Young Teenagers Ages

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Adolescent and young adult health
Key facts
Over 1.5 million adolescents and young adults aged 10–24 years died in 2019, nearly 5000 every day.
Young adolescents aged 10–14 years have the lowest risk of death of all age groups.
Injuries (including road traffic injuries and drowning), violence, self-harm and maternal conditions are the leading causes of death among adolescents and young adults
Half of all mental health disorders in adulthood start by age 14, but most cases are undetected and untreated
Early onset of substance use is associated with higher risks of developing dependence and other problems during adult life, and people of younger ages are disproportionately affected by substance use compared with people of older ages
Globally, there are 43 births per 1000 to girls aged 15–19 years per year
Survival chances for adolescents and young adults vary greatly across the world. In 2019, the probability of dying among those aged 10–24 years was highest in sub-Saharan Africa, Central and Southern Asia, Oceania (excluding Australia and New Zealand), and Latin America and the Caribbean (1). The average global probability of a 10-year-old dying before age 24 was 6 times higher in sub-Saharan Africa than in Northern America and Europe.
At the country level, mortality for those 10–14 years ranged from 0.2 to 14.8 deaths per 1000 adolescents aged 10, for 15 to19-year-olds it ranged from 0.8 to 24.9 per 1000 adolescents aged 15 and for 20 to 24-year-olds, it ranged from 0.8 to 27.9 per 1000 young adults aged 20 years. The higher mortality countries are concentrated in sub-Saharan Africa.
Unintentional injuries are the leading cause of death and disability among adolescents. In 2019, over 115 000 adolescents died as a result of road traffic accidents. Many of those who died were “vulnerable road users”, including pedestrians, cyclists or users of motorized two-wheelers. In many countries, road safety laws need to be made more comprehensive, and enforcement of such laws needs to be strengthened. Furthermore, young drivers need advice on driving safely, while laws that prohibit driving under the influence of alcohol and drugs need to be strictly enforced among all age groups. Blood alcohol levels should be set lower for young drivers than for adults. Graduated licences for novice drivers with zero-tolerance for drink-driving are recommended.
Drowning is also among the top causes of death among adolescents – more than 30 000 adolescents, over three quarters of them boys, are estimated to have drowned in 2019. Teaching children and adolescents to swim is an essential intervention to prevent these deaths.
Interpersonal violence is the fourth leading cause of death in adolescents and young people globally. Its prominence varies substantially by world region. It causes nearly a third of all adolescent male deaths in low- and middle-income countries in the WHO Region of the Americas. According to the global school-based student health survey 42% of adolescent boys and 37% of adolescent girls were exposed to bullying. Sexual violence also affects a significant proportion of youth: 1 in 8 young people report sexual abuse.
Violence during adolescence also increases the risks of injury, HIV and other sexually transmitted infections, mental health problems, poor school performance and dropout, early pregnancy, reproductive health problems, and communicable and noncommunicable diseases.
Effective prevention and response strategies include promoting parenting and early childhood development; addressing school-based bullying prevention, programmes that develop life and social skills, and community approaches to reduce access to alcohol and firearms. Effective and empathetic care for adolescent survivors of violence, including ongoing support, can help with the physical and psychological consequences.
Depression is one of the leading causes of illness and disability among adolescents, and suicide is the third leading cause of death in people aged 15–19 years. Mental health conditions account for 16% of the global burden of disease and injury in people aged 10–19 years. Half of all mental health disorders in adulthood start by age 14, but most cases are undetected and untreated.
Many factors have an impact on the well-being and mental health of adolescents. Violence, poverty, stigma, exclusion, and living in humanitarian and fragile settings can increase the risk of developing mental health problems. The consequences of not addressing adolescent mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives as adults.
Building socioemotional skills in children and adolescents and providing them with psychosocial support in schools and other community settings can help promote good mental health. Programmes to help strengthen the ties between adolescents and their families and improve quality of home environments are also important. If problems arise, they should be detected and timely managed by competent and caring health workers.
Drinking alcohol among adolescents is a major concern in many countries. It can reduce self-control and increase risky behaviours, such as unsafe sex or dangerous driving. It is an underlying cause of injuries (including those due to road traffic accidents), violence and premature deaths. It can also lead to health problems in later life and affects life expectancy. Worldwide, more than a quarter of all people aged 15-19 years are current drinkers, amounting to 155 million adolescents. Prevalence of heavy episodic drinking among adolescents aged 15­–19 years was 13.6% in 2016, with males most at risk.
Cannabis is the most widely used psychoactive drug among young people with about 4.7% of people aged 15–16 years using it at least once in 2018. Alcohol and drug use in children and adolescents is associated with neurocognitive alterations which can lead to behavioural, emotional, social and academic problems in later life.
Prevention of alcohol and drug use are important areas of public health actions and may include population-based strategies and interventions, activities in school, community, family and on the individual level. Setting a minimum age for buying and consuming alcohol and eliminate marketing and advertising to minors are among the key strategies for reducing drinking among adolescents.
The vast majority of people using tobacco today began doing so when they were adolescents. Prohibiting the sale of tobacco products to minors (under 18 years) and increasing the price of tobacco products through higher taxes, banning tobacco advertising and ensuring smoke-free environments are crucial. Globally, at least 1 in 10 adolescents aged 13–15 years uses tobacco, although there are areas where this figure is much higher.
An estimated 1.7 million adolescents (age 10–19 years) were living with HIV in 2019 with around 90% in the WHO African Region (2). While there have been substantial declines in new infections amongst adolescents from a peak in 1994, adolescents still account for about 10% of new adult HIV infections, with three-quarters amongst adolescent girls (3). Additionally, while new infections may have fallen in many of the most severely affected countries, recent testing coverage remains low suggesting that many adolescents and young people living with HIV may not know their status (4).
Adolescents living with HIV have worse access to antiretroviral treatment, adherence to treatment, retention in care and viral suppression. A key factor contributing to these is limited provision of adolescent-friendly services including psychosocial interventions and support.
Adolescents and young people need to know how to protect themselves from HIV infection and must also have the means to do so. This includes being able to obtain access HIV prevention interventions including voluntary medical male circumcision, condoms and pre-exposure prophylaxis, better access to HIV testing and counselling, and stronger links to HIV treatment services for those who test HIV positive.
Thanks to improved childhood vaccination, adolescent deaths and disability from measles have fallen markedly – for example, adolescent mortality from measles fell by 90% in the African Region between 2000 and 2012.
Diarrhoea and lower respiratory tract infections (pneumonia) are estimated to be among the top 10 causes of death for adolescents 10–14 years. These two diseases, along with meningitis, are all among the top 5 causes of adolescent death in African low- and middle-income countries.
Infectious diseases like with Human Papilloma Virus that normally occurs after onset of sexual activity can lead to both short-term disease (genital warts) during adolescence but more importantly also leads to cervical and other cancers several decades later. Early adolescence (9-14 years) is the optimal time for vaccination against HPV infection and it is estimated that if 90% of girls globally get the HPV vaccine more than 40 million lives could be saved over the next century. However, it is estimated that in 2019 only 15% of girls globally received the vaccine.
Approximately 12 million girls aged 15–19 years and at least 777 000 girls under 15 years give birth each year in developing regions. The leading cause of death for girls aged 15-19 years globally is complications from pregnancy and childbirth.
 The UN Population Division puts the global adolescent birth rate in 2020 at 43 births per 1000 girls this age – country rates range from 1 to over 200 births per 1000 girls (5). This indicates a marked decrease since 1990. This decrease is reflected in a similar decline in maternal mortality rates among girls aged 15–19 years.
One of the specific targets of the health Sustainable Development Goal (SDG 3) is that by 2030, the world should ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
Adolescents need and have a right to comprehensive sexuality education, a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. Better access to contraceptive information and services can reduce the number of girls becoming pregnant and giving birth at too young an age. Laws that are enforced that specify a minimum age of marriage at 18 can help.
Girls who do become pregnant need access to quality antenatal care. Where permitted by law, adolescents who opt to terminate their pregnancies should have access to safe abortion.
Iron deficiency anaemia was the second leading cause of years lost by adolescents to death and disability in 2016. Iron and folic acid supplements are a solution that also helps to promote health before adolescents become parents. Regular deworming in areas where intestinal helminths such as hookworm are common is recommended to prevent micronutrient (including iron) deficiencies.
Developing healthy eating habits in adolescence are foundations for good health in adulthood. Reducing the marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt and providing access to healthy foods are important for all, but especially for children and adolescents.
Many boys and girls in developing countries enter adolescence undernourished, making them more vulnerable to disease and early death. At the other end of the spectrum, the number of adolescents who are overweight or obese is increasing in low-, middle- and high-income countries.
Globally, in 2016, over one in six adolescents aged 10–19 years was overweight. Prevalence varied across WHO regions, from lower than 10% in the WHO South-East Asia region to over 30% in the WHO Region of the Americas.
Physical activity provides fundamental health benefits for adolescents, including improved cardiorespiratory and muscular fitness, bone health, maintenance of a healthy body weight, and psychosocial benefits. WHO recommends for adolescents to accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity daily, which may include play, games, sports, but also activity for transportation (such as cycling and walking), or physical education.
Globally, only 1 in 5 adolescents are estimated to meet these guidelines. Prevalence of inactivity is high across all WHO regions, and higher in female adolescents as compared to male adolescents.
To increase activity levels, countries, societies and communities need to create safe and enabling environments and opportunities for physical activity for all adolescents.
The rights of children (people under 18 years of age) to survive, grow and develop are enshrined in international legal documents. In 2013, the Committee on the Rights of the Child (CRC), which oversees the child rights convention, published guidelines on the right of children and adolescents to the enjoyment of the highest attainable standard of health, and a General Comment on realizing the rights of children during adolescence was published in 2016. It highlights states’ obligations to recognize the special health and development needs and rights of adolescents and young people.
The Convention on the Elimination of Discrimination Against Women (CEDAW) also sets out the rights of women and girls to health and adequate health care.
In May 2017, WHO published a major report: Global Accelerated Action for the Health of Adolescents (AA-HA!): Guidance to support country implementation. The AA-HA! Guidance has drawn on inputs received during extensive consultations with Member States, United Nations agencies, adolescents and young people, civil society and other partners. It aims to assist governments in deciding what they plan to do and how they plan to do it as they respond to the health needs of adolescents in their countries. This reference document targets national-level policy-makers and programme managers to assist them in planning, implementing, monitoring and evaluation of adolescent health programmes. Teams from over 68 countries have been trained in applying the AA-HA! guidance for national priority-setting, programming, monitoring and evaluation, and many countries are in the process of using the AA-HA! approach to update national strategies and policies.
To improve adolescent health measurement globally, WHO, in collaboration with UNAIDS, UNESCO, UNFAP, UNICEF, UN Women, the World Bank Group, and the World Food Programme (WFP), has established the Global Action for Measurement of Adolescent health (GAMA) Advisory Group. GAMA provides technical guidance to WHO and UN partner agencies to define a core set of adolescent health indicators, for the purpose of harmonizing efforts around adolescent health measurement and reporting. 
Overall, WHO carries out a range of functions to improve the health of young people, including:
(1) United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME). Levels and Trends in Child Mortality: Report 2020. https://www.unicef.org/reports/levels-and-trends-child-mortality-report-2020
(4) Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach – 2nd ed: World Health Organization; 2016.
(5) United Nations Department of Economic and Social Affairs, Population Division. World population prospects: fertility data 2020-2025. 2020. https://population.un.org/wpp/Download/Standard/Fertility/.
Reframing child and adolescent health for the SDG era 18 March 2021
WHO issues new guidelines on the management of chronic pain in children 1 February 2021
Adolescent pregnancy 31 January 2020
Adolescent mental health 28 September 2020
Human papillomavirus (HPV) and cervical cancer 11 November 2020

CDC has updated its guidance for people who are fully vaccinated. See Recommendations for Fully Vaccinated People.
CDC recommends schools continue to use the current COVID-19 prevention strategies for the 2020-2021 school year. Learn more
Important update: Healthcare facilities
CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more
Although fewer children have been infected with COVID-19 compared to adults, children can:
CDC recommends everyone 12 years and older should get a COVID-19 vaccination to help protect against COVID-19. Widespread vaccination is a critical tool to help stop the pandemic. People who are fully vaccinated can resume activities that they did prior to the pandemic. Learn more about what you and your child or teen can do when you have been fully vaccinated. Children 12 years and older are able to get the Pfizer-BioNTech COVID-19 Vaccine.
Children between the ages of 2 and 12 should wear a mask in public spaces and around people they don’t live with.
Find a COVID-19 Vaccine: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you.
Getting a COVID-19 vaccination can help protect your child from getting COVID-19. Early information shows that the vaccines may help keep people from spreading COVID-19 to others. They can also help keep your child from getting seriously sick even if they do get COVID-19. Help protect your whole family by getting yourself and your children 12 years and older vaccinated against COVID-19.
Cases of myocarditis and pericarditis in adolescents and young adults have been reported more often after getting the second dose than after the first dose of one of these two mRNA COVID-19 vaccines. These reports are rare and the known and potential benefits of COVID-19 vaccination outweigh the known and potential risks, including the possible risk of myocarditis or pericarditis.
Get a COVID-19 vaccine for your child as soon as you can.
Prepare for your child’s vaccination visit.
Your child may have some side effects, which are normal signs that their body is building protection.
Tiredness
Headache
Muscle pain
Chills
Fever
Nausea
These side effects may affect your child’s ability to do daily activities, but they should go away in a few days. Some people have no side effects.
Ask your child’s healthcare provider for advice on using a non-aspirin pain reliever and other steps you can take at home to comfort your child. It is not recommended you give pain relievers befo
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Young Teenagers Ages