What vaccinations are recommended for a 12-year-old individual with no specified medical history?

Vaccinations Recommended for a 12-Year-Old

A 12-year-old should receive three core vaccines: HPV vaccine (first dose of a 2-dose series), Tdap (tetanus-diphtheria-pertussis), and MenACWY (meningococcal conjugate vaccine), all of which can and should be administered during the same visit. 1

Core Adolescent Vaccines

HPV Vaccine (Human Papillomavirus)

• The HPV vaccine is routinely recommended at age 11-12 years for both males and females, ideally before potential exposure to HPV through sexual activity. 1, 2
• At age 12, a 2-dose schedule is appropriate: the first dose at the initial visit, and the second dose 6-12 months later. 2, 3
• This vaccine prevents multiple types of cancer, with HPV types 16 and 18 responsible for approximately 70% of cervical cancers and HPV types 6 and 11 causing approximately 90% of genital warts. 4, 1
• The 9-valent HPV vaccine (Gardasil-9) is currently the only HPV vaccine available in the United States, protecting against 9 HPV types. 3
• Strong, unambiguous provider recommendation is the single most important factor in vaccine acceptance. 1

Tdap Vaccine

• One dose of Tdap should be administered at age 11-12 years for adolescents who have completed the childhood DTP/DTaP vaccination series. 4, 1
• This vaccine protects against tetanus, diphtheria, and pertussis (whooping cough). 1
• National coverage for Tdap reached 86% in 2015, indicating good but not universal uptake. 1

MenACWY Vaccine (Meningococcal Conjugate)

• One dose of MenACWY should be administered at age 11-12 years, protecting against meningococcal disease caused by serogroups A, C, W, and Y. 1
• A booster dose will be required at age 16 years. 1
• Meningococcal disease has increased incidence in late adolescence and can cause serious complications including neurologic sequelae, limb amputation, and death. 1

Additional Recommended Vaccines

Annual Influenza Vaccine

• Annual influenza vaccination is recommended for all adolescents every fall/winter season. 1
• Coverage for influenza vaccine among adolescents was only 46.8% in the 2015-2016 season, indicating significant room for improvement. 1

Catch-Up Vaccines (If Needed)

• Hepatitis B series should be completed if not done in childhood. 1
• Two-dose series of MMR should be completed if not done in childhood. 1
• Two-dose series of Varicella is required for adolescents without reliable history of chickenpox. 1

Critical Implementation Points

Co-Administration

• All three core adolescent vaccines (Tdap, MenACWY, HPV) can and should be administered during the same visit. 1
• Bundling vaccines increases completion rates—72.4% of students in one study received HPV vaccine bundled with other vaccinations. 5

Provider Recommendation Strategy

• Frame HPV vaccine as cancer prevention rather than focusing on sexual transmission to improve acceptance. 1
• Avoid framing HPV vaccination guidelines in reference to age 15, as this may discourage on-time vaccination by introducing confusion about the recommended age. 6
• Lack of provider recommendation is a major reason for non-receipt of adolescent vaccines. 1

Common Pitfalls to Avoid

• Missing the opportunity to vaccinate at age 11-12: Initiating HPV vaccine at age ≤11 years results in 73.6% completion rates versus only 45.1% when initiated at age ≥12 years. 5
• Delaying HPV vaccination: Starting HPV vaccination at age 9-10 years results in 97.5% series completion by age 13.5 years, compared to only 78.0% completion when started at age 11-12 years. 1
• Providing weak or ambiguous vaccine recommendations: Strong healthcare provider recommendations are crucial for vaccine acceptance. 2
• Failing to use non-comprehensive visits: Alternative vaccination sites and use of minor illness visits or sports physicals should be considered for adolescents with limited access to healthcare. 2

Special Considerations

• For immunocompromised individuals: A 3-dose HPV vaccine schedule is recommended regardless of age at initiation. 2, 3
• If vaccination schedule is interrupted: It does not need to be restarted—simply continue where left off. 3
• No pre-vaccination testing is needed: Pap testing and screening for HPV DNA or HPV antibody are not needed before vaccination. 2, 3