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Risk of Invasive Meningococcal Disease in Children Aged <11 Years in the United States
Oscar Herrera-Restrepo1, Elizabeth Packnett2, Megan K Richards2
1GSK, Philadelphia, Pennsylvania, USA.
Insights
Invasive meningococcal disease (IMD) incidence is low in US children but higher in Medicaid-insured infants. Early vaccination can reduce IMD risk and burden.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Background:
- Invasive meningococcal disease (IMD) presents significant mortality and long-term health issues.
- Infants under one year, particularly those under six months, exhibit the highest IMD incidence rates in the US.
Purpose of the Study:
- To estimate the incidence of IMD in commercially and Medicaid-insured infants, toddlers, and children up to 10 years old.
- To identify demographic and clinical factors associated with IMD risk in pediatric populations.
Main Methods:
- A retrospective claims analysis using MarketScan® data from January 2005 to December 2022.
- Evaluation of IMD incidence, time at risk, incidence rates (IR), and incidence rate ratios (IRR) across different age groups and insurance types.
Main Results:
- Overall IMD IRs per 100,000 person-years were 0.45 (commercial) and 1.97 (Medicaid) for infants, 0.17 (commercial) and 0.45 (Medicaid) for toddlers, and 0.11 (commercial) and 0.18 (Medicaid) for children.
- Incidence peaked in infants under four months, with rates of 1.03 and 4.65 per 100,000 PY for commercially and Medicaid-insured infants, respectively.
- Elevated IRRs were linked to rural residence, immunocompromised status, and complement deficiencies.
Conclusions:
- IMD incidence in the US is low but shows variability based on age, insurance status, and specific characteristics.
- Implementing timely preventive measures, including early vaccination, is crucial for mitigating IMD incidence and its associated health burden.
Background:
Invasive meningococcal disease (IMD) is associated with high case-fatality rates and severe long-term sequelae. In the United States (US), IMD incidence rate (IR) is highest among infants aged <1 year, with most cases occurring in infants aged <6 months. This study estimated IMD incidence in commercially and Medicaid-insured infants, toddlers, and children aged <11 years.
Methods:
This retrospective claims analysis utilized real-world data (01 January 2005 to 31 December 2022) from the MarketScan® Commercial and Multi-State Medicaid Research Databases of infants (aged <1 year), toddlers (aged 1-4 years), and children (aged 5-10 years). IMD incidence, time at risk for IMD, IR, and IR ratio (IRR) were evaluated overall and by demographic/clinical characteristics.
Results:
Within the commercially and Medicaid-insured cohorts, 21 and 115 infants, 34 and 80 toddlers, and 36 and 37 children with IMD were identified, respectively. Overall IMD IRs in infants, toddlers, and children were 0.45, 0.17, and 0.11 per 100 000 person-years (PY; commercially insured) and 1.97, 0.45, and 0.18 per 100 000 PY (Medicaid-insured), respectively. Incidence rates were highest in infants aged <4 months (1.03 and 4.65 per 100 000 PY for infants aged 2 to <3 months [commercially insured] and 1 to <2 months [Medicaid-insured], respectively). Significantly elevated IRRs were observed among infants and children with specific demographic and clinical characteristics, including residence in rural counties, immunocompromised status, and complement component deficiency.
Conclusions:
IMD incidence is low in the United States, but varies by age, insurance type, and demographic/clinical characteristics. Timely preventative interventions, such as early vaccination, may reduce the incidence, risk, and associated burden of IMD.
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