2460. Factors Associated With Uptake of Meningococcus B Vaccination After an ACIP Category B Recommendation

Background Two meningococcal vaccines (MenB) were licensed for 10–25 year olds in 2015 and given a Category B recommendation with a preferred window of 16–18 years old without high-risk comorbidity. Little is known about uptake of MenB after a Category B recommendation. Methods We conducted a retrospective cohort study of 16–23 year olds presenting to 31 primary care sites in a pediatric care network October 23, 2015–April 30, 2017. Using pivot tables and chi square analysis, we examined EHR data for associations between MenB receipt and patient/provider demographics (patient age, sex, race, insurance; provider years in practice), vaccinations, care site (urban vs. suburban), and high-risk comorbidity (asplenia, sickle cell, complement deficiency). Results Of 45,428 patients, 51% were female, 68% were 16–18 years old, and 21% received ≥1 MenB. 43% of those patients completed the 2-dose series. Rates of MenACWY booster receipt (32%) exceeded MenB, and 28% received both vaccines. A higher proportion of patients with ≥1 MenB were Asian, older, and privately insured (Table 1). More privately insured patients completed the series (48% vs. 26% Medicaid, P < 0.001). 22% of high-risk patients received MenB, similar to their peers. MenB receipt increased with provider years in practice but declined in those practicing >30 years (Table 1). MenB initiation varied widely between sites (1–45%). Conclusion MenB uptake in this cohort was low. Variation by site, provider years in practice, and potential sociodemographic disparity suggests that advice and acceptance in the setting of a Category B recommendation is not uniform. Further study is needed to clarify how these factors influence MenB receipt in teens.Table 1: % 16–23 Year Olds With ≥1 MenB by Patient and Provider Characteristics Total (%) N = 45,428 % with ≥1 MenB N = 9,393 P-value Sex Female 23,167 (51) 21 0.31 Male 22,261 (49) 21 Age 16–18 31,307 (69) 18 <0.001 19–23 14,121 (31) 28 Race White 26,280 (58) 27 <0.001 Black 13,186 (29) 18 Asian 1,237 (27) 22 Insurance Medicaid 10,507 (23) 17 <0.001 Private 34,854 (77) 22 Vaccinations MenACWY 14,753 (33) 28 HPV 10,007 (22) 21 Tdap 619 (1.4) 23 Comorbidities Sickle cell 543 (1.2) 22 Complement deficiency 3 (0.007) 33 Asplenia 19 (0.04) 42 Prov. years in practice ≤10 7,564 (24) 16 11–20 9,205 (29) 18 21–30 9,330 (29) 19 >30 5,939 (17) 12 <0.001 Care site Urban 9,845 (22) 21 0.09 Suburban 35,583 (78) 20 Disclosures All authors: No reported disclosures.