2455. Is Category B Working? Uptake Patterns of Meningococcal Group B Vaccine Among US Adolescents and Young Adults

Abstract

Background

In October 2015, ACIP recommended that serogroup B meningococcal (MenB) vaccine may be administered to persons aged 16–23 years (age 16–18 preferentially) as Category B (individual clinical decision-making), in addition to the Category A recommendation made in June 2015 for at-risk individuals aged ≥10 years. Currently, MenB vaccine coverage among adolescents and young adults (AYAs), including whether disparities exist, is not well-described.

Methods

We performed a cross-sectional analysis of claims data collected by IQVIA and linked to sociodemographic data collected by Experian to estimate overall and subpopulation-level uptake of MenB vaccine (≥1 dose) among AYAs aged 10–25 years as of May 31, 2017.

Results

Among 2,501,188 AYAs aged 10–25 years, MenB vaccine uptake was only 1.4% at the end of May 2017. MenB vaccination varied by age, with uptake of 0.2%, 2.5%, 1.6%, and 0.2% among individuals aged 10‒15, 16‒18, 19‒23, and 24‒25 years (P < 0.01), respectively. Lower uptake was observed for non-Hispanic blacks (1.0% vs. 1.4% among non-Hispanic whites, P < 0.01), AYAs in lower income households (1.0% vs. 2.2% among lowest vs. highest income deciles, P < 0.01), and those living in rural (0.6%) or urban/inner-city (0.9%) areas (vs. 1.5% in suburban areas, P < 0.01). The strongest predictors of MenB vaccination were previously receiving quadravalent meningococcal (MenACWY) or human papillomavirus (HPV) vaccines. These AYAs were 36.1 and 5.1 times more likely to have received MenB vaccine and had MenB uptake of 9.8% and 5.1%, respectively.

Conclusion

As of May 2017, MenB vaccine uptake among AYAs aged 10‒25 years was low (<2%). Even though absolute differences were small, significant disparities in MenB uptake existed. Uptake was notably higher for AYAs who had received ≥1 dose of MenACWY or HPV vaccine. This suggests MenB vaccination is occurring primarily among AYAs who have received other Category A vaccines, and that conversations between clinicians and patients about MenB vaccination—which are at the heart of a Category B recommendation—are limited outside of this context. Given the real-world inadequacies of a Category B recommendation highlighted by our study, future efforts should improve the AYA vaccination platform to ensure adequate immunization of AYAs, especially in underserved communities.

Disclosures

F. L. Khan, Pfizer, Inc.: Employee and Shareholder, Salary and Stock and Stock Options. D. L. Swerdlow, Pfizer Inc.: Employee and Shareholder, Salary. L. J. York, Pfizer, Inc.: Employee and Shareholder, Salary and Stock and Stock Options. P. Balmer, Pfizer, Inc.: Employee and Shareholder, Salary and Stock and Stock Options. R. E. Isturiz, Pfizer, Inc.: Employee and Shareholder, Salary and Stock and Stock Options. J. M. McLaughlin, Pfizer, Inc.: Employee and Shareholder, Salary and Stock and Stock Options.