.0% 33.7% 36.6% 41.4% 44.3% 55.2% 55.5%  65.9% 69.6%

The same methodology was not used for all years.

View survey results from prior years:

2019 National Immunization Survey Results

2018 National Immunization Survey Results

2017 National Immunization Survey Results

2016 National Immunization Survey Results

2015 National Immunization Survey Results

2014 National Immunization Survey Results

2013 National Immunization Survey Results

2010 National Immunization Survey Results

2009 National Immunization Survey Results

2008 National Immunization Survey Results

2007 National Immunization Survey Results

2006 National Immunization Survey Results

2005 National Immunization Survey Results

2004 National Immunization Survey Results

2003 National Immunization Survey Results

2002 National Immunization Survey Results

2001 National Immunization Survey Results

2000 National Immunization Survey Results 

Last updated June 3, 2022