Immunization Services Division, National Center for Immunization and Respiratory Diseases, CCID, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, USA.
Vaccine. 2010 Mar 8;28(11):2350-5. doi: 10.1016/j.vaccine.2009.12.032. Epub 2009 Dec 29.
An estimated 1000-2000 cases of invasive meningococcal diseases occur annually in the United States. In 2005, a new quadrivalent meningococcal conjugate vaccine (MCV4) was approved and, because of supply constraints, was recommended for routine vaccination of some groups of adolescents. In August 2007, vaccination recommendations were expanded for all adolescents 11-18 years.
We analyzed data from the 2007 National Immunization Survey-Teen (NIS-Teen), a nationally representative random digit dialed telephone survey. Estimates of MCV4 coverage were assessed from provider-reported vaccination histories. A multivariable logistic regression analysis and predictive marginal model were performed to identify factors independently associated with MCV4 vaccination.
Provider-reported vaccination histories were available for 2947 adolescents aged 13-17 years with a response rate of 55.9%. Overall, MCV4 coverage was 32.4% (95% confidence interval (CI)=30.2-34.7%) in 2007. Vaccination coverage was similar among adolescents aged 13-14 years compared to those aged 15-17 years (32.1% vs. 32.6%, respectively). Coverage was 30.6% for non-Hispanic whites, 35.9% for non-Hispanic blacks, and 36.1% for Hispanics; however, these variations were not statistically significant. Characteristics independently associated with a higher likelihood of MCV4 vaccination included having > or =2 physician contacts in the past year, having a well child visit at age 11-12 years, and ever having a doctor recommendation for meningitis vaccination of the adolescent.
In 2007, MCV4 coverage among 13-17 years old increased 20.7 percentage points from 2006. Achieving high vaccination coverage among adolescents will be challenging. Targeting adolescents with no health insurance and no recent healthcare provider visits may be important to increase coverage.
据估计，每年有 1000-2000 例侵袭性脑膜炎球菌病发生在美国。2005 年，一种新的四价脑膜炎球菌结合疫苗（MCV4）获得批准，由于供应限制，建议对一些青少年群体进行常规接种。2007 年 8 月，扩大了所有 11-18 岁青少年的疫苗接种建议。
我们分析了 2007 年全国免疫调查-青少年（NIS-Teen）的数据，这是一项具有全国代表性的随机数字拨号电话调查。通过提供者报告的疫苗接种记录评估 MCV4 覆盖率的估计值。进行了多变量逻辑回归分析和预测边缘模型，以确定与 MCV4 疫苗接种独立相关的因素。
提供者报告的疫苗接种记录可用于 2947 名年龄在 13-17 岁的青少年，应答率为 55.9%。总体而言，2007 年 MCV4 覆盖率为 32.4%（95%置信区间[CI]：30.2-34.7%）。13-14 岁青少年的疫苗接种率与 15-17 岁青少年相似（分别为 32.1%和 32.6%）。非西班牙裔白人的覆盖率为 30.6%，非西班牙裔黑人为 35.9%，西班牙裔人为 36.1%；然而，这些差异没有统计学意义。与 MCV4 疫苗接种可能性更高独立相关的特征包括过去一年有≥2 次与医生的接触、11-12 岁时进行过健康儿童就诊，以及曾有过医生建议为青少年接种脑膜炎疫苗。
2007 年，13-17 岁青少年的 MCV4 覆盖率比 2006 年增加了 20.7 个百分点。在青少年中实现高疫苗接种率将具有挑战性。针对没有健康保险和最近没有医疗服务提供者就诊的青少年可能是提高覆盖率的重要途径。
