Racial and Ethnic Disparities in Meningococcal Vaccination Coverage and Disease Burden Among U.S. Adolescents

Examining racial disparities in meningococcal vaccination (MenACWY) uptake and disease burden is essential for understanding the potential implications of a revised MenACWY schedule and guiding targeted efforts to reduce health inequities. We assessed associations of socioeconomic factors with MenACWY coverage (≥1 dose), drop-out from the second (booster) dose, and disparities in vaccination coverage and invasive meningococcal disease (IMD) burden among adolescents aged 13-17 years living in noninstitutionalized households in the United States.

We conducted a retrospective cross-sectional study (2016-2022) using National Immunization Survey-Teen data for vaccine uptake, and Centers for Disease Control and Prevention data for IMD incidence. Segmented logistic regression analyzed MenACWY uptake and drop-out trends. Multivariable models assessed associations with poverty-income ratio, maternal education, and access barriers. Adjusted odds ratios (aORs) compared uptake and drop-out across racial groups, and Poisson regression estimated adjusted relative risks for IMD incidence.

Compared to non-Hispanic (NH) White adolescents, NH African American (aOR: 1.33; 95% confidence interval [CI]: 1.23-1.44) and Hispanic (aOR: 1.20; 95% CI: 1.13-1.29) adolescents had higher odds of receiving ≥1 MenACWY dose. Hispanic adolescents had lower odds of drop-out (aOR: 0.79; 95% CI: 0.70-0.89), while NH African American (p = .148) and Other/Multiple races adolescents (p = .098) showed no significant difference. Drop-out was higher among low-income adolescents (p < .001) and those whose mothers did not have college education (aOR: 1.26; 95% CI: 1.14-1.39). Among 16-23-year-olds, IMD incidence was significantly higher in African Americans compared to Whites (adjusted relative risk: 2.66; 95% CI: 1.39-5.07).

Persistent disparities in MenACWY coverage and disease burden among US adolescents by race and socioeconomic status highlight the need for targeted efforts within the two-dose program.