B 群脑膜炎球菌疫苗接种在大学校园的实践模式。
Serogroup B meningococcal vaccination practice patterns on college campuses.
机构信息
General and Community Pediatrics, Children's National Hospital, 111 Michigan Ave., NW, Washington, DC 20010 USA.
NYU Student Health, New York University, 726 Broadway, New York, NY 10003 USA.
出版信息
Vaccine. 2020 Oct 27;38(46):7350-7356. doi: 10.1016/j.vaccine.2020.09.035. Epub 2020 Oct 1.
BACKGROUND
Most Neisseria meningitidis involved in invasive disease among American college students express serogroup B antigen. The Advisory Committee on Immunization Practices (ACIP) recommends healthcare providers (HCPs) share clinical decision making with patients to determine individual value of meningococcal serogroup B vaccination (MenB) rather than routinely recommend vaccination as with the meningococcal A,C,W,Y vaccine (MenACWY). This study examines the attitudes and practices of HCPs working in college student health centers (SHCs) regarding the recommendation and administration of MenB to students.
METHODS
The study was conducted as an online and phone survey of SHC HCPs from a sample of colleges across the United States between May 2017 and July 2018. Items compared college SHC policies and practices for MenB to those for MenACWY. It also assessed perceived barriers to and facilitators of MenB delivery to students.
RESULTS
Among the 147 respondents, almost 50% more reported their SHC stocked and administered MenACWY (54.1%) than MenB (37%) (p = .004). Almost five times as many colleges required their students receive MenACWY as MenB (53.5% vs. 10.5%, p < .001). A greater percentage requested students to submit records for MenACWY than MenB (77.3% vs. 46.9%, p < .001), and over three times as many tracked student-body coverage rates for MenACWY than MenB (55.6% vs. 15.8%, p < .001). Nearly three quarters of respondents estimated their college's student body MenB coverage rate to be ≤ 10% or were unable to provide any estimate. Factors perceived by over half of the participants as moderate to extreme barriers to administering MenB included high upfront costs for SHCs to purchase and stock MenB (68.7%), and high out-of-pocket costs for students to receive it (82.8%).
CONCLUSIONS
A minority of college SHCs require, offer or track Men B vaccination on their campuses. Financial concerns are common barriers to SHCs' stocking and administering MenB to students.
背景
在美国大学生中，大多数侵袭性脑膜炎奈瑟菌都表达 B 群抗原。免疫实践咨询委员会（ACIP）建议医疗保健提供者（HCP）与患者共同做出临床决策，以确定脑膜炎球菌 B 群疫苗（MenB）对个体的价值，而不是像使用脑膜炎球菌 A、C、W、Y 疫苗（MenACWY）那样常规推荐接种。本研究调查了在美国各地的大学生健康中心（SHC）工作的 HCP 对向学生推荐和接种 MenB 的态度和做法。
方法
这项研究是在 2017 年 5 月至 2018 年 7 月期间，对来自美国各所大学的 SHC HCP 进行的在线和电话调查。调查项目将大学生 SHC 针对 MenB 和 MenACWY 的政策和做法进行了比较。它还评估了向学生提供 MenB 的障碍和促进因素。
结果
在 147 名受访者中，报告其 SHC 库存和管理 MenACWY（54.1%）的比例几乎比 MenB（37%）高 50%（p=0.004）。要求学生接种 MenACWY 的大学数量几乎是 MenB 的五倍（53.5% vs. 10.5%，p<0.001）。要求学生提交 MenACWY 记录的比例高于 MenB（77.3% vs. 46.9%，p<0.001），追踪学生群体 MenACWY 覆盖率的比例也高于 MenB（55.6% vs. 15.8%，p<0.001）。近四分之三的受访者估计其大学的学生群体 MenB 覆盖率≤10%，或无法提供任何估计。超过一半的参与者认为管理 MenB 的适度到极端障碍包括 SHC 购买和储备 MenB 的前期成本高（68.7%），以及学生接受疫苗的自付费用高（82.8%）。
结论
少数大学生 SHC 在其校园内要求、提供或跟踪 Men B 疫苗接种。财务问题是 SHC 为学生储备和接种 MenB 的常见障碍。
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