Many doctors skip meningococcal vaccine talks with teens

(Reuters Health) – Many pediatricians and family physicians don’t discuss the meningococcal B vaccine with teens even though these conversations are recommended to determine whether adolescents should get shots to protect against this lethal infection, a U.S. study suggests.

Just 51 percent of pediatricians and 31 percent of family physicians surveyed for the study said they “often” or “always” discussed the so-called MenB vaccine with teen patients. When they did discuss it, 91 percent of doctors recommended vaccination.

Among participants who “never” or “rarely” discussed the MenB vaccine, however, only 11 percent recommended it to their patients.

“Our survey shows that many providers have gaps in knowledge about Meningococcal type B disease and about MenB vaccine, and lack of knowledge appears to be associated with not discussing it with parents and patients,” said lead author Dr. Allison Kempe of the University of Colorado Anschutz Medical Campus and Children’s Hospital in Aurora.

The trouble with MenB may be that it’s new, and that it’s not recommended as a routine vaccine like shots for many other childhood illnesses because there’s no long-term data yet on its safety and effectiveness, Kempe said by email. The older MenACWY vaccine covers four other strains of meningococcal disease, is recommended as a routine childhood vaccination and has been credited with helping to make meningococcal disease quite rare in the U.S.

The disease still kills about 10 to 15 percent of people who catch it, researchers note in Pediatrics. Many survivors have lasting impairments like neurological deficits, loss of limbs or digits and hearing loss.

Meningococcal disease is a serious bacterial infection that can lead to bloodstream infections and severe swelling in the brain and spinal cord.

The strain known as meningococcal disease serogroup B is uncommon, with just 130 cases in 2016 in the U.S., 41 of which were in patients aged 16 to 23 years old, the study authors point out. But numerous outbreaks on college campuses led to the approval of new MenB vaccines in 2015 and 2016.

For the study, researchers surveyed a nationally representative group of 660 physicians in 2016 by email and through online outreach.

Overall, 73 percent of pediatricians and 41 percent of family physicians said they currently administered the MenB vaccine.

Doctors were more likely to use the vaccine when they were aware of recent meningococcal B outbreaks, the study found.

But for many doctors, the lack of a recommendation for routine use of the vaccine made them reluctant to use it for their patients.

The study wasn’t a controlled experiment designed to prove whether or how vaccine recommendations affect physicians’ practice, and it’s possible the results might be different in 2018, now that the vaccine has been around a bit longer.

Still, the results suggest that many doctors may consider this vaccine optional because it’s not on the list of routine childhood vaccinations, said Dr. Michael Brady of Nationwide Children’s Hospital in Columbus, Ohio, who wrote an accompanying editorial.

Teens also come to the doctor infrequently, and this may mean doctors prioritize other things to discuss – like school performance, mental health, sexual activity and substance use – instead of talking about the MenB vaccine, Brady said by email. While routine vaccinations might not take much time to discuss, weighing the pros and cons of the MenB vaccine to decide if it’s needed could take longer.

Teens and parents should take the initiative to ask about the MenB vaccine during checkups, Brady advised.

“Meningococcal B disease is severe and even life-threatening, and the MenB vaccine may prevent MenB disease,” Brady said. “Those who are concerned about preventing MenB disease and are between the ages of 16 and 19 years should contact their medical provider to discuss and likely receive the MenB vaccine.”

SOURCE: bit.ly/2L9LQIk and bit.ly/2LcqZUz Pediatrics, online August 20, 2018.