A Real-world Claims Data Analysis of Meningococcal Serogroup B Vaccine Series Completion and Potential Missed Opportunities in the United States

Abstract

Background: In the United States, meningococcal serogroup B MenB vaccination is recommended for 16-23-year-olds based on shared clinical decision-making. We estimated series completion among individuals initiating MenB vaccination for the 2 available vaccines: MenB 4-component MenB-4C, doses at 0 and ≥1 month and MenB factor H binding protein MenB-FHbp, doses at 0 and 6 months. Methods: This retrospective health insurance claims data analysis included 16-23-year-olds who initiated MenB vaccination index date during January 2017 to November 2018 MarketScan Commercial Claims and Encounters Database or January 2017 to September 2018 MarketScan Multi-State Medicaid Database and had continuous enrollment for ≥6 months before and ≥15 months after index. The main outcome was MenB vaccine series completion within 15 months. Among noncompleters, preventive care/well-child and vaccine administrative office visits were identified as potential missed opportunities for series completion. Robust Poisson regression models identified independent predictors of series completion. Results: In the Commercial n = 156,080 and Medicaid n = 57,082 populations, series completion was 56.7% and 44.7%, respectively, and was higher among those who initiated MenB-4C versus MenB-FHbp 61.1% versus 49.8% and 47.8% versus 33.9%, respectively; both P < 0.001. Among noncompleters, 40.2% and 34.7% of the Commercial and Medicaid populations, respectively, had ≥1 missed opportunity for series completion. Receipt of MenB-4C and younger age were independently associated with a higher probability of series completion. Conclusions: Series completion rates were suboptimal but were higher among those who initiated MenB-4C. To maximize the benefits of MenB vaccination, interventions to improve completion and reduce missed opportunities should be implemented.