159. Knowledge of Invasive Meningococcal Disease and Vaccination Recommendations for Adolescents and Young Adults among US Physicians

Neisseria meningitidis is a leading cause of life-threatening meningitis and sepsis in the United States (US). The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommends vaccination against meningococcal serogroups A, C, W, and Y (MenACWY) for all 11–12-year-old adolescents, with a booster dose at age 16. Additionally, the ACIP recommends vaccination against meningococcal serogroup B (MenB) at age 16–23 (preferably age 16–18) under shared clinical decision making (SCDM) between patients/caregivers and providers. However, uptake of the MenACWY booster dose and the MenB vaccination series is low. To shed light on this problem, this study evaluated US physicians’ understanding of meningococcal disease epidemiology and their knowledge of vaccination recommendations. A questionnaire was developed to assess providers’ knowledge, attitudes, and practices regarding meningococcal disease and vaccination recommendations. Physicians were randomly recruited from a proprietary panel of healthcare providers in April–May 2022 to complete the questionnaire online. Participants were board-certified pediatricians, family physicians/general practitioners (FPs/GPs), and internists who reported having recommended, prescribed, or administered a MenACWY booster to ≥1 16–21-year-old patient and/or MenB vaccination to ≥1 16–23-year-old patient during the past year; worked ≥20 hours per week in patient care; could complete the questionnaire in English; and consented to the study. A total of 407 physicians (202 pediatricians, 130 FPs/GPs, 75 internists) were included and identified as MenACWY vaccinators (n=385) and/or MenB vaccinators (n=391). Although 66% of the participants reported having encountered a 16–23-year-old patient with meningococcal disease during training or in practice, 50% did not know that MenB currently causes the highest proportion of cases in adolescents and young adults in the US. The CDC immunization schedule and the ACIP guidelines were reported as the most commonly used resources (85% and 63%, respectively). However, 18% of participants (4% of pediatricians, 30% of FPs/GPs, 35% of internists) did not know that MenACWY vaccination is routinely recommended, and 54% of participants (53% of pediatricians, 60% of FPs/GPs, 47% of internists) did not know that MenB vaccination is recommended under SCDM. When deciding whether to recommend meningococcal vaccination, physicians considered school/college requirements (81%), clinical judgement (65%), and state immunization information systems (60%). When asked about receipt of training or other information on implementing SCDM for MenB vaccination, 78% of MenB vaccinators reported having received some training or other information; 51% reported self-training using published vaccination guidelines. Almost a quarter (22%) of MenB vaccinators reported having received neither training nor other information (19% of pediatricians, 23% of FPs/GPs, 30% of internists). This survey found gaps in the knowledge of meningococcal disease epidemiology and vaccination recommendations among US physicians, particularly relating to MenB disease and MenB vaccination recommendations. Knowledge gaps and training about SCDM varied across specialties. Targeted training of physicians may improve knowledge of meningococcal disease and understanding of vaccination recommendations, especially for MenB disease and vaccination.