Parental Awareness of Meningococcal B Vaccines and Willingness to Vaccinate Their Teens

In the United States (US), the Advisory Committee on Immunization Practices (ACIP) actively encourages parents of teens and health care personnel to discuss meningococcal vaccines and to decide how best to protect against meningococcal disease. Increasing vaccine uptake and ensuring the sustainability of high uptake of both MenAWCY and MenB vaccines is critical to achieving the Healthy People 2020 goal of reducing the number of annual, laboratory confirmed cases of meningococcal disease by 10% among all age groups. In that light, this study was designed to determine how knowledgeable US parents are about meningococcal vaccines and meningococcal disease, and how willing they are to have their child vaccinated with MenB vaccines compared to MenACWY vaccines.

The researchers conducted an in-person, cross-sectional survey at the University of Minnesota's (UMN) Driven to Discover (D2D) research facility during the 2017 Minnesota State Fair. Potential participants were eligible if they had a child who would be attending high school during the 2017-18 academic year and if they read and understood English. The survey consisted of 27-31 questions, depending upon the skip pattern.

Of the 445 parents who completed the survey, 89.2% reported that their child had received at least one vaccine in the past (any type at any age). Nearly all participants (91.5%; 95% confidence interval (CI): 88.5, 93.9) were aware of meningococcal disease, and, of those, 76.9% (95% CI: 72.5, 80.9) reported being at least somewhat knowledgeable about the disease. Overall, 75.5% (95% CI: 71.2, 79.4) of parents reported that they were aware of meningococcal vaccines in general, and 71.7% (95% CI: 66.6, 76.5) of those respondents considered themselves at least somewhat knowledgeable about meningococcal vaccines. Just over seventy percent (95% CI: 65.9%, 74.5%) of participants reported that they are at least somewhat concerned about the disease. Participants' reported willingness to vaccinate their teen with MenB and MenACWY vaccine were similar, with 89.6% at least somewhat willing to vaccinate with Bexsero® or Trumenba® (95% CI: 86.5, 92.3) and 91.2% at least somewhat willing to vaccinate with Menactra® or Menveo® (95% CI: 88.2, 93.7). The top reasons parents indicated that their child had not received MenACWY or MenB vaccine were that they did not know about this vaccine (40.0% [95% CI: 31.0, 49.6] and 31.5% [CI: 24.4, 39.2], respectively) or that their healthcare provider did not recommend the vaccine (33.9% [95% CI: 25.3, 43.3] and 32.7% [95% CI: 25.6, 40.5], respectively).

Based on logistic regression models, parents who were aware of at least one of the MenB vaccines compared with those who were not aware had significantly higher odds of being willing to vaccinate their child with MenB vaccine (odds ratio (OR): 3.8; 95% CI: 1.2, 12.2; p = 0.03), with MenACWY vaccine (OR: 6.3; 95% CI: 1.3, 29.4; p = 0.02), and with enough doses to fully vaccinate their child (OR: 1.9; 95% CI: 1.1, 3.2; p = 0.02). In addition, participants who were at least somewhat concerned about meningococcal disease compared to those not at all concerned had a higher odds of being willing to vaccinate their child with MenB vaccine (OR: 3.1; 95% CI: 1.5, 6.3; p = 0.002), with MenACWY vaccine (OR: 3.9; 95% CI: 1.8, 8.4; p < 0.001), and with enough doses to fully vaccinate their child to protect against 5 meningococcal groups (OR 2.0; 95%CI: 1.3, 3.2; p = 0.002).

At the end of the survey, the majority of participants indicated that they would like more information from their doctor about both MenB and MenACWY vaccines (81.1% [95% CI: 77.2, 84.7] and 79.6% [95% CI: 75.5, 83.2], respectively). Overall, 55.3% (95% CI: 50.5, 60.0) of participants were at least somewhat interested in receiving text or email notifications from their doctor about their child's eligibility for meningococcal vaccines.

The researchers stress that lack of parental awareness coupled with knowledge gaps among physicians are significant barriers to MenB vaccination. As noted, current ACIP recommendations encourage parents to discuss MenB vaccination with their child's healthcare providers, but the study's results suggest that parents have heard of meningococcal vaccines in general, but few had specific knowledge about the vaccines currently available. Because parents may be unlikely to raise the topic themselves, healthcare providers should consider initiating conversations about the risk of meningococcal disease and the availability of MenB vaccines. Resources that are cited in the article are designed to educate and support providers as they do so.

Currently in the US, MenB vaccines are recommended for routine use among high-risk adolescents and permissive use among all adolescents; at least 14 colleges and universities are now requiring MenB vaccine for incoming students, while approximately a dozen others are considering such a requirement. Considering that this study has shown that awareness of MenB vaccines, along with concern for meningococcal disease, are important predictors of willingness to vaccinate with the newly licensed MenB vaccines, it would seem that greater awareness is needed among parents of high school students to minimise missed opportunities for meningococcal prevention. Conversation with healthcare providers is recommended here as a means for facilitating that awareness and, by extension, the decision to vaccinate.