A substantial number of primary care providers are not knowledgeable about serogroup B meningococcal (MenB) disease and vaccine, which may contribute to a lack of vaccine discussions with parents and healthy adolescents, according to a study published in Pediatrics.
A team of researchers from the University of Colorado conducted a national survey, in collaboration with the Centers for Disease Control and Prevention (CDC), among family physicians and pediatricians to evaluate MenB vaccine delivery practices and factors that would sway decisions to recommend or discuss MenB vaccination to patients.
Of the 916 clinicians invited to participate, 660 (72%) completed the survey: 374 pediatricians and 286 family physicians. Fifty-one percent of pediatricians and 31% of family physicians reported always or often discussing MenB vaccines during routine visits. The majority of clinicians who reported always or often discussing vaccines also recommended vaccination to their patients (91%), while 11% of those who rarely or never discussed vaccination recommended the MenB vaccine to patients; 73% and 41% of participating pediatricians and family physicians administer the MenB vaccine in their practices.
The results of the survey suggested that many primary care physicians are unfamiliar with the data required to confidently discuss the pros and cons of MenB vaccination in healthy adolescents. Issues associated with a greater likelihood of vaccine recommendations included MenB disease outbreaks (89%), incidence of disease (62%), efficacy (52%), safety (48%), and duration of MenB protection (39%). In contrast, the Advisory Committee on Immunization Practices decision to categorize the vaccine as Category B instead of Category A decreased the likelihood of vaccine recommendation among physicians (45%).
MenB vaccine discussion was less likely among physicians who were not at all or somewhat aware of the MenB vaccine and those participating in a health maintenance organization (risk ratio, 0.32 and 0.39, respectively) vs those who were more aware of disease outbreaks in their state (risk ratio, 1.25).
“Many primary care physicians do not appear to be familiar enough with the data required to have a well-informed discussion with parents and patients about the pros and cons of the MenB vaccination in healthy adolescents,” the authors wrote. “Because category B recommendations are likely to continue to occur in certain situations, it will be key for national clinical organizations such as the [American Academy of Pediatrics] and [American Academy of Family Physicians] to provide as specific guidance as possible about how to implement Category B recommendations for different vaccines, including talking points, to assist in the complex decision-making that such a recommendation requires,” they concluded.
Kempe A, Allison MA, MacNeil JR, et al. Adoption of serogroup B meningococcal vaccine recommendations. Pediatrics. 2018;142(3):e20180344