Evaluation of the MenACWY Vaccination Catch-Up Campaign Among Adolescents in Madrid: Coverage, Trends, and Determinants

<b>Background</b>: Invasive meningococcal disease (IMD) caused by <i>Neisseria meningitidis</i> remains a major public health concern due to its severity, lethality, and long-term sequelae. To address the rise in serogroups W and Y in Spain, the Community of Madrid implemented a catch-up campaign in 2019-2021, targeting adolescents (ages 13-18) alongside routine tetravalent meningococcus vaccine (MenACWY) at age 12. This study evaluated MenACWY catch-up vaccination uptake in routine practice by describing vaccine coverage, temporal trends, and associated factors in adolescents born between 2001 and 2006. <b>Methods</b>: A population-based cross-sectional study was conducted using data from the Community of Madrid's vaccination registry (SISPAL Vacunas). Vaccination coverage was calculated for adolescents with at least one recorded MenACWY dose from age 10 onwards. Temporal trends were analyzed by birth cohort and calendar time, and multivariable logistic regression models were used to identify factors associated with vaccination uptake. <b>Results</b>: Among 424,059 adolescents, overall vaccination coverage by December 2021 was 63.8%, ranging from 54.4% to 78.2% across birth cohorts. Coverage was highest in the 2006 cohort, likely due to co-administration with the tetanus and diphtheria (Td) booster. A slightly higher uptake was observed among females and adolescents with chronic conditions, while foreign-born adolescents consistently showed lower coverage. COVID-19 disruptions led to temporal variability, with sharp declines during lockdowns and partial recoveries thereafter, with persistent sociodemographic differences in uptake. <b>Conclusions</b>: By December 2021, coverage was incomplete, with marked variability across birth cohorts. Higher uptake was observed when vaccination was integrated into routine visits, while persistent sociodemographic disparities remained evident. These observational findings are consistent with the programmatic value of combined catch-up and routine strategies and the need for targeted actions to ensure equitable MenACWY coverage.