Meningococcal-group B (MenB) vaccine series completion and adherence to dosing schedule in the United States: A retrospective analysis by vaccine and payer type

Abstract Background Two MenB vaccines with different dosing schedules are approved in the US: MenB-4C (2 doses) and MenB-FHbp (2–3 doses). Both vaccines were licensed on the basis of immunogenicity demonstrated after vaccine series completion. We evaluated vaccination completion and adherence to dosing schedules. Methods This retrospective analysis used data from MarketScan Commercial Claims and Encounters Database (Commercial) January 1, 2015 - February 28, 2018 and Multi-State Medicaid Database (Medicaid) January 1, 2015 - December 31, 2017 to examine vaccine series completion and adherence to dosing schedule in individuals who initiated a MenB series at ages 16–23 years. Vaccine series completion and dose schedule adherence were assessed during a 15-month follow-up period after the first dose. Completion was defined as individual receipt of the recommended number of doses, with current recommendations applied retroactively to allow individuals who initiated the MenB-FHbp series to be complete with either the 2- or the 3-dose schedule. Results The study population comprised 65,205 commercially-insured individuals (36,118 initiated MenB-4C; 29,087 initiated MenB-FHbp) and 13,535 Medicaid-covered individuals (10,153 initiated MenB-4C; 3382 initiated MenB-FHbp). In Commercial, 63% of individuals who initiated MenB-4C and 52% of individuals who initiated MenB-FHbp completed vaccination within 15 months; dosing schedule adherence was 62% for MenB-4C initiators and 18% for MenB-FHbp initiators. In Medicaid, 15-month completion rates for MenB-4C and MenB-FHbp initiators were 49% and 31%, respectively, with corresponding dosing schedule adherence of 48% and 8%. Among individuals who completed the series, median time to completion was 68 days for MenB-4C versus 258 days for MenB-FHbp in Commercial and 88 days for MenB-4C versus 309 days for MenB-FHbp in Medicaid. Conclusion During the study period, MenB vaccine series completion was suboptimal. However, completion was significantly higher for MenB-4C, with notably shorter time to completion. This may reflect the flexible dosing schedule of MenB-4C.