The Impact of Social Determinants of Health on Meningococcal Vaccination Awareness, Delivery, and Coverage in Adolescents and Young Adults in the United States: A Systematic Review

Abstract

Vaccines remain a fundamental intervention for preventing illness and death. In the United States, suboptimal vaccine uptake in adolescents and young adults has been observed for meningococcal conjugate (MenACWY) and serogroup B meningococcal (MenB) vaccines, particularly among marginalized communities, despite current recommendations by the Advisory Committee on Immunization Practices. A systematic literature search was conducted in the MEDLINE and MEDLINE In-Process, Embase, Cochrane, PsychInfo, and CINAHL databases to identify both drivers of, and barriers to, MenACWY and MenB vaccine uptake in adolescents and young adults. A total of 34 of 46 eligible studies that presented outcomes stratified by race/ethnicity, geography, and socioeconomic status were selected for review. Results showed MenACWY and MenB vaccination coverage in adolescents and young adults is impacted by racial/ethnic, socioeconomic, and geographic disparities. Gaps also exist in insurance for, or access to, these vaccines in adolescents and young adults. Moreover, there was variability in the understanding and implementation of the shared decision-making recommendations for the MenB vaccine. Disease awareness campaigns, increased clarity in accessing all meningococcal vaccines, and further research on the relationships between measures of marginalization and its impact on vaccine coverage in adolescents and young adults are needed to reduce the incidence of severe infections.

Invasive meningococcal disease in South-Eastern European countries: Do we need to revise vaccination strategies?

“… 57 Additionally, the lack of vaccine equity leads to inequality in access and distribution of vaccines in general, which is even more pronounced in the case of IMD, as this disease primarily affects those from lower socio-economic backgrounds. 58 , 59 Therefore, revision of the countries’ reimbursement strategies related to IMD is strongly recommended. Lastly, further data collection in this region in the post-COVID-19 era is warranted, as the number of IMD cases reported across Europe are progressively increasing after removal of social restriction measures, and this increasing trend in IMD cases will likely to be seen in this region in the near future.…”

The impact of regional disparities on the availability of meningococcal vaccines in the US

“…Health insurance coverage plays a crucial role in determining access to health care services, including vaccines, as do disparities in race/ethnicity, geography, and socioeconomics. A recent systematic literature review assessing the impact of social determinants of health, specifically for meningococcal vaccination, showed a consistent variance in MenACWY and MenB coverage across population subgroups [ 12 ]. ACIP recognizes the importance of considering issues related to health equity and includes this as a domain in the ACIP’s Evidence to Recommendations (EtR) framework [ 13 ].…”