Meningococcal vaccination in patients with newly diagnosed asplenia in the United States

• Published in: Vaccine Vol. 39; no. 2; pp. 272 - 281
• Main Authors: Ghaswalla, Parinaz K., Bengtson, Lindsay G.S., Marshall, Gary S., Buikema, Ami R., Bancroft, Tim, Schladweiler, Krista M., Koep, Eleena, Novy, Patricia, Hogea, Cosmina S.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 08.01.2021; Elsevier Limited
• Subjects: Age; Asplenia; Child; Codes; Comorbidity; Confidence intervals; Diagnosis; Ethnicity; Family income; Hazard identification; Health care policy; Humans; Infections; Medical screening; Meningococcal Infections - diagnosis; Meningococcal Infections - epidemiology; Meningococcal Infections - prevention & control; Meningococcal Vaccines; Meningococcus serogroup B; Meningococcus serogroups A, C, W, and Y; Neisseria meningitidis; Patients; Regression analysis; Regression models; Retrospective Studies; Sickle cell disease; Statistical analysis; United States; Vaccination; Vaccines; Vaccines, Conjugate; Variables; United States; United States > US; PCV13; CDC; ICD-10; NS; CI; CPT; MenB; Meningococcus serogroup B; HR; Meningococcal vaccines; SD; ICD-9; OPSI; Meningococcus serogroups A, C, W, and Y; NA; SCD; Asplenia; PPSV23; UK; ACIP; US; MenACWY; SCDM
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2020.11.068

•Asplenic patients in the US are recommended to receive meningococcal vaccinations (MenACWY and MenB).•During 3 years after a new asplenia diagnosis, only 28.1% received the MenACWY and only 9.7% received MenB vaccine.•Evidence of pneumococcal vaccination and well-care visits were associated with increased meningococcal vaccination. Patients with asplenia are recommended to receive meningococcal ACWY (MenACWY) and B (MenB) vaccines in the United States (US). To examine uptake and time to receipt of meningococcal vaccines in newly diagnosed asplenia patients, and identify factors associated with vaccination. 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. 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). 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.