Since 2011, ACIP guidelines for routine meningococcal ACWY vaccination (MenACWY) include a primary dose before age 16 (preferably at ages 11-12) and a booster dose (preferred age 16). Data on rates and drivers of meningococcal vaccination completion and compliance with ACIP recommendations down to state level are limited.
2011-2016 US National Immunization Survey-Teen data among adolescents aged 17 were used (GSK study identifier: HO-17-18202). National and state prevalence were estimated for MenACWY completion (receipt of primary dose at ages 11-15 and booster dose at age 16 or older) and compliance (receipt of primary dose at ages 11-12 and booster dose at age 16). Determinants such as state of residence, demographics, clinical/provider characteristics, vaccine mandates were assessed using multivariable logistic regression. Survey sampling weights were used to obtain population-based estimates.
The estimated national average prevalence based on 2011-2016 data was 23.2% for MenACWY vaccine completion and 12.1% for compliance in US adolescents. Across states, prevalence varied from 8.7-39.7% for completion and 3.1-26.2% for compliance (Figure 1). Beyond state of residence, factors significantly associated with higher likelihood of both completion and compliance included being male, being up-to-date on other routine vaccines, having private or hospital-based vaccine providers (vs. public), and having >1 child in the household. Factors associated only with completion included having an 11-12 year old well-child exam (OR [95% CI]: 1.5 [1.0-2.2]), >1 annual healthcare visit (2-5 vs. none) (1.4 [1.1-1.8]), and an existing state booster dose vaccine mandate (2.0 [1.5-2.8]) while factors associated with only compliance included history of asthma (1.3 [1.1-1.6]) and high-risk health conditions (1.4 [1.0-2.0]).
Adolescent completion and compliance rates for MenACWY vaccination in the US are suboptimal, with significant variability across states. Determinants of completion and compliance with ACIP recommendations identified in this study may help guide clinical, policy, and educational interventions to promote healthcare access/utilization among adolescents in order to increase vaccine uptake.
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P. Novy, GSK: Employee , Salary .
C. O'Connor, Analysis Group, Inc.: Employee , Research grant .
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C. Hogea, GSK: Employee , Salary .