POLICY REPORTS

Meningococcal Vaccination: Adolescents and At-Risk Groups Report 2020

The Working Group on Meningococcal Vaccinations examined how the pandemic disrupted routine and school-based immunization, and the longer-term risks of delay. Across three themes, routine vaccination delays, reaching adolescents, and HCP education on high-risk groups, the Group set out observations, challenges, strategies, and actions to keep meningococcal protection on track.

Download the PDF

5th Life Course
Immunisation Summit
December 2020

Working Group on Meningococcal Vaccinations

Observations, Challenges, Strategies and Actions

Delays in Routine Vaccinations
Observations
Delayed Meningococcal Vaccination Programmes Could Have Longer-Term Implications
  • Initial confusing messages have driven delays to scheduled vaccinations.
  • Clear instructions and campaigns not to postpone scheduled vaccinations have helped the rate to rebound quickly.
  • Parents were pleased about the measures put in place by their general practitioners to minimise the risk of acquiring an infection.
  • The implementation of social distancing measures and lockdown has had a significant impact on the spread and detection of many other diseases, including invasive meningococcal disease.
Challenges
Broad Understanding That the Scheduled Vaccinations Should Not Be Delayed
  • 86% remained of the opinion that children needed to continue to be immunised during the pandemic.
  • Modellers have shown that social distancing for 6–12 months would have a prolonged effect on meningococcal disease by lowering carriage prevalence and so the risk of infection.
  • In the hospital pharmacy sector, unprecedented lows in shortages have been reported. Just 20% of hospital pharmacists in Europe reported problems with vaccine shortages, compared to 43% in 2018.
Strategies
Making Sure All Missed Vaccinations Are Provided
  • Mobilise healthcare professionals to reach out to their patients every time a lockdown is in place to ensure that vaccinations are not missed.
  • Mobilise healthcare professionals to check their records to ensure no one has missed their vaccination, rescheduling them if needed.
  • Help healthcare professionals to safely organise their practices and communicate to parents that a visit will not be a risk for the child or the parents.
  • Catch-up campaigns and strategies are needed for the immunocompromised and other people at risk.
Adolescents
Observations
Disruptions in Meningococcal Vaccinations for Adolescents
  • Schools closing during the COVID pandemic had a significant impact on school-based immunisation programs in many European countries.
  • Meningococcal vaccinations are likely to be worse affected than HPV vaccinations, because they are given later in the year and will have been more affected by lockdowns.
  • Older children, who are somewhat harder to vaccinate through other channels, are more affected by disruptions to school-based vaccination programs.
Challenges
Adolescents Are One of the Hardest At-Risk Groups to Reach
  • Adolescents are notably one of the harder-to-reach groups for vaccination.
  • Disease prevalence might have decreased in the previous year, but with adolescents being the first not to commit to social distancing, they may be at higher risk if not protected.
  • Adolescent immunisation for meningococcal disease protects the individual and develops immunity in the community to protect younger children and others.
Strategies
Priority for School-Based Vaccines to Resume and Individual Vaccines Rescheduled
  • Make every effort so that the school-based vaccination program resumes and further disruptions are avoided.
  • Mobilise healthcare professionals to reach out to parents and schedule the missed vaccinations.
  • Work through local healthcare professionals, schools and community pharmacists to reach adolescents in their environments.
  • Create awareness on social media platforms and media channels that adolescents use.
HCP Education – High-Risk Groups
Observations
Not Enough Feedback Is Given to HCPs to Stimulate Interest
  • A lower disease prevalence might result in a loss of interest among paediatricians, thinking there is no longer a risk for meningitis infection.
  • Lesser numbers of cases are not necessarily connected in HCPs' minds with the success of vaccination programs.
  • Disease outbreaks in schools in the past have attracted attention and helped increase awareness.
  • Several clinical trials have been impacted as some parents deny participation because they perceive meningitis is not the problem anymore.
Challenges
We Must Demonstrate to HCPs the 'Return on Investment' in Meningococcal Vaccines
  • We don't inform HCPs on what the immunisation programs have achieved every year, which would allow them to be connected and engaged.
  • Not all healthcare professionals have gone through an infected patient's experience; therefore, the disease burden remains theoretical knowledge for many.
  • Inequity across Europe exists, with some countries favouring a universal funded vaccination program and others leaving uptake to people's discretion to pay.
  • Disruptions in clinical trials might demonstrate a shift in public opinion.
Strategies
An Excellent Way of Maintaining a Program Is by Giving Feedback
  • Provide feedback to HCPs every year on disease prevalence, allowing them to adopt the immunisation programs as their achievement.
  • Share patients' stories to showcase to HCPs the disease burden and associated risks.
  • Sustain meningococcal vaccination programs by making them a norm that shouldn't be disrupted or delayed.
  • Targeted campaigns to HCPs to reach people living in large households, in boarding schools, and groups such as young military recruits.

Meningococcal Vaccinations Suggested Actions and Campaigns 2021/22

  • Campaign Aimed at HCPs to Demonstrate the 'Return on Investment' in Meningococcal Vaccines — providing feedback to HCPs every year on disease prevalence allows them to adopt the immunisation programs as their achievement. Share patients' stories to showcase to HCPs the disease burden and associated risks.
  • Meningococcal Vaccination Catch-up Campaigns and Strategies for the Immunocompromised — organising campaigns for at-risk groups, people living in large households, people living in boarding schools or young military recruits, to avoid a meningitis epidemic in the future.
  • Continuation of the "Now More Than Ever…" Campaign — mobilising HCPs to reach out to their patients every time a lockdown is in place, to ensure vaccinations are not missed and communicate to parents that a visit will not be a risk for the child or the parents.
  • HCP-Led Campaign to Support the Swift Restarting of Schools-Based Vaccines — community HCPs supporting school programmes by rescheduling individual vaccines where appropriate, working through local healthcare professionals, schools and community pharmacists to reach adolescents in their environments.
  • 2021 Expert Working Group on Communicating the Risk of Meningococcal Disease to Adolescents — hosting an expert group on how to reach out and communicate with adolescents to increase meningococcal vaccination uptake.

Meningococcal Vaccinations Suggested Actions and Campaigns 2021/22

  • Social Media Campaign Targeting Adolescents and Young People — a social media campaign targeting adolescents and their parents to increase awareness that symptoms resembling COVID-19 might hide a meningococcal infection; they must look for the signs and contact their GP or paediatrician. Create awareness on social media platforms and media channels that adolescents use.
  • "The Risk of Meningococcal Disease Is As Important as Ever" Campaign for the Public — a social media campaign, with the focus now on COVID-19 infections and mortality, needed to maintain in the public's minds the seriousness and implications of meningitis, especially among the younger population.

Contributors

George Syrogiannopoulos • Dace Zavadska • Nenad Miljković (EAHP) • Catherine Weil-Olivier • Carlo Signorelli • Elisabeth Sanders (RVIM) • Hanna Nohynek (THL) • Simon Kroll • Mirjam Knol (RVIM) • Francisco Gimenez-Sanchez (Balmis) • Elena Moya (COMO)