Merative (formerly IBM Watson Health), Cambridge, MA, USA.
GSK, Philadelphia, PA, USA.
Hum Vaccin Immunother. 2023 Dec 31;19(1):2165382. doi: 10.1080/21645515.2023.2165382. Epub 2023 Jan 30.
In the United States (US), meningococcal serogroup B (MenB) vaccination has been recommended for 16-23-year-olds (preferably 16-18 years) based on shared clinical decision-making since 2015. MenB vaccine coverage (≥1 dose) by age 17 years has been reported, but initiation at older ages and by insurance type is unknown. In this retrospective cohort study, claims data were analyzed to assess MenB vaccine series initiation (i.e. receipt of a first dose) during 2017-2020 among US commercially insured and Medicaid-covered individuals aged 16-18 and 19-23 years. Kaplan-Meier curves were generated to estimate series initiation at various times from index (latest of 1/1/2017 or 16/19 birthday, depending on the cohort). Multivariable analyses were conducted to identify factors associated with series initiation. Among 1,450,354 Commercial and 1,140,977 Medicaid 16-18-year-olds, MenB vaccine series initiation rates within 3 years of each person's first eligibility were estimated to be 33% and 20%, respectively; among 1,857,628 Commercial and 747,483 Medicaid 19-23-year-olds, 3% and 1%, respectively. Factors identified to be significantly associated with increased likelihood of initiating a MenB vaccine series included co-administration of meningococcal serogroups ACWY (MenACWY) vaccine, younger age, female sex, nonwhite race (Medicaid only), New England or Middle Atlantic location (Commercial only), urban residence, and previous influenza vaccination. MenB vaccine series initiation among the studied US adolescents and young adults was low. There is a need for continued efforts to better understand barriers to the uptake of vaccines that are recommended based on shared clinical decision-making.
在美国（US），自 2015 年以来，根据共同的临床决策，建议对 16-23 岁（最好是 16-18 岁）的人接种脑膜炎球菌 B 型（MenB）疫苗。已经报告了 17 岁以下人群的 MenB 疫苗接种覆盖率（≥1 剂），但不知道在较大年龄和保险类型下的接种启动情况。在这项回顾性队列研究中，分析了索赔数据，以评估 2017-2020 年期间美国商业保险和医疗补助覆盖的 16-18 岁和 19-23 岁个体中 MenB 疫苗系列接种（即第一剂接种）的启动情况。生成了 Kaplan-Meier 曲线，以估计从指数（最新的 1/1/2017 或 16/19 生日，取决于队列）开始的不同时间内的系列接种启动情况。进行了多变量分析，以确定与系列接种启动相关的因素。在 1450354 名商业保险和 1140977 名医疗补助 16-18 岁的人群中，每个人首次有资格接种疫苗后的 3 年内，MenB 疫苗系列接种率估计分别为 33%和 20%；在 1857628 名商业保险和 747483 名医疗补助 19-23 岁的人群中，分别为 3%和 1%。被确定为与增加 MenB 疫苗系列接种可能性显著相关的因素包括同时接种脑膜炎球菌血清型 ACWY（MenACWY）疫苗、年龄较小、女性、非白种人（仅限医疗补助）、新英格兰或中大西洋地区（仅限商业）、城市居住和以前接种过流感疫苗。研究中美国青少年和年轻人的 MenB 疫苗系列接种率较低。需要继续努力，以更好地了解基于共同临床决策推荐的疫苗接种的障碍。
