Patients with functional or anatomic asplenia, including sickle cell anemia; complement component deficiency; or human immunodeficiency virus (HIV) infection have a significantly increased risk of developing meningococcal disease. The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommends vaccination with a quadrivalent meningococcal conjugate vaccine against serogroups A, C, W, and Y (MenACWY) for individuals 2 months of age or older who are diagnosed with functional or anatomic asplenia, complement component deficiency, or HIV infection. Vaccination with a meningococcal vaccine against serogroup B (MenB) is also recommended for individuals 10 years of age or older who are diagnosed with functional or anatomic asplenia or complement component deficiency. Despite these recommendations, recent studies have shown that vaccination coverage in these populations is low. In this podcast, the authors discuss the challenges for implementing vaccine recommendations for individuals with medical conditions at increased risk of developing meningococcal disease and discuss strategies to increase coverage. Suboptimal vaccination rates could be addressed by better educating healthcare providers about recommendations for MenACWY and MenB vaccines in individuals at increased risk, increasing awareness of low vaccination coverage, and tailoring the education to the needs of particular healthcare providers and their respective patient populations. Barriers to vaccination could also be removed by administering vaccines at alternative sites of care, bundling preventative services, and implementing vaccination reminder systems that are tied to immunization information systems.
Keywords: Asplenia; Complement component deficiency; HIV; Meningococcal vaccination.
Invasive meningococcal disease is rare, but serious. Some people are at increased risk because of their medical conditions, including: People without a working spleen People with reduced immune function due to conditions known as complement component deficiencies People living with human immunodeficiency virus (HIV) infection Vaccines are available to prevent meningococcal disease, and these vaccines are recommended for healthy young people as well as for people at increased risk. Studies have shown that a low proportion of people at increased risk has been vaccinated. Strategies are needed to make sure more people in these groups get vaccinated. We suggest educating healthcare providers about the recommended vaccines and making it easier for people to get vaccinated by, for example, providing vaccines in places they might visit more often than a doctor’s office.
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