Trantham L, Kurosky S, Irwin D, Packnett E, Novy P, Whelan J, Hogea C. MenACWY vaccination among adolescents in the United States, 2011-2016: a tale of two age platforms. Poster presented at the 48th National Immunization Conference; May 15, 2018. Atlanta, GA.

BACKGROUND: In the United States (US), routine immunization with meningococcal conjugate vaccine (MenACWY) is recommended at ages 11-12 years and at 16 years (booster). National survey-based estimates suggest uptake is lower among older adolescents than younger adolescents.

OBJECTIVES: To compare receipt of MenACWY and related healthcare factors in older vs. younger adolescents.

METHODS: We conducted a retrospective analysis (GSK study identifier: HO-16-17936) of healthcare claims of commercially insured individuals in the MarketScan Commercial Claims and Encounters Database (CCAE) and Medicaid enrollees in the US (2011-2016). Receipt of a MenACWY dose and related healthcare characteristics in the younger adolescent age group (10.5-13 years) vs. the older age group (15.5-18 years) with continuous enrollment during the respective age ranges were compared within each database. Multivariable logistic regressions (MVLR) were used to identify factors associated with MenACWY vaccination.

RESULTS: More adolescents in the younger age group received MenACWY compared to the older age group: CCAE, 71.7% (270,185/376,825) vs. 48.9% (205,131/419,814) [P<0.001]; Medicaid, 59.3% (184,172/310,383) vs. 31.8% (65,657/206,301) [P<0.001]. Amongst younger vaccinated adolescents, most received MenACWY at ages 11-12 (CCAE, 91.9%; Medicaid, 87.4%); majority of older vaccinated adolescents received MenACWY at ages 17-18 (CCAE, 64.2%; Medicaid, 53.4%). More younger adolescents received MenACWY simultaneously with another vaccine at a well-child visit compared to older adolescents (CCAE, 74.6% vs. 39.4% [P<0.001]; Medicaid, 70.9% vs. 47.1% [P<0.001]). In separate MVLR models for CCAE and Medicaid, respectively, the older age group and having a non-pediatric primary provider were consistently associated with decreased likelihood of vaccination, while more well-child visits were associated with increased likelihood of vaccination.

CONCLUSION: Most younger vaccinated adolescents received MenACWY at ages 11-12. MenACWY uptake was lower among older adolescents, frequently occurring past age 16. As co-vaccination opportunities for older adolescents are limited, vaccination during non-well-child visits and with non-pediatricians may provide opportunities to improve uptake.

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