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      Parental awareness of Meningococcal B vaccines and willingness to vaccinate their teens

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          Abstract

          Background:

          In the US, Meningococcal B (MenB) vaccines were first licensed in 2014. In 2015, the Advisory Committee on Immunization Practices recommended that parents of teens talk to their provider about receiving MenB vaccine, rather than issuing a routine recommendation. We assessed parental awareness of MenB vaccines and willingness to vaccinate their teens with MenB vaccines compared to MenACWY vaccines, which have been routinely recommended for many years.

          Methods:

          We surveyed parents of teens attending high school in 2017–18 during the Minnesota State Fair. Parents reported via iPad their knowledge of and concern about meningococcal disease and their awareness of and willingness to vaccinate with MenB and MenACWY vaccines. We assessed the relationship between meningococcal disease knowledge and concern, MenB and MenACWY vaccine awareness, and willingness to vaccinate with MenB and MenACWY using adjusted logistic regression.

          Results:

          Among 445 parents, the majority had not heard of the newly introduced MenB vaccines Bexsero ® (80.0%; 95% CI: 76.0–83.6) or Trumenba ® (82.0%; 95% CI: 78.1–85.5) or the MenACWY vaccines Menactra ® or Menveo ® (68.8%; 95% CI: 64.2–73.0). The majority were at least somewhat willing to vaccinate their teen with MenB vaccine (89.6%; 95% CI: 86.5, 92.3) and MenACWY vaccine (91.2%; 95% CI: 88.2, 93.7). Awareness of MenB vaccines (OR: 3.8; 95% CI: 1.2–12.2) and concern about meningococcal disease (OR: 3.1; 95% CI: 1.5–6.3) were significantly associated with willingness to vaccinate with MenB vaccine.

          Conclusions:

          Awareness of MenB vaccine is lacking among parents of teens but is an important predictor of willingness to vaccinate with the newly licensed MenB vaccines.

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          Most cited references21

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          Clinical recognition of meningococcal disease in children and adolescents.

          Meningococcal disease is a rapidly progressive childhood infection of global importance. To our knowledge, no systematic quantitative research exists into the occurrence of symptoms before admission to hospital. Data were obtained from questionnaires answered by parents and from primary-care records for the course of illness before admission to hospital in 448 children (103 fatal, 345 non-fatal), aged 16 years or younger, with meningococcal disease. In 373 cases, diagnosis was confirmed with microbiological techniques. The rest of the children were included because they had a purpuric rash, and either meningitis or evidence of septicaemic shock. Results were standardised to UK case-fatality rates. The time-window for clinical diagnosis was narrow. Most children had only non-specific symptoms in the first 4-6 h, but were close to death by 24 h. Only 165 (51%) children were sent to hospital after the first consultation. The classic features of haemorrhagic rash, meningism, and impaired consciousness developed late (median onset 13-22 h). By contrast, 72% of children had early symptoms of sepsis (leg pains, cold hands and feet, abnormal skin colour) that first developed at a median time of 8 h, much earlier than the median time to hospital admission of 19 h. Classic clinical features of meningococcal disease appear late in the illness. Recognising early symptoms of sepsis could increase the proportion of children identified by primary-care clinicians and shorten the time to hospital admission. The framework within which meningococcal disease is diagnosed should be changed to emphasise identification of these early symptoms by parents and clinicians.
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            Provider communication about HPV vaccination: A systematic review.

            Improving HPV vaccination coverage in the US will require healthcare providers to recommend the vaccine more effectively. To inform quality improvement efforts, we systematically reviewed studies of provider communication about HPV vaccination.
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              Is Open Access

              National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2017

              The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of persons aged 11–12 years with human papillomavirus (HPV) vaccine, quadrivalent meningococcal conjugate vaccine (MenACWY), and tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap). A booster dose of MenACWY is recommended at age 16 years ( 1 ), and catch-up vaccination is recommended for hepatitis B vaccine (HepB), measles, mumps, and rubella vaccine (MMR), and varicella vaccine (VAR) for adolescents whose childhood vaccinations are not up to date (UTD) ( 1 ). ACIP also recommends that clinicians may administer a serogroup B meningococcal vaccine (MenB) series to adolescents and young adults aged 16–23 years, with a preferred age of 16–18 years ( 2 ). To estimate U.S. adolescent vaccination coverage, CDC analyzed data from the 2017 National Immunization Survey–Teen (NIS-Teen) for 20,949 adolescents aged 13–17 years.* During 2016–2017, coverage increased for ≥1 dose of HPV vaccine (from 60.4% to 65.5%), ≥1 dose of MenACWY (82.2% to 85.1%), and ≥2 doses of MenACWY (39.1% to 44.3%). Coverage with Tdap remained stable at 88.7%. In 2017, 48.6% of adolescents were UTD with the HPV vaccine series (HPV UTD) compared with 43.4% in 2016. † On-time vaccination (receipt of ≥2 or ≥3 doses of HPV vaccine by age 13 years) also increased. As in 2016, ≥1-dose HPV vaccination coverage was lower among adolescents living in nonmetropolitan statistical areas (MSAs) (59.3%) than among those living in MSA principal cities (70.1%). § Although HPV vaccination initiation remains lower than coverage with MenACWY and Tdap, HPV vaccination coverage has increased an average of 5.1 percentage points annually since 2013, indicating that continued efforts to target unvaccinated teens and eliminate missed vaccination opportunities might lead to HPV vaccination coverage levels comparable to those of other routinely recommended adolescent vaccines.
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                Author and article information

                Journal
                8406899
                7945
                Vaccine
                Vaccine
                Vaccine
                0264-410X
                1873-2518
                2 January 2019
                23 December 2018
                21 January 2019
                21 January 2020
                : 37
                : 4
                : 670-676
                Affiliations
                [a ]Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
                [b ]Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
                [c ]Department of Applied Economics, University of Minnesota, Saint Paul, MN, USA
                Author notes
                [* ]Corresponding author: 1300 Second Street South, West Bank Office Building Suite 300, University of Minnesota, Minneapolis, MN 55454, USA. nebasta@ 123456umn.edu (N.E. Basta).

                Contributors’ statement

                Dr. Basta supervised the research, designed the study, designed the survey, collected data, designed the analyses, interpreted the results, and wrote the final manuscript.

                Mr. Becker conducted analyses and contributed to revising the manuscript.

                Mr. Li contributed to analyses and contributed to revising the manuscript.

                Ms. Nederhoff designed the survey, supervised data collection and collected data, and contributed to drafting the manuscript.

                Article
                NIHMS1517365
                10.1016/j.vaccine.2018.11.078
                6441613
                30587431
                7478a6e6-40d2-42eb-bb0d-29a5b7c78da1

                This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Categories
                Article

                Infectious disease & Microbiology
                meningococcal vaccines,meningococcal b,awareness,parents,adolescents,survey

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