Knowledge, perception, and practice regarding meningococcal vaccination in infants 3-7 months of age: A nationwide cross-sectional study in China
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Published on: November 5, 2019
Yilan Xia1, Xiang Guo2, Xiaoya Fu3
1Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China; Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.
Insights
Healthcare practitioners and caregivers in China recognize the need for early meningococcal vaccination. Multivalent meningococcal vaccines like MPCV-ACYW show promise for improved infant safety and tolerability.
Area of Science:
- Public Health
- Immunization Practices
- Vaccinology
Background:
- Meningococcal serogroup distribution varies globally, impacting vaccination strategies.
- China utilizes both national EPI (MPSV-A) and self-paid (MPCV-AC/ACYW) meningococcal vaccines.
- Infant vaccination schedules differ, with EPI vaccines given at 6 months and self-paid options from 3 months.
Purpose of the Study:
- To investigate healthcare practitioner (HCP) and caregiver knowledge, perceptions, and practices regarding meningococcal vaccines in China.
- To understand preferences for different meningococcal vaccine types (MPSV-A, MPCV-AC, MPCV-ACYW) among HCPs and caregivers.
- To assess infant safety and tolerability outcomes associated with different meningococcal vaccines.
Main Methods:
- A large-scale, cross-sectional survey conducted from January 2023 to December 2024 across 29 Chinese provinces.
- Inclusion of 5069 HCPs at vaccination points and 148,269 caregivers of infants aged 3-7 months.
- Data collection via structured questionnaires on vaccine knowledge, perceptions, preferences, and practices.
Main Results:
- High acknowledgment of meningococcal disease burden by HCPs (91.9%), but uncertainty in prevention (99.4%) due to low public awareness (85.3%).
- HCPs and caregivers choosing MPCV-ACYW prioritized efficacy and serogroup coverage; those choosing MPSV-A or MPCV-AC prioritized safety and cost.
- MPCV-ACYW showed better infant safety and tolerability (milder irritability/crying) compared to MPCV-AC (p < 0.001).
- 35.4% of infants received simultaneous administration of meningococcal vaccines with other routine vaccines.
Conclusions:
- This is the first systematic study on meningococcal vaccination perceptions and practices in China involving both HCPs and caregivers.
- HCPs recognize the importance of early vaccination and the effectiveness of MPCV-ACYW.
- Findings highlight the need for enhanced public awareness, targeted health advocacy, and promotion of multivalent meningococcal vaccines.
Background:
Meningococcal serogroup distribution evolves globally. In China, meningococcal polysaccharide vaccine (MPSV)-A is included in the National Expanded Program on Immunization (EPI) for infants at 6 months of age, while meningococcal polysaccharide conjugate vaccines (MPCV)-AC/ACYW are classified as non-EPI (self-paid) vaccines administered starting at 3 months of age. This study aimed to investigate the knowledge, perception, and practice of meningococcal vaccines among healthcare practitioners (HCPs) at points of vaccination (POVs) and caregivers of infants aged 3-7 months.
Methods:
A cross-sectional survey was conducted between January 2023 and December 2024 across 29 provinces in China. A total of 5069 HCPs at POVs and 148,269 caregivers of infants aged 3-7 months were enrolled. Structured questionnaires were distributed to collect data on vaccine knowledge, perception, preferences, and vaccination practice.
Findings:
Most HCPs (91·9 %) acknowledged the substantial burden of meningococcal disease. However, 99·4 % of HCPs reported uncertainty in meningococcal disease prevention, primarily due to insufficient public awareness (85·3 %). When selecting self-paid meningococcal vaccines, HCPs prioritized protective efficacy (73·1 %) and serogroup coverage (70·5 %), aligning with the priorities of caregivers choosing MPCV-ACYW (78·2 %). Conversely, caregivers choosing MPSV-A or MPCV-AC prioritized safety (42·2 % and 50·6 %, respectively) and cost-effectiveness (52·6 % and 42·7 %, respectively). Moreover, caregivers reported infants receiving the MPCV-ACYW experienced milder irritability and crying, and exhibited better overall safety and tolerability, compared to MPCV-AC (each p < 0·001). Additionally, 35·4 % of infants received simultaneous administration of their first-dose meningococcal vaccine and other vaccines. Simultaneous administration patterns of meningococcal vaccines and other vaccines differed by age and vaccine type.
Interpretation:
This study is the first to systematically determine the perceptions and practices of meningococcal vaccination from both HCPs and caregivers across provinces in China. Most HCPs acknowledged the necessity of early meningococcal vaccination and MPCV-ACYW effectiveness. The findings indicate a need to strengthen public awareness of meningococcal disease, implement tailored health advocacy, and promote multivalent meningococcal vaccines.
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