Suboptimal uptake of meningococcal vaccines among older adolescents: Barriers, solutions, and future research directions

Niccolai, Linda M.; Hansen, Caitlin E.

doi:10.1080/21645515.2020.1754052

Cited by 8 publications

(9 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, meningococcal vaccine was introduced into adolescent vaccination program around the same time as HPV in many jurisdictions, but received limited attention in research studies. Given that suboptimal vaccine uptake during adolescence is by no means limited to HPV [90,[106][107][108], future studies should examine other vaccines routinely recommended during adolescents. In addition, more qualitative data from adolescents in LMICs would be helpful with accounting for diverse settings in which adolescent vaccines are being administered and informing vaccine education strategies.…”

Section: Discussionmentioning

confidence: 99%

What do adolescents think about vaccines? Systematic review of qualitative studies

Mitchell

Lim²,

Gill³

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

Adolescence presents a key opportunity to build vaccine-related health literacy and promote vaccine confidence and uptake. Although adolescents are central to vaccination programs, their views around vaccines are frequently underrepresented in qualitative literature. We reviewed qualitative studies to systematically identify and summarize existing evidence on adolescents’ own understanding of vaccines and experiences with vaccine decision-making, including self-consent when applicable. CINAHL; Embase; Ovid Medline; and Psych Info database searches were last updated on May 28, 2022. Data pertaining to general study characteristics, participant demographics, and qualitative content were extracted independently by two reviewers and analyzed using textual narrative synthesis. Out of 3559 individual records, 59 studies were included. The majority of the studies were conducted in high-income countries and 75% focused on human papilloma virus vaccines, with the remaining studies looking at COVID-19, meningococcal, hepatitis B and influenza vaccines or adolescent experiences with vaccines in general. Adolescent self-consent was explored in 7 studies. Perspectives from sexual and gender minorities were lacking across studies. Adolescents often had limited understanding of different vaccines and commonly perceived vaccine information to be directed towards their parents rather than themselves. Many adolescents felt school-based vaccine education and information available through healthcare providers were insufficient to make informed decisions about vaccines. While adolescents described obtaining vaccine information from traditional and online media, face-to-face interactions and opinions from trusted adults remained important. Adolescents generally relied on their parents for vaccine-decision making, even when self-consent was an option. A notable exception to this included marginalized adolescents who could not rely on parents for health-related advice. Qualitative literature about adolescent vaccines would be enriched by studies examining vaccines other than the HPV vaccine, studies examining adolescent vaccine programs in low and middle-income countries, and by deliberately eliciting vaccine experiences of adolescent with diverse sexual orientation and gender identities.

show abstract

Section: Discussionmentioning

confidence: 99%

What do adolescents think about vaccines? Systematic review of qualitative studies

Mitchell

Lim²,

Gill³

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

show abstract

“…age, gender, ethnicity/race, smoking status, relationship status, socioeconomic status (SES)) that were known potential confounders associated with vaccination uptake among adolescents based on the published literature. 10 , 19 , 20 , 23 Given the relatively high follow-up rate and high adherence to the trial protocol in year 10 and 11 students, the overall missing information in either outcomes (vaccination status) or baseline (predictors) was minimal ranging between 0.1% to 6.9%. Therefore, all available data were used in the analyses.…”

Section: Methodsmentioning

confidence: 99%

“…8,9 One reason for low MenB vaccine uptake among adolescents is lack of routine and publicly funded MenB vaccination programs. 10,11 In the USA, MenB vaccine is recommended for adolescents or young adults aged 16-23 years (preferred age 16-18 years) on the basis of shared clinical decision-making. 12 In Australia, the MenB vaccine (4CMenB) is not funded in the National Immunization Program (NIP) for this age group, however South Australia has a state-funded MenB vaccine program for adolescents with 74% uptake for one dose and 66% for two doses in 15-year-olds in the first year of the program.…”

Section: Introductionmentioning

confidence: 99%

“…14 While the recommendation for specific meningococcal vaccine use in each country depends on the predominant disease-causing serogroups, 15 low completion of multidose schedules is common among adolescents and young adults. 16 Although barriers and facilitators to vaccine uptake among adolescents have been extensively reviewed, 10,[17][18][19][20] there is no comprehensive assessment of social and behavioral factors influencing nonvaccination or incompletion of MenB vaccine dose series in this group. This study aimed to determine demographic, social and behavioral predictors of non-vaccination or noncompletion of the recommended two-dose of MenB vaccine series among adolescents aged 15-19 years.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Social and behavioral predictors of two-doses 4CMenB vaccine series among adolescents enrolled in a cluster randomized controlled trial in Australia

Mohammed

McMillan

Marshall

2021

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

This study aimed to determine social and behavioral predictors of completing a course of 4CMenB vaccine in adolescents in a parallel cluster randomized controlled trial enrolling secondary school students (approximately 15-18 years of age) in South Australia. Participating schools were randomized to vaccination at baseline (intervention) or 12 months (control). Students assigned to the intervention group were excluded because they have received the first dose of 4CMenB vaccine at baseline. Logistic regression models examined factors associated with non-vaccination or incomplete 4CMenB doses. The study population comprised 11391 students. Overall, 8.3% (n = 946) received no doses and 91.7% (n = 10445) at least one dose. Of 10445 students who initiated their primary dose, 1334 (12.8%) did not complete the two-dose course. The final adjusted model indicated factors associated with non-vaccination in school students were older age (adjusted odds ratio; aOR 7.83, 95% CI: 4.13-14.82), smoking cigarettes (aOR 3.24, 95% CI: 1.93-5.44), exposure to passive smoke (aOR 2.64, 95% CI: 1.48-4.71), Aboriginal or Torres Strait Islander (aOR 1.77, 95% CI: 1.23-2.55), smoking water pipes (aOR 1.94, 95% CI:1.28-2.92), low socioeconomic status (aOR 1.77, 95% CI:1.21-2.60), attending government schools (aOR 1.76, 95% CI: 1.28, 2.43) and participating in intimate kissing (aOR 1.40, 95% CI:1.10-1.79). Multivariable analysis for incomplete vaccination yielded similar findings. Social and behavioral predictors of non-vaccination or incomplete MenB doses were also known risk factors for carriage of Neisseria meningitidis. Immunization strategies to improve MenB vaccination completion need to be tailored to social behavior of adolescents.

show abstract

“…The uptake of meningococcal vaccines among adolescents can also be challenging [86]. Patient-associated factors among adolescents that could account, at least in part, for diminished vaccine uptake include less healthcare utilization compared with younger individuals and missed opportunities for vaccination (i.e., a healthcare visit in which vaccines could have been administered but were not).…”

Section: Challenges With Vaccinating Infants and Adolescentsmentioning

confidence: 99%

Rationale for the Development of a Pentavalent Meningococcal Vaccine: A US-Focused Review

2022

View full text Add to dashboard Cite

While invasive meningococcal disease (IMD) is uncommon, it can result in serious sequelae and even death. In 2018 in the United States, the incidence of IMD per 100,000 people was 0.03 among adolescents 11-15 years of age, 0.10 among persons 16-23 years of age, and 0.83 among infants\1 year of age. Serogroup B accounted for 86%, 62%, and 66% of cases, respectively, in those age groups. Currently, routine meningococcal vaccination covering serogroups ACWY (MenACWY) is recommended in the United States for all adolescents at 11-12 years of age, with a booster dose at 16 years of age, whereas a meningococcal serogroup B (MenB) vaccine series is recommended for persons 16-23 years of age under the shared clinical decision-making paradigm.The MenACWY vaccination program in adolescents has been successful in reducing disease burden, but does not prevent disease caused by serogroup B, which accounts for more than half of IMD cases. There are currently no approved vaccines that cover all of the most common disease-causing meningococcal serogroups, which are A, B, C, W, and Y. A pentavalent MenABCWY vaccine that is constituted from 2 licensed meningococcal vaccines-MenB-FHbp and MenACWY-TT-is being investigated in healthy persons C 10-25years of age. The addition of a MenABCWY vaccine is the next natural step in the incremental meningococcal immunization program in the United States to improve protection against the most common serogroup causing IMD, with no increase in the number of immunizations needed. With high uptake, routine use of MenABCWY could reduce IMD cases and associated mortality, the rate of long-term physical and psychosocial sequelae in survivors, and costs associated with controlling outbreaks, particularly on college campuses. A MenABCWY vaccine would also reduce the number of injections required for adolescents, potentially improving compliance.

show abstract

Suboptimal uptake of meningococcal vaccines among older adolescents: Barriers, solutions, and future research directions

Cited by 8 publications

References 45 publications

What do adolescents think about vaccines? Systematic review of qualitative studies

What do adolescents think about vaccines? Systematic review of qualitative studies

Social and behavioral predictors of two-doses 4CMenB vaccine series among adolescents enrolled in a cluster randomized controlled trial in Australia

Rationale for the Development of a Pentavalent Meningococcal Vaccine: A US-Focused Review

Contact Info

Product

Resources

About