Meningococcal disease is a severe illness caused by the bacteria Neisseria meningitidis, which can affect anyone, but individuals with human immunodeficiency virus (HIV) have a 4.5-fold to 12.9-fold increased risk of contracting the illness due to their compromised immune system. Newly diagnosed HIV patients benefit greatly from swift vaccination against meningococcal disease to prevent adverse health consequences or death. The best form of prevention is by keeping up to date with the most current vaccine.
The two-dose series of Meningococcal A, C, W, Y (MenACWY) vaccine was recommended to HIV patients in 2016 by the US Advisory Committee on Immunisation Practices. This vaccine offers protection against the most common disease-causing serotypes in the US. Despite this, further education on vaccine recommendations is still needed in the healthcare space, as Ghaswalla and colleagues disclosed poor uptake and time to receipt of the first dose of the MenACWY vaccine in newly admitted HIV patients from 2016 to 2018 in their recent, US-based study published in JAMA Network Open.
GlobalData epidemiologists estimate that there will be 1.3 million diagnosed prevalent cases of HIV in men and women of all ages in the US by the end of this year, with this number projected to rise to 1.4 million by the end of 2029 (as shown in Figure 1). In addition, GlobalData epidemiologists forecast there will be 311 lab-confirmed incident cases of invasive meningococcal disease (all serotypes) in men and women of all ages by the end of this year, which is expected to rise to 327 by 2029 (as shown in Figure 2). An increasing population that is vulnerable to contracting meningococcal disease, among other bacterial infections, raises the question of what can be done to reduce future mortality and morbidity in the HIV community due to meningococcal disease, as well as prevent a potential increase in lab-confirmed incident cases of meningococcal disease.
The US nationwide cohort study conducted by Ghaswalla and colleagues examined the uptake and time of receipt of one or more doses of the MenACWY vaccine as the primary outcomes, and the uptake and time of receipt of two or more vaccine doses as the secondary outcomes. A total of 1,208 individuals aged two years and older with at least one inpatient or two outpatient claims of new HIV diagnosis were retrospectively identified from an extensive US health insurance database, Optum Research Database, from January 2016 to March 2018. The research found that by 12 months, 18 months, and 24 months after the initial HIV diagnosis, 10.6%, 12.9% and 16.3% of the cohort received one or more doses of the MenACWY vaccine, respectively.
Of the 71 participants who received an initial first dose of the MenACWY vaccine, 66.2% were estimated to have received their second dose within one year of their first dose. Vaccine uptake varied by age group, and the group ages 56 years and older was significantly associated with reduced uptake. In contrast, factors associated with significantly increased vaccine uptake included receipt of a pneumococcal vaccine, attendance at a well-care visit, male sex, and living in the West or Midwest regions in the US.
MenACWY vaccine uptake was low among the HIV population, which calls for increased education around vaccination recommendations and administration for this high-risk group, which is more prone to falling ill with meningococcal disease. Creating more awareness will help reduce HIV patients’ risk of contracting this bacterial infection and lower future incident cases of meningococcal disease.