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La EM, Garbinsky D, Hunter S, Poston S, Novy P, Ghaswalla P. National and State-Level Composite Completion of Recommended Vaccines Among Adolescents in the United States, 2015-2018. J Adolesc Health 2021; 69:762-768. [PMID: 34518068 DOI: 10.1016/j.jadohealth.2021.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Routine adolescent vaccination recommendations in the United States include tetanus, diphtheria, and acellular pertussis, quadrivalent meningococcal conjugate vaccine, and human papillomavirus vaccines. Although coverage for these individual vaccines is known, limited data are available on composite completion for all three vaccines. METHODS This cross-sectional analysis of pooled 2015-2018 National Immunization Survey-Teen data used logistic regression to estimate model-adjusted composite vaccination completion nationally and by state among United States adolescents aged 17 years. National Immunization Survey-Teen data were combined with state-level data to estimate a multilevel model identifying factors associated with composite vaccination completion. RESULTS The pooled model-adjusted composite vaccination completion was 30.6% (95% confidence interval [CI], 30.13%-31.04%) nationally, varying from 11.3% in Idaho (6.91%-17.95%) to 56.4% (49.81%-62.82%) in Rhode Island. Individual-level factors with the greatest impact on composite completion were having a provider's recommendation for human papillomavirus vaccination (odds ratio, 3.24; 95% CI, 2.76-3.80) and a check-up visit at age 16-17 years (odds ratio, 2.35; 95% CI, 1.80-3.07), with other individual-level factors associated with completion including being Medicaid insured, female, Hispanic, or non-Hispanic black. State-level quadrivalent meningococcal conjugate vaccination mandates were also associated with an increased likelihood of composite vaccination completion (odds ratio, 1.64; 95% CI, 1.16-2.33). CONCLUSIONS Fewer than one-third of 17-year-old individuals have completed all three recommended vaccines, with rates varying by state. Although this study identified implementable strategies to improve composite completion, additional research is needed to further understand factors associated with adolescent vaccination completion.
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Affiliation(s)
| | - Diana Garbinsky
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Shannon Hunter
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Sara Poston
- GlaxoSmithKline, Philadelphia, Pennsylvania.
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Azzari C, Diez-Domingo J, Eisenstein E, Faust SN, Konstantopoulos A, Marshall GS, Rodrigues F, Schwarz TF, Weil-Olivier C. Experts' opinion for improving global adolescent vaccination rates: a call to action. Eur J Pediatr 2020; 179:547-553. [PMID: 32072304 PMCID: PMC7080665 DOI: 10.1007/s00431-019-03511-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 09/12/2019] [Accepted: 10/21/2019] [Indexed: 01/17/2023]
Abstract
Worldwide, lifestyle and resource disparities among adolescents contribute to unmet health needs, which have crucial present and future public health implications for both adolescents and broader communities. Risk of infection among adolescents is amplified by biological, behavioral, and environmental factors; however, infectious diseases to which adolescents are susceptible are often preventable with vaccines. Beyond these concerns, there is a lack of knowledge regarding adolescent vaccination and disease risk among parents and adolescents, which can contribute to low vaccine uptake. Promising efforts have been made to improve adolescent vaccination by programs with motivational drivers and comprehensive communication with the public. In May 2017, a multidisciplinary group of experts met in Amsterdam, Netherlands, to discuss adolescent vaccine uptake, as part of an educational initiative called the Advancing Adolescent Health Spring Forum. This article presents consensus opinions resulting from the meeting, which pertain to the burden of vaccine-preventable diseases among adolescents, reasons for low vaccine uptake, and common characteristics of successful strategies for improving adolescent vaccination.Conclusion: There is an urgent "call to action," particularly targeting healthcare providers and public health authorities, for the prioritization of adolescent vaccination as a necessary element of preventive healthcare in this age group.What is Known:• Despite increased risk of certain infectious diseases, adolescent vaccination uptake remains low.What is New:• Barriers to adolescent vaccine uptake include lack of information regarding vaccines and disease risk, health system inadequacies, and insufficient healthcare follow-up.• Successful efforts to improve adolescent vaccine uptake need cohesive leadership and involvement of multiple stakeholders, as well as youth-friendly messaging; healthcare providers and policymakers should prioritize adolescent vaccination and implement proven program strategies to improve adolescent health worldwide.
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Affiliation(s)
- Chiara Azzari
- Department of Health Sciences, University of Florence and Meyer Children’s Hospital, viale Pieraccini 24, 50139 Florence, Italy
| | | | - Evelyn Eisenstein
- University of the State of Rio de Janeiro, - UERJ Bloco C - 9º andar, R. São Francisco Xavier, 524 - Maracanã, 20550-900 Rio de Janeiro, Brazil
| | - Saul N. Faust
- National Institute of Health Research Clinical Research Facility, University of Southampton and University Hospital NHS Foundation Trust, Southampton Centre for Biomedical Research, C Level West Wing, Mailpoint 218, Southampton General Hospital, Tremona Road, SO16 6YD, Southampton, UK
| | | | - Gary S. Marshall
- Department of Pediatrics, University of Louisville School of Medicine, 571 S. Floyd St., Suite 321, Louisville, KY 40202 USA
| | - Fernanda Rodrigues
- Hospital Pediátrico – Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Tino F. Schwarz
- Institute of Laboratory Medicine and Vaccination Centre, Klinikum Wuerzburg Mitte, Standort Juliusspital, Juliuspromenade 19, 97070 Wuerzburg, Germany
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Mbaeyi S, Stokley S. Meningococcal Conjugate Vaccine in the United States: Remaining Challenges for Adolescent Vaccination. J Adolesc Health 2019; 65:11-12. [PMID: 31229051 PMCID: PMC9014371 DOI: 10.1016/j.jadohealth.2019.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 04/26/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Sarah Mbaeyi
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shannon Stokley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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McDaniel A, Dempsey A, Srivastava A. A physician's guide to the 2-dose schedule of MenB-FHbp vaccine. Hum Vaccin Immunother 2019; 15:2729-2737. [PMID: 30932730 PMCID: PMC6930067 DOI: 10.1080/21645515.2019.1596711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/27/2019] [Accepted: 03/07/2019] [Indexed: 11/24/2022] Open
Abstract
Meningococcal serogroup B (MenB) is the predominant cause of invasive meningococcal disease in the United States, with older adolescents and young adults attending college at increased risk. Notably, MenB caused all meningococcal disease outbreaks at US colleges between 2011 and 2018. MenB disease is vaccine-preventable. The MenB-FHbp vaccine can be administered on a 2-dose (0 and 6 months) schedule to healthy adolescents and young adults or as a tailored 3-dose (0, 1-2, and 6 months) schedule for individuals at increased risk. This review focuses on the 2-dose schedule (0 and 6 months) of MenB-FHbp. Clinical evidence demonstrating strong and broadly protective immunogenicity in adolescents after primary vaccination, immune persistence up to 48 months post-primary vaccination (18-61% of subjects across schedules), and immune memory evidenced by robust response to a single booster dose are described. Implementation approaches to ensure adolescents and young adults are fully vaccinated against meningococcal disease are discussed.
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Affiliation(s)
- Angee McDaniel
- Medical Development, Scientific & Clinical Affairs, Pfizer Vaccines, Pfizer Inc, Collegeville, PA, USA
| | - Amanda Dempsey
- University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA
| | - Amit Srivastava
- Medical Development, Scientific & Clinical Affairs, Pfizer Vaccines, Pfizer Inc, Cambridge, MA, USA
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Alderfer J, Srivastava A, Isturiz R, Burman C, Absalon J, Beeslaar J, Perez J. Concomitant administration of meningococcal vaccines with other vaccines in adolescents and adults: a review of available evidence. Hum Vaccin Immunother 2019; 15:2205-2216. [PMID: 30779683 PMCID: PMC6773407 DOI: 10.1080/21645515.2019.1581542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Invasive meningococcal disease (IMD), a rapidly progressing and potentially fatal illness, disproportionately affects adolescents and young adults. While IMD is best prevented by vaccination, vaccine uptake in these groups is low. An evidence-based understanding of the safety and effectiveness of concomitant vaccination of meningococcal vaccines, including the newer MenB protein vaccines and the more established MenACWY conjugate vaccines, with other vaccines recommended for adolescents and young adults may help maximize vaccination opportunities. We identified 21 studies assessing concomitant administration of meningococcal vaccines with other vaccines in adolescents and adults. Although studies varied in methodology, concomitant administration generally did not affect immunogenicity of the meningococcal or coadministered vaccines. In some cases, reactogenicity increased following concomitant administration, but no definitive safety concerns were raised. In general, data suggest that meningococcal vaccines can be safely and effectively coadministered with other vaccines.
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Affiliation(s)
- Justine Alderfer
- Pfizer Vaccines Medical Development & Scientific and Clinical Affairs , Collegeville , PA , USA
| | - Amit Srivastava
- Pfizer Vaccines Medical Development & Scientific and Clinical Affairs , Collegeville , PA , USA
| | - Raul Isturiz
- Pfizer Vaccines Medical Development & Scientific and Clinical Affairs , Collegeville , PA , USA
| | - Cynthia Burman
- Pfizer Vaccines Medical Development & Scientific and Clinical Affairs , Collegeville , PA , USA
| | - Judith Absalon
- Pfizer Vaccine Clinical Research and Development , Pearl River , NY , USA
| | | | - John Perez
- Pfizer Vaccine Clinical Research and Development , Collegeville , PA , USA
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Middleman AB. Another Vaccine. Another Meningococcal Vaccine. Another Adolescent Vaccine. Another Article About a Vaccine. J Adolesc Health 2018; 63:263-264. [PMID: 30236995 DOI: 10.1016/j.jadohealth.2018.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 06/26/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Amy B Middleman
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Public Health Opportunities to Improve Late-Adolescent Immunization. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 24:554-557. [PMID: 29498957 PMCID: PMC6170148 DOI: 10.1097/phh.0000000000000792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Seven state/local immunization program managers were convened to discuss how public health immunization programs could enhance their efforts to promote adolescent vaccination, with an emphasis on late adolescence (ages 16-18 years). The Centers for Disease Control and Prevention's revised childhood immunization schedule for 2017 and a recently proposed preventive care platform at 16 years of age provide a unique opportunity to focus on increasing adolescent immunization rates in this population. Public health officials discussed challenges to immunizing this population and suggested key strategies for supporting late-adolescent immunization, including partnerships between public health and immunization providers; nationally supported public information campaigns; and using immunization data specific to this population to track progress.
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Myers TR, McNeil MM. Current safety issues with quadrivalent meningococcal conjugate vaccines. Hum Vaccin Immunother 2017; 14:1175-1178. [PMID: 28934061 DOI: 10.1080/21645515.2017.1366393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Invasive meningococcal disease, although rare, can present as sudden, life-threatening disease with high risk of mortality or severe long-term sequelae. The main prevention strategy for invasive meningococcal disease in the United States is the routine vaccination of adolescents and other persons at increased risk of meningococcal disease with quadrivalent meningococcal conjugate vaccines. Two such vaccines are currently licensed and available in the United States, Menactra® (Sanofi Pasteur) and Menveo® (GlaxoSmithKline), and usage in the adolescent population has steadily increased since their introduction. Although early reports raised concerns about a possible association of Menactra with Guillain-Barré syndrome, a comprehensive safety review determined that if such risk existed it was no more than 0.66 cases per 1 million vaccinations. More recently, a study found an elevated risk of Bell's palsy when Menveo was administered concomitantly with other vaccines but no association was found when the vaccine was administered alone. In this commentary, we describe the current state of knowledge with respect to the safety of quadrivalent meningococcal conjugate vaccines, and we identify potential areas for safety research for these vaccines.
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Affiliation(s)
- Tanya R Myers
- a Immunization Safety Office, Division of Healthcare Quality Promotion , National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA.,b Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Michael M McNeil
- a Immunization Safety Office, Division of Healthcare Quality Promotion , National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
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Klein J, Tan LLJ, Zimet GD. Improving Adolescent Immunization Coverage: The Time to Act Is Now. J Adolesc Health 2017; 61:541-543. [PMID: 29061231 DOI: 10.1016/j.jadohealth.2017.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 08/25/2017] [Accepted: 08/25/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Judy Klein
- Unity Consortium, Newtown, Pennsylvania.
| | | | - Gregory D Zimet
- Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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