Parinaz K Ghaswalla1, Lindsay G S Bengtson2, Gary S Marshall3, Ami R Buikema4, Tim Bancroft5, Krista M Schladweiler6, Eleena Koep7, Patricia Novy8, Cosmina S Hogea9. 1. Vaccines, GSK, 5, Crescent Drive, Philadelphia, PA 19112, USA. Electronic address: parinaz.k.ghaswalla@gsk.com. 2. Optum, 11000 Optum Circle, Eden Prairie, MN 55344, USA. Electronic address: lindsay.bengtson@optum.com. 3. Norton Children's and University of Louisville School of Medicine, 571 S. Floyd St., Suite 321, Louisville, KY 40202, USA. Electronic address: gary.marshall@louisville.edu. 4. Optum, 11000 Optum Circle, Eden Prairie, MN 55344, USA. Electronic address: ami.buikema@optum.com. 5. Optum, 11000 Optum Circle, Eden Prairie, MN 55344, USA. Electronic address: thimothy.bancrift@optum.com. 6. Optum, 11000 Optum Circle, Eden Prairie, MN 55344, USA. Electronic address: krista.schladweiler@optum.com. 7. UnitedHealth Group, 12700 Whitewater Drive, Minnetonka, MN 55343, USA. Electronic address: eleena.koep@uhg.com. 8. Vaccines, GSK, 5, Crescent Drive, Philadelphia, PA 19112, USA. Electronic address: patricia.l.novy@gsk.com. 9. Vaccines, GSK, 5, Crescent Drive, Philadelphia, PA 19112, USA. Electronic address: cosmina.s.hogea@gsk.com.
Abstract
BACKGROUND: Patients with asplenia are recommended to receive meningococcal ACWY (MenACWY) and B (MenB) vaccines in the United States (US). OBJECTIVES: To examine uptake and time to receipt of meningococcal vaccines in newly diagnosed asplenia patients, and identify factors associated with vaccination. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
BACKGROUND: Patients with asplenia are recommended to receive meningococcal ACWY (MenACWY) and B (MenB) vaccines in the United States (US). OBJECTIVES: To examine uptake and time to receipt of meningococcal vaccines in newly diagnosed asplenia patients, and identify factors associated with vaccination. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Authors: Parinaz K Ghaswalla; Gary S Marshall; Lindsay G S Bengtson; Ami R Buikema; Tim Bancroft; Eleena Koep; Patricia Novy; Cosmina S Hogea Journal: JAMA Netw Open Date: 2022-04-01
Authors: Gary S Marshall; Parinaz K Ghaswalla; Lindsay G S Bengtson; Ami R Buikema; Tim Bancroft; Eleena Koep; Patricia Novy; Cosmina S Hogea Journal: Clin Infect Dis Date: 2022-08-24 Impact factor: 20.999