Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.
Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut.
J Adolesc Health. 2021 Nov;69(5):769-773. doi: 10.1016/j.jadohealth.2021.04.029. Epub 2021 Jun 17.
In this study, we evaluated factors associated with receipt of meningococcal serogroup B (MenB) vaccine among adolescents in the United States.
We used public use data files from the National Immunization Survey-Teen from 2017 to 2018. Logistic regression was used to model associations among sociodemographic, healthcare, and vaccination variables of interest and MenB vaccine receipt (≥1 vs. 0 dose). To explore associations between state-level meningococcal vaccination requirements and MenB vaccine uptake, we performed a secondary analysis stratified by presence of a quadrivalent meningococcal (MenACWY) vaccination requirement for secondary school attendance in the adolescent's state of residence (no requirement vs. a one- or two-dose requirement).
Among 7,288 adolescents, MenB vaccine receipt was significantly associated with up-to-date human papillomavirus (adjusted odds ratio [aOR] 1.74, 95% confidence interval [CI] 1.29-2.35) and MenACWY (aOR 5.81, 95% CI 4.14-8.13) vaccination status in multivariable analysis. Adolescents with private insurance were less likely to be vaccinated (aOR .61, 95% CI .46-.79) compared to adolescents with other health insurance types. In secondary analyses, health insurance was no longer significantly associated with MenB vaccine uptake among adolescents in states with a MenACWY requirement.
We found that MenB vaccination is associated with receipt of other vaccines recommended for use in adolescents. Adolescents with private health insurance were less likely to be vaccinated against MenB, although state MenACWY requirements appeared to modify the effect of insurance on MenB vaccine receipt. Further work to understand how these factors may influence delivery and acceptance of MenB vaccine can inform interventions and strategies to improve uptake.
本研究评估了美国青少年接种脑膜炎球菌 B 型(MenB)疫苗的相关因素。
我们使用了 2017 年至 2018 年国家免疫调查-青少年的公共使用数据文件。使用逻辑回归模型来分析与社会人口统计学、医疗保健和疫苗接种相关的变量与 MenB 疫苗接种(≥1 剂与 0 剂)之间的关系。为了探索州级脑膜炎球菌疫苗接种要求与 MenB 疫苗接种率之间的关系,我们根据青少年所在州是否有四价脑膜炎球菌(MenACWY)疫苗接种要求(无要求、一剂或两剂要求)进行了二次分析。
在 7288 名青少年中,多变量分析显示,MenB 疫苗接种与 HPV 疫苗(调整后的优势比 [aOR] 1.74,95%置信区间 [CI] 1.29-2.35)和 MenACWY(aOR 5.81,95% CI 4.14-8.13)疫苗接种状态显著相关。与其他类型的医疗保险相比,有私人保险的青少年接种疫苗的可能性较低(aOR.61,95% CI.46-.79)。在二次分析中,在有 MenACWY 要求的州,医疗保险与青少年接种 MenB 疫苗之间的关系不再显著。
我们发现,MenB 疫苗接种与推荐用于青少年的其他疫苗接种有关。有私人医疗保险的青少年接种 MenB 疫苗的可能性较低,尽管州级 MenACWY 要求似乎改变了保险对 MenB 疫苗接种率的影响。进一步研究这些因素如何影响 MenB 疫苗的接种和接受程度,可以为提高接种率的干预措施和策略提供信息。