Meningococcal vaccination: a discussion with all adolescents, whether college-bound or not

Abstract

Introduction: Adolescents and young adults are the primary reservoirs and transmitters of meningococci. In the US, meningococcal serogroup B (MenB) disease predominates over A, C, W, and Y; ACIPrecommended MenACWY and MenB vaccines are available. We investigated invasive meningococcal disease (IMD) burden and vaccination among non-college adolescents. Methods: IMD incidence by college attendance status and vaccination rates were analyzed using publicly available surveillance data. Results: 64/158 IMD cases occurred in non-college 18-24-year-olds during 2015-2017. Among noncollege cases, the MenACWY vaccination rates were 38%-57% vs 90%-100% among college cases when vaccination status was known; MenB vaccination was 0% vs 0%-7%, respectively. In 2018, 17.2% of all 17-year-olds received ≥1 dose of multidose MenB vaccines; ≤50% completed the series. Conclusion: Meningococcal vaccination is emphasized for college-bound adolescents, but non-college adolescents bear much of the disease burden. Low vaccine receipt preserves their risk, underscoring the need to protect all adolescents through vaccination.

The Impact of Social Determinants of Health on Meningococcal Vaccination Awareness, Delivery, and Coverage in Adolescents and Young Adults in the United States: A Systematic Review

“…While college students are known to be at increased risk for meningococcal disease, Alderfer et al [ 64 ] note that 18–24 year old noncollege individuals are also at risk for the disease. Alderfer et al [ 64 ] compared incidence of IMD occurring among 18- to 24-year-olds based on college attendance. The authors reported that 64 of 158 cases of IMD (40.5%) occurred in noncollege 18- to 24-year-olds.…”

“…For MenB vaccination, 0% (none) of the reported cases among noncollege students had received MenB versus 0–7% in those attending college This analysis also, identified disparities in MenACWY vaccination coverage among cases of meningococcal disease in noncollege 18- to 24-year-olds versus those in college, with 90–100% of college cases reporting vaccination with MenACWY versus 38–57% of noncollege cases reporting vaccination with MenACWY. These results highlight that while non-college adolescents bear a significant portion of disease burden meningococcal vaccination is most often discussed for those who are college-bound [ 64 ]. Additionally, the most recent CDC meningococcal disease surveillance report (2019) continues to show similar disparities in meningococcal vaccination status in individuals aged 18–24 years attending college versus those not attending college.…”