Background: Vaccination against both Human papillomavirus (HPV) and meningococcal disease is recommended for all adolescents aged 11-12 years; however, many teens have not received these vaccinations.

Aim: This study aims to assess trends in dual vaccination against HPV and meningococcal disease among teens in the United States.

Methods: We analyzed data on 31,083 adolescents aged 13-17 years from the 2020 National Immunization Survey - Teen. Bivariate and multivariate logistic regression models were constructed to determine dual vaccination rates and associations between vaccination status and sociodemographic characteristics.

Results: Teens were 2.03 (95%CI: 1.98-2.09) times more likely to be vaccinated against meningococcal disease compared to HPV. Additionally, teens vaccinated against HPV were 1.21 (1.15-1.27) times more likely to be dually vaccinated than teens who were vaccinated against meningococcal disease. Among teens living in the South relative to the Northeast, the likelihood for being vaccinated against only HPV increased by a factor of 1.30 (1.07-1.58) and against only meningococcal disease increased by a factor of 1.17 (1.03-1.33). Relative to those living in the Northeast, the risk for being unvaccinated rather than dually vaccinated increased by a factor of 1.51 (1.25-1.83) for those living in the Midwest, 1.62 (1.30- 2.03) for those living in the West, and 1.80 (1.50-2.15) for those living in the South. Although less significant, we also found association between sex, race/ethnicity and income-to-poverty ratio.

Conclusion: Dual vaccination against HPV and meningococcal disease among adolescents in the United States is associated with many factors including state legislation, physician recommendation, sex and census region. Although administration of both vaccines is recommended by the Advisory Committee on Immunization Practices (ACIP) to all adolescents aged 11-12 years, meningococcal vaccination is two times more likely than HPV vaccination. Given the trends in immunization and vaccine efficacy, we recommend that physicians advise patients in this age range to receive both vaccines during a single appointment. Increased vaccination at a societal level will increase protection against preventable diseases that cause significant burden to adolescents and young adults.