Meningococcal vaccination rates are low among eligible patients with complement component deficiencies, according to a study of U.S. data.
Researchers used a nationwide database to assess uptake of vaccines against meningococcal serogroups A, C, W and Y (MenACWY) and meningococcal B (MenB) in the years after the vaccines were recommended for patients with complement component deficiencies (CDs).
“Recommendations to immunize complement-deficient persons against invasive meningococcal disease — something for which they are at greatly increased risk — have been in place for decades, yet heretofore there were no data on uptake,” Gary S. Marshall, MD, professor of pediatrics and chief of the division of pediatric infectious diseases at Norton Children’s and the University of Louisville School of Medicine, told Healio. “We were curious to know if the recommendations were being followed.”
For MenB in particular, Marshall said they wondered if the recommendation to routinely vaccinate high-risk patients — made by the CDC’s Advisory Committee on Immunization Practices (ACIP) in 2015 — was “lost” in the confusion surrounding a shared clinical decision-making recommendation for healthy adolescents and young adults.
Their retrospective study used data from the deidentified Optum Research Database to assess uptake and time to vaccination among patients with newly diagnosed CDs between January 2010 through March 2018 for MenACWY and January 2015 through March 2018 for MenB — dates that were based on when the ACIP first made recommendations.
Overall, 1,470 MenACWY-eligible and 396 MenB-eligible patients were included in the primary analyses. The study revealed that only 4.6% and 2.2% of patients received MenACWY and MenB vaccinations, respectively, within 3 years of a CD diagnosis.
Additionally, the estimated uptake of a second dose of a MenACWY vaccine was also low (4.4% within 1 year), and that although the estimated uptake of a second dose of a MenB vaccine was much higher (83.3% within 1 year), only six patients received a first dose, suggesting that the results “should be interpreted with caution.”
“Providers should ensure that patients with complement deficiency are fully immunized against invasive meningococcal disease,” Marshall said. “Special effort is warranted to highlight risk-based vaccine recommendations, especially in the context of coexisting routine recommendations for various populations.”