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Study authors: Pediatricians need more guidance on MenB vaccine :

August 20, 2018

Many physicians say they don’t often discuss the option of a meningococcal B (MenB) vaccine with teens, a new study found.

Authors said clinicians need more information about the vaccine so they can help patients weigh their options.

In the midst of college campus outbreaks, the Food and Drug Administration accelerated approval of two MenB vaccines for use in those ages 10-25 years. The Academy and Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) say the vaccine can be considered for low-risk 16- to 23-year-olds with a preference for those who are 16-18. They did not make it routine due to limited data on safety and efficacy as well as the relatively low numbers of infections.

Researchers set out to see how many physicians are discussing the vaccine with their teen patients. They surveyed 660 pediatricians and family physicians in late 2016, a year after the ACIP recommendation.

About 73% of pediatricians and 41% of family physicians said their practices administer MenB vaccine. During routine visits with 16- to 18-year-old patients, about half of pediatricians and 31% of family physicians always or often discuss MenB vaccination and nearly all of those who typically discuss the vaccine recommend it, according to the study “Adoption of Serogroup B Meningococcal Vaccine Recommendations” (Kempe A, et al. Pediatrics. Aug. 20, 2018, https://doi.org/10.1542/peds.2018-0344). Discussions were more frequent during pre-college exams.

Outbreaks, effectiveness and safety were key factors in doctors’ decision to recommend the vaccine. But others said they were less likely to do so because ACIP hasn’t taken a strong stance on the vaccine. Many also said they were not knowledgeable enough about it.

“With our data, we highlight the challenges providers face with implementing recommendations for vaccination based on individual clinical decision-making when they have limited experience with a disease and limited knowledge of a new vaccine,” authors wrote.

They encouraged the AAP and the American Academy of Family Physicians to provide more guidance to clinicians.

In a related commentary, Michael T. Brady, M.D., FAAP, acknowledged it can be tough to make time to discuss MenB among all the other issues teens are facing, especially when the vaccine is not routinely recommended.

“Pediatricians appreciate recommendations that are evidence-based, clear, and unequivocal,” wrote Dr. Brady, an ex officio member of the AAP Committee on Infectious Diseases and associate editor of the AAP Red Book. “… Recommendations that require clinical decision-making need to provide clear guidance that informs providers so that they can determine what needs to be discussed with their patients and families and determine how strongly to recommend the vaccine.”

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