Adoption of Serogroup B Meningococcal Vaccine Recommendations

Abstract

BACKGROUND AND OBJECTIVES:In 2015, the Advisory Committee on Immunization Practices recommended that 16-to 23-year-olds may be vaccinated with the serogroup B meningococcal (MenB) vaccine on the basis of individual clinical decision-making (Category B). We assessed the following among US pediatricians and family physicians (FPs): (1) practices regarding MenB vaccine delivery, (2) factors influencing a decision to recommend the MenB vaccine, and (3) factors associated with discussing the MenB vaccine.

A review of the immunogenicity, safety and current recommendations for the meningococcal serogroup B vaccine, MenB‐FHbp

“…GRADE Category B is a recommendation for vaccination based on individual clinical decision‐making between the clinician and patient . Many physicians may misinterpret the individual decision‐making (previously Category B) recommendation to imply that they should decide whether or not to raise the topic with patients, while in reality the goal is for healthcare providers and patients to jointly discuss the benefits and risks of possible vaccination together to reach a clinical decision . In some cases, such as a lack of available information, ACIP may not make any recommendation…”

“…75 Many physicians may misinterpret the individual decision-making (previously Category B 76,77 ) recommendation to imply that they should decide whether or not to raise the topic with patients, while in reality the goal is for healthcare providers and patients to jointly discuss the benefits and risks of possible vaccination together to reach a clinical decision. 63,[78][79][80] In some cases, such as a lack of available information, ACIP may not make any recommendation. 75 In early 2015, ACIP issued a Category A recommendation for MenB vaccination of individuals ≥10 years of age at increased risk for IMD (Table 4 5 18 years.…”

Increased Risk of MenB Infection in College Students: Time to Reconsider Vaccine Recommendations?

“…The mortality rate ranges between 10% and 15%, and those who survive can have severe sequelae. 1 Globally, it is estimated that 1.2 million cases of invasive meningococcal infections occur annually and result in 135 000 deaths. 2 Primary prevention of disease through vaccination is essential for control of endemic and epidemic meningococcal disease.…”

“…In 2016, there were 130 cases of MenB disease in the United States; of these, 41 occurred in individuals 16 to 23 years of age. 1 Mbaeyi et al 3 report that the annual incidence in collegeaged persons 18 to 24 years old was 0.17 cases per 100 000 population between 2014 and 2016. The incidence in individuals the same age but not in college was 0.05 cases per 100 000 population.…”

Strength and Clarity of Vaccine Recommendations Influence Providers’ Practice

“…2,4 Duration of immunity, effectiveness of a newly structured meningococcal vaccine (ie, outer membrane protein antigens rather than conjugated polysaccharide antigens), long-term adverse effects, and the proportion of meningococcal B strains that would be covered by the 2 vaccines had yet to be established. 3,4 In this month's issue of Pediatrics, 5 results from a survey of pediatricians and family physicians were used to provide insight as to how providers might discuss and recommend MenB vaccines. The survey was used to query providers to assess factors influencing their plans to discuss and recommend MenB vaccines.…”