By Millicent Gorham
September 5, 2023
As teenagers move away from home to start college, head back to school, or enter the workforce, they have so much to be excited about. Yet, in beginning this new phase of their lives, they should not have to consider whether they might become seriously ill from a vaccine-preventable disease.
Meningococcal disease is a bacterial disease that is severe, and even sometimes deadly, causing an infection of the lining of the brain, spinal cord or bloodstream. College students, and especially those who are living in close proximity to one another in dorms, are especially prone to the disease. When my friend’s daughter contracted meningitis as a college student, she became seriously ill, and ultimately received two arm amputations to save her life. This was a devastating way for her to begin her journey into young adulthood.
Luckily, meningitis is vaccine-preventable. Currently, two vaccine series exist to protect teenagers and young adults against the disease. The MenACWY vaccine is a quadrivalent vaccine, meaning it protects against four strains (A, C, W and Y) of the disease, while the MenB vaccine protects against a single strain (B).
The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) is the body that recommends the use of approved vaccines. Currently, ACIP recommends the MenACWY vaccine as a routine vaccination at age 11-12 (with a booster dose at age 16). However, ACIP recommends the MenB vaccine through shared clinical decision-making for those not at an increased risk (preferred at age 16-18), meaning that the decision for whether to get the MenB vaccine is shared by the physician and the patient. These differing recommendations and schedules for the MenACWY and MenB vaccines can lead to confusion for patients and their parents and, unsurprisingly, to lower vaccine uptake for the MenB vaccine, which is not routinely recommended.
A new survey commissioned by Pfizer and conducted by Survey Healthcare Global reveals that physicians, too, are confused about the meningococcal vaccines and their associated recommendations. The survey findings are now available on the AWHP website and found that, notably, more than half of physicians incorrectly believed that ACIP recommends the MenB vaccine as routine. If the physicians making the recommendations themselves are not familiar with the guidance, how can true “shared clinical decision-making” occur?
While I believe that shared clinical decision-making is an important tool for ensuring a strong patient-provider relationship, improving health literacy and increasing vaccine uptake, it cannot be achieved without clear, simple guidelines for physicians to follow. The current recommendations for meningococcal vaccines are evidently confusing, and could result in patients who may benefit from receiving the MenB vaccine not receiving it.
An additional option may be on the horizon, however. A potential new vaccine that is “pentavalent,” meaning it protects against five strains of meningococcal meningitis — A, C, W, Y and B — is currently in development. If this vaccine is approved and becomes available, patients in the future might not need to juggle confusing, differing guidelines, and could be able to get full protection through a singular vaccine series. The survey found that 95% of physicians believe patients would prefer this vaccination format.
Given our commitment to preventive health for women and girls across the lifespan, AWHP welcomes a simplified vaccine process for a serious, yet preventable disease and encourages meningococcal vaccination among young women — who should be safe, healthy and protected as they begin the exciting next phase of their lives. In the interim, parents and guardians of teens should speak with their teen’s healthcare provider to consider the two currently available meningococcal vaccines.