Implementation Experience With Meningococcal Serogroup B Vaccines in the United States: Impact of a Nonroutine Recommendation.
Journal
The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858
Informations de publication
Date de publication:
01 03 2021
01 03 2021
Historique:
entrez:
10
2
2021
pubmed:
11
2
2021
medline:
25
9
2021
Statut:
ppublish
Résumé
Meningococcal serogroup B (MenB) is the leading cause of invasive meningococcal disease among US adolescents and young adults, accounting for 62% of cases in 16-23-year-olds in 2018. Since 2015, the Advisory Committee on Immunization Practices (ACIP) has recommended vaccination of healthy adolescents against MenB based on shared clinical decision-making (previously called "Category B" or individual clinical decision-making). However, MenB vaccine coverage and series completion rates remain low. Herein we examine implementation experience of adolescent MenB vaccination in the United States under this nonroutine ACIP recommendation. PubMed was searched for English-language articles published after 2015 examining MenB vaccination implementation in the United States. Studies reporting MenB vaccination awareness, coverage, knowledge of recommendations and implementation barriers or access disparities were included. Identified studies provided evidence that ACIP's MenB vaccination recommendation is poorly understood and prone to misinterpretation by US healthcare providers. Parental awareness of MenB vaccines is low, and racial and socioeconomic disparities exist regarding vaccine receipt. Parents rely on providers to learn about MenB disease risk and benefits of vaccination, with provider recommendations carrying substantial weight in vaccination decisions. Five years of evidence regarding the MenB vaccination implementation experience suggest that the nonstandard recommendation for MenB vaccines is partly responsible for low vaccine coverage. Further, inconsistent implementation of ACIP recommendations could be limiting access to MenB vaccines. Providers need additional support and guidance to implement the shared clinical decision-making recommendation, in turn ensuring equitable access for vaccine-eligible adolescents to enable comprehensive protection against meningococcal disease.
Sections du résumé
BACKGROUND
Meningococcal serogroup B (MenB) is the leading cause of invasive meningococcal disease among US adolescents and young adults, accounting for 62% of cases in 16-23-year-olds in 2018. Since 2015, the Advisory Committee on Immunization Practices (ACIP) has recommended vaccination of healthy adolescents against MenB based on shared clinical decision-making (previously called "Category B" or individual clinical decision-making). However, MenB vaccine coverage and series completion rates remain low. Herein we examine implementation experience of adolescent MenB vaccination in the United States under this nonroutine ACIP recommendation.
METHODS
PubMed was searched for English-language articles published after 2015 examining MenB vaccination implementation in the United States. Studies reporting MenB vaccination awareness, coverage, knowledge of recommendations and implementation barriers or access disparities were included.
RESULTS
Identified studies provided evidence that ACIP's MenB vaccination recommendation is poorly understood and prone to misinterpretation by US healthcare providers. Parental awareness of MenB vaccines is low, and racial and socioeconomic disparities exist regarding vaccine receipt. Parents rely on providers to learn about MenB disease risk and benefits of vaccination, with provider recommendations carrying substantial weight in vaccination decisions.
CONCLUSIONS
Five years of evidence regarding the MenB vaccination implementation experience suggest that the nonstandard recommendation for MenB vaccines is partly responsible for low vaccine coverage. Further, inconsistent implementation of ACIP recommendations could be limiting access to MenB vaccines. Providers need additional support and guidance to implement the shared clinical decision-making recommendation, in turn ensuring equitable access for vaccine-eligible adolescents to enable comprehensive protection against meningococcal disease.
Identifiants
pubmed: 33565815
doi: 10.1097/INF.0000000000003033
pii: 00006454-202103000-00021
doi:
Substances chimiques
Meningococcal Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
269-275Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
L.H. and A.S. are employees of Pfizer and may hold stock or stock options. J.F. is a speaker for Pfizer and a consultant/advisory board member for Pfizer and GlaxoSmithKline. A.H. has no conflicts of interest to disclose.
Références
Martinón-Torres F. Deciphering the burden of meningococcal disease: conventional and under-recognized elements. J Adolesc Health. 2016;59(2 suppl):S12–S20.
Centers for Disease Control and Prevention. Enhanced Meningococcal Disease Surveillance Report, 2018. 2018. Available at: https://www.cdc.gov/meningococcal/downloads/NCIRD-EMS-Report-2018.pdf . Accessed August 28, 2020.
Mbaeyi SA, Blain A, Whaley MJ, et al. Epidemiology of meningococcal disease outbreaks in the United States, 2009-2013. Clin Infect Dis. 2019;68:580–585.
Mbaeyi SA, Joseph SJ, Blain A, et al. Meningococcal disease among college-aged young adults: 2014-2016. Pediatrics. 2019;143:e20182130.
Marshall GS, Dempsey AF, Srivastava A, et al. US college students are at increased risk for serogroup B meningococcal disease. J Pediatric Infect Dis Soc. 2019;9:244–247.
Cohn AC, MacNeil JR, Clark TA, et al. Prevention and Control of Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP). 2013. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm . Accessed February 3, 2020.
Ahmed F; Centers for Disease Control and Prevention. U.S. Advisory Committee on Immunization Practices (ACIP) Handbook for Developing Evidence-Based Recommendations. Version 1.2. 2013. Available at: http://www.cdc.gov/vaccines/acip/recs/GRADE/downloads/handbook.pdf . Accessed July 2, 2020.
Folaranmi T, Rubin L, Martin SW, et al.; Centers for Disease Control (CDC). Use of serogroup B meningococcal vaccines in persons aged ≥10 years at increased risk for serogroup B meningococcal disease: recommendations of the Advisory Committee on Immunization Practices, 2015. MMWR Morb Mortal Wkly Rep. 2015;64:608–612.
MacNeil JR, Rubin L, Folaranmi T, et al. Use of serogroup B meningococcal vaccines in adolescents and young adults: recommendations of the Advisory Committee on Immunization Practices, 2015. MMWR Morb Mortal Wkly Rep. 2015;64:1171–1176.
Advisory Committee on Immunization Practices. Summary Report, June 26-27, 2019. 2019. Available at: https://www.cdc.gov/vaccines/acip/meetings/downloads/min-archive/min-2019-06-508.pdf . Accessed July 2, 2020.
Kempe A, Allison MA, MacNeil JR, et al. Knowledge and attitudes regarding category B ACIP recommendations among primary care providers for children. Acad Pediatr. 2018;18:763–768.
Centers for Disease Control and Prevention. ACIP Shared Clinical Decision-Making Recommendations. 2020. Available at: https://www.cdc.gov/vaccines/acip/acip-scdm-faqs.html . Accessed April 23, 2020.
Walker TY, Elam-Evans LD, Yankey D, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years - United States, 2018. MMWR Morb Mortal Wkly Rep. 2019;68:718–723.
Advisory Committee on Immunization Practices. Advisory Committee on Immunization Practices (ACIP) Summary Report. 2019. Available at: https://www.cdc.gov/vaccines/acip/meetings/downloads/min-archive/min-2019-02-508.pdf . Accessed November 20, 2019.
Basta NE, Becker AB, Li Q, et al. Parental awareness of meningococcal B vaccines and willingness to vaccinate their teens. Vaccine. 2019;37:670–676.
Srivastava A, Dempsey A, Galitsky A, et al. Parental awareness and utilization of meningococcal serogroup B vaccines in the United States. BMC Public Health. 2020;20:1109.
C.S. Mott Children’s Hospital. Mott Poll Report: Parents Not Keeping Up With Teen Vaccines. 2017. Available at: https://mottpoll.org/sites/default/files/documents/071717_teenvaccines.pdf . Accessed April 27, 2020.
Johnson R, Fairchild A, Huang L, et al. Understanding patient preferences for meningococcal serogroup B vaccines [281]. J Adolesc Health. 2020;66:S141–S142.
Kempe A, Allison MA, MacNeil JR, et al. Adoption of serogroup B meningococcal vaccine recommendations. Pediatrics. 2018;142:e20180344.
Huang L, Goren A, Lee LK, et al. Disparities in healthcare providers’ interpretations and implementations of ACIP’s meningococcal vaccine recommendations. Hum Vaccin Immunother. 2020;16:933–944.
Rand CM, Goldstein NPN. Patterns of primary care physician visits for US adolescents in 2014: implications for vaccination. Acad Pediatr. 2018;18:S72–S78.
Ulrich A, McKearnan S, Lammert S, et al. Validity of self-reported vaccination status and knowledge and attitudes toward MenB vaccine after an outbreak. In: The 15th European Meningococcal and Haemophilus Disease Society Congress, May 27–30, 2019. Lisbon, Portugal, Available at: https://emgm.eu/meetings/emgm2019/emgm2019_abstracts.pdf .
Oliver S; Centers for Disease Control and Prevention. Meningococcal Vaccine Policies Among Colleges and Universities — United States, 2017. 2018. Available at: https://www.acha.org/documents/resources/CDC-ACHA_College_Policies_Meningococcal_Vaccines_2017.pdf . Accessed April 27, 2020.
Marshall GS, Tan L. Understanding the category B recommendation for serogroup B meningococcal vaccine. Pediatrics. 2017;139:e20163484.
Watkins E, Feemster K. Factors associated with uptake of meningococcus B vaccination after an ACIP category B recommendation [2460]. Open Forum Infect Dis. 2018;5:S737.
Bart SM, Eberhart M, Feemster K. Impact of a Category B Recommendation: Meningococcal B (MenB) Vaccine Uptake Among Adolescents in Philadelphia County. 2018. Available at: https://www.xcdsystem.com/pas/program/2018/index.cfm?pgid=156&printmode=1&sid=668&abid=2453 . Accessed April 27, 2020.
Esposito S, Principi N, Cornaglia G; ESCMID Vaccine Study Group (EVASG). Barriers to the vaccination of children and adolescents and possible solutions. Clin Microbiol Infect. 2014;20(suppl 5):25–31.
Watkins E, Feemster K. Factors associated with uptake of meningococcus B vaccination after an ACIP category B recommendation. In: Open Forum Infectious Diseases, October 6, 2018.San Franscisco, CA,
Bright Futures/American Academy of Pediatrics. Recommendations for Preventive Pediatric Health Care. Available at: https://downloads.aap.org/AAP/PDF/periodicity_schedule.pdf . Accessed April 27, 2020.
Boland L, Graham ID, Légaré F, et al. Barriers and facilitators of pediatric shared decision-making: a systematic review. Implement Sci. 2019;14:7.
Pieterse AH, Stiggelbout AM, Montori VM. Shared decision making and the importance of time. JAMA. 2019;322:25–26.
Brady MT. Strength and clarity of vaccine recommendations influence providers’ practice. Pediatrics. 2018;142:e20181633.
Centers for Disease Control and Prevention. Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger. 2020. Available at: https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf . Accessed April 24, 2020.
Munger M, Yasuda K, Hollier LM, et al. 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations. 2019. Available at: https://mma.prnewswire.com/media/957264/Immunization_Action_Coalition_Teen_Vaccine_Letter.pdf?p=pdf . Accessed April 27, 2020.
Elwyn G, Frosch D, Thomson R, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27:1361–1367.
van de Pol MH, Fluit CR, Lagro J, et al. Expert and patient consensus on a dynamic model for shared decision-making in frail older patients. Patient Educ Couns. 2016;99:1069–1077.
Politi MC, Han PK, Col NF. Communicating the uncertainty of harms and benefits of medical interventions. Med Decis Making. 2007;27:681–695.
Agency for Healthcare Research and Quality. The SHARE Approach. Essential Steps of Shared Decisionmaking: Expanded Reference Guide With Sample Conversation Starters. 2014. Available at: https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/shareddecisionmaking/tools/tool-2/share-tool2.pdf . Accessed March 3, 2020.
Wexler R; Informed Medical Decisions Foundation. Six Steps of Shared Decision Making. 2012. Available at: https://www.mainequalitycounts.org/image_upload/SixStepsSDM2.pdf . Accessed March 3, 2020.
Steffensen KD, Vinter M, Crüger D, et al. Lessons in integrating shared decision-making into cancer care. J Oncol Pract. 2018;14:229–235.
Lee GM. Shared Clinical Decision–Making for Immunization Recommendations (National Foundation for Infectious Diseases Webinar). 2020. Available at: https://www.nfid.org/event/shared-clinical-decision-making-for-immunization-recommendations/ . Accessed April 29, 2020.
Meites E, Szilagyi PG, Chesson HW, et al. Human papillomavirus vaccination for adults: updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019;68:698–702.
Matanock A, Lee G, Gierke R, et al. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019;68:1069–1075.
Hardt K, Bonanni P, King S, et al. Vaccine strategies: optimising outcomes. Vaccine. 2016;34:6691–6699.
ClinicalTrials.gov. A Trial to Describe the Immunogenicity and Safety of 2 Doses of Bivalent rLP2086 (Trumenba) and a Pentavalent Meningococcal Vaccine in Healthy Subjects ≥10 to <26 Years of Age. 2017. Available at: https://clinicaltrials.gov/ct2/show/NCT03135834 . Accessed April 1, 2020.
Saez-Llorens X, Aguilera Vaca DC, Abarca K, et al. Immunogenicity and safety of investigational vaccine formulations against meningococcal serogroups A, B, C, W, and Y in healthy adolescents. Hum Vaccin Immunother. 2015;11:1507–1517.
Sáez-Llorens X, Beltran-Rodriguez J, Novoa Pizarro JM, et al. Four-year antibody persistence and response to a booster dose of a pentavalent MenABCWY vaccine administered to healthy adolescents and young adults. Hum Vaccin Immunother. 2018;14:1161–1174.