Ghaswalla PK, Bengtson LGS, Marshall GS, Buikema AR, Bancroft T, Schladweiler KM, Koep E, Novy P, Hogea CS. Meningococcal vaccination in patients with newly diagnosed asplenia in the United States.
Vaccine 2020;
39:272-281. [PMID:
33309081 DOI:
10.1016/j.vaccine.2020.11.068]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/14/2020] [Accepted: 11/27/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND
Patients with asplenia are recommended to receive meningococcal ACWY (MenACWY) and B (MenB) vaccines in the United States (US).
OBJECTIVES
To examine uptake and time to receipt of meningococcal vaccines in newly diagnosed asplenia patients, and identify factors associated with vaccination.
METHODS
For this retrospective database analysis, patients were identified from 1/1/2010 (MenACWY) or 1/1/2015 (MenB) through 3/31/2018 from an administrative claims database including commercially insured US patients with ≥1 inpatient or ≥2 outpatient claims with evidence of a new asplenia diagnosis (sickle cell disease was excluded); continuous enrollment for ≥12 months before and ≥6 months after the index date; and age ≥2 (MenACWY) or ≥10 (MenB) years. Co-primary outcomes were uptake and time to receipt of ≥1 dose, separately for MenACWY and MenB, by Kaplan-Meier analysis. Cox proportional hazards regression models were used to identify characteristics associated with vaccination.
RESULTS
Among 2,273 and 741 patients eligible for the MenACWY and MenB analyses, respectively, 28.1% and 9.7% received MenACWY and MenB in the first 3 years after a new asplenia diagnosis. Patients were more likely to receive meningococcal vaccines if they had received pneumococcal vaccines (MenACWY: hazard ratio [HR] 26.02; 95% confidence interval [CI] 21.01-32.22; MenB: HR 3.89; 95% CI 2.07-7.29) or attended ≥1 well-care visit (MenACWY: HR 6.63; 95% CI 4.84-9.09; MenB: HR 11.17; 95% CI 3.02-41.26).
CONCLUSIONS
Meningococcal vaccination rates among newly diagnosed asplenia patients were low, highlighting the need to educate providers about the recommendations for high-risk conditions and ensure healthcare access for vulnerable patients.
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