2460. Factors Associated with Uptake of Meningococcus B Vaccination After an ACIP Category B Recommendation
Session: Poster Abstract Session: Adolescent Vaccines
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • poster v1_kaf_ew_kaf_ew3.pdf (682.5 kB)
  • Background:

    Two meningococcal vaccines (MenB) were licensed for 10-25 year olds in 2015 and given a Category B recommendation with a preferred window of 16-18 years old without high-risk comorbidity. Little is known about uptake of MenB after a Category B recommendation.

    Methods:

    We conducted a retrospective cohort study of 16-23 year olds presenting to 31 primary care sites in a pediatric care network Oct. 23, 2015 - April 30, 2017. Using pivot tables and chi square analysis, we examined EHR data for associations between MenB receipt and patient/provider demographics (patient age, sex, race, insurance; provider years in practice), vaccinations, care site (urban vs suburban), and high-risk comorbidity (asplenia, sickle cell, complement deficiency).

    Results:

    Of 45,428 patients, 51% were female, 68% were 16-18 years old, and 21% received ≥1 MenB. 43% of those patients completed the 2-dose series. Rates of MenACWY booster receipt (32%) exceeded MenB, and 28% received both vaccines. A higher proportion of patients with ≥1 MenB were Asian, older, and privately insured (Table 1). More privately insured patients completed the series (48% vs 26% Medicaid, p<.001). 22% of high-risk patients received MenB, similar to their peers. MenB receipt increased with provider years in practice but declined in those practicing >30 years (Table 1). MenB initiation varied widely between sites (1-45%).

    Conclusion:

    MenB uptake in this cohort was low. Variation by site, provider years in practice, and potential sociodemographic disparity suggests that advice and acceptance in the setting of a Category B recommendation is not uniform. Further study is needed to clarify how these factors influence MenB receipt in teens.

    Table 1: % 16-23 year olds with ≥1 MenB by patient & provider characteristics
    Total (%)
    N=45,428
    % with ≥1 MenB
    N=9,393
    p-value
    Sex
    Female 23167 (51) 21 0.31
    Male 22261 (49) 21
    Age
    16-18 31307 (69) 18 <0.001
    19-23 14121 (31) 28
    Race
    White 26280 (58) 27 <0.001
    Black 13186 (29) 18
    Asian 1237 (27) 22
    Insurance
    Medicaid 10507 (23) 17 <0.001
    Private 34854 (77) 22
    Vaccinations
    MenACWY 14753 (33) 28
    HPV 10007 (22) 21
    Tdap 619 (1.4) 23
    Comorbidities
    Sickle cell 543 (1.2) 22
    Complement deficiency 3 (0.007) 33
    Asplenia 19 (0.04) 42
    Prov. years in practice
    ≤10 7564 (24) 16
    11-20 9205 (29) 18
    21-30 9330 (29) 19
    >30 5939 (17) 12 <0.001
    Care site
    Urban 9845 (22) 21 0.09
    Suburban 35583 (78) 20

    Emily Watkins, MD, Internal Medicine/Pediatrics, Children's Hospital of Philadelphia/Hospital of the University of Pennsylvania, Philadelphia, PA and Kristen Feemster, MD, MPH, MSHP, Division of Infectious Diseases, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Immunization and Acute Communicable Disease Programs, Philadelphia Department of Public Health Division of Disease Control, Philadelphia, PA

    Disclosures:

    E. Watkins, None

    K. Feemster, None

    See more of: Adolescent Vaccines
    See more of: Poster Abstract Session

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.