Disparities in Meningococcal Vaccination by Healthcare Facility Type Among US Teens, Findings From the 2022 National Immunization Survey-Teen

CONTEXT: Meningococcal ACWY conjugate vaccines (MenACWY) are recommended for all US adolescents. However, vaccine coverage is incomplete and varies by sociodemographic factors. METHODS: We used publicly available data from the US 2022 National Immunization Survey-Teen (NIS-Teen), which includes both a survey of parents of 13-17-year-olds and that teen's provider(s) (analytic n = 15,489). We examine whether facility type of reporting provider (ie, public, private, etc.) was associated with receipt of MenACWY and whether this association varied by the MenACWY vaccination policy for the state in which the teen resided. We used confounder-adjusted multivariable logistic regression models to calculate adjusted prevalence odds ratios (aORs) and 95% confidence intervals. FINDINGS: Compared to adolescents whose provider report was from a private facility, those with reports from public facilities had a lower odds of both having received at least 1 MenACWY dose before age 13 (aOR = 0.54 [0.40, 0.72]) and of having received at least 1 MenACWY dose before the parent/guardian survey date (aOR = 0.62 [0.42, 0.93]) in fully adjusted models. While living in a state with a MenACWY mandatory vaccination policy was associated with a greater odds (aOR = 1.51 [1.26, 1.81]) of having received at least 1 MenACWY dose before the age of 13, adjustment for MenACWY statewide policy did not change the public-private clinic disparity in coverage. CONCLUSIONS: Given the severity of invasive meningococcal disease and the variability of MenACWY vaccine uptake for teens receiving care across various settings, there is a need to improve MenACWY vaccination coverage among adolescents who seek care in public facilities.