Herrera-Restrepo Oscar, Clements Diana E, Conley Wanda J, Marshall Gary S
GSK, FMC Tower Suite 1700, 2929 Walnut Street, Philadelphia, PA, 19104, USA.
Norton Children's and the University of Louisville School of Medicine, Louisville, KY, USA.
Infect Dis Ther. 2023 Apr;12(4):1019-1027. doi: 10.1007/s40121-023-00778-1. Epub 2023 Mar 13.
Patients with functional or anatomic asplenia, including sickle cell anemia; complement component deficiency; or human immunodeficiency virus (HIV) infection have a significantly increased risk of developing meningococcal disease. The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommends vaccination with a quadrivalent meningococcal conjugate vaccine against serogroups A, C, W, and Y (MenACWY) for individuals 2 months of age or older who are diagnosed with functional or anatomic asplenia, complement component deficiency, or HIV infection. Vaccination with a meningococcal vaccine against serogroup B (MenB) is also recommended for individuals 10 years of age or older who are diagnosed with functional or anatomic asplenia or complement component deficiency. Despite these recommendations, recent studies have shown that vaccination coverage in these populations is low. In this podcast, the authors discuss the challenges for implementing vaccine recommendations for individuals with medical conditions at increased risk of developing meningococcal disease and discuss strategies to increase coverage. Suboptimal vaccination rates could be addressed by better educating healthcare providers about recommendations for MenACWY and MenB vaccines in individuals at increased risk, increasing awareness of low vaccination coverage, and tailoring the education to the needs of particular healthcare providers and their respective patient populations. Barriers to vaccination could also be removed by administering vaccines at alternative sites of care, bundling preventative services, and implementing vaccination reminder systems that are tied to immunization information systems.
功能性或解剖性无脾的患者，包括镰状细胞贫血患者、补体成分缺陷患者或人类免疫缺陷病毒（HIV）感染者，发生脑膜炎球菌病的风险显著增加。美国疾病控制与预防中心（CDC）的免疫实践咨询委员会（ACIP）建议，对于2月龄及以上被诊断为功能性或解剖性无脾、补体成分缺陷或HIV感染的个体，接种针对A、C、W和Y血清群的四价脑膜炎球菌结合疫苗（MenACWY）。对于10岁及以上被诊断为功能性或解剖性无脾或补体成分缺陷的个体，也建议接种针对B血清群的脑膜炎球菌疫苗（MenB）。尽管有这些建议，但最近的研究表明，这些人群的疫苗接种覆盖率较低。在本期播客中，作者讨论了对脑膜炎球菌病发病风险增加的有医疗状况个体实施疫苗接种建议所面临的挑战，并讨论了提高覆盖率的策略。可以通过更好地向医疗服务提供者宣传针对风险增加个体的MenACWY和MenB疫苗接种建议、提高对低疫苗接种覆盖率的认识以及根据特定医疗服务提供者及其各自患者群体的需求调整教育内容，来解决疫苗接种率不理想的问题。还可以通过在替代护理地点接种疫苗、捆绑预防性服务以及实施与免疫信息系统相关的疫苗接种提醒系统来消除疫苗接种的障碍。
