PDF(Pubmed)
Abstract：
BACKGROUND: Invasive meningococcal disease (IMD) is a severe and life-threatening disease. In the United States (US), vaccine coverage with MenACWY and MenB meningococcal vaccines is suboptimal among adolescents/young adults aged 16-23 years. A combined meningococcal vaccine (MenABCWY) could increase convenience (e.g., fewer injections) and improve coverage. The objective was to quantify preferences for hypothetical meningococcal vaccine profiles among adolescents/young adults and parents.
METHODS: An online discrete choice experiment was conducted among 16- to 23-year-olds, and parents of 16- to 18-year-olds. Attributes (3 × 4) and levels (1 × 2) were based on the literature and focus groups. Participants made ten pair-wise forced trade-off choices, systematically varied using a D-optimal design. Random parameter logit quantified the relative importance of vaccination attributes and estimated the trade-offs. Differences in preferences by subgroups were assessed.
RESULTS: Totals of 300 adolescents and young adults (median age 20 years) and 300 parents (median age 46 years) completed the survey. Overall, 89.6% of 16- to 23-year-olds and 69.1% of parents preferred a simplified hypothetical meningococcal vaccination profile, e.g., with fewer injections (3 vs. 4) and fewer healthcare provider (HCP) visits (2-3 vs. 4). Having HCP advice and clear Centers for Disease Control and Prevention recommendations impacted vaccination choice, with both groups reporting high trust in HCP information (83.3% among 16- to 23-year-olds; 98.7% among parents). Barriers to vaccination included lack of HCP advice or awareness of meningococcal vaccines, and income level and out-of-pocket costs for parents.
CONCLUSIONS: Adolescents/young adults and parents demonstrated a significant preference for a meningococcal vaccine that is more convenient (such as combined MenABCWY). Parents\' vaccination preferences differed by income level and out-of-pocket costs, suggesting financial barriers to vaccination may exist which could result in IMD prevention inequalities. Findings from this study provide important information to support patient-facing informed policy discussions. A simplified vaccination schedule and strong recommendation could help improve vaccine uptake, schedule compliance, disease prevention, and reduce inequalities in IMD risk and prevention. A graphical abstract is available with this article.
METHODS: An online discrete choice experiment was conducted among 16- to 23-year-olds, and parents of 16- to 18-year-olds. Attributes (3 × 4) and levels (1 × 2) were based on the literature and focus groups. Participants made ten pair-wise forced trade-off choices, systematically varied using a D-optimal design. Random parameter logit quantified the relative importance of vaccination attributes and estimated the trade-offs. Differences in preferences by subgroups were assessed.
RESULTS: Totals of 300 adolescents and young adults (median age 20 years) and 300 parents (median age 46 years) completed the survey. Overall, 89.6% of 16- to 23-year-olds and 69.1% of parents preferred a simplified hypothetical meningococcal vaccination profile, e.g., with fewer injections (3 vs. 4) and fewer healthcare provider (HCP) visits (2-3 vs. 4). Having HCP advice and clear Centers for Disease Control and Prevention recommendations impacted vaccination choice, with both groups reporting high trust in HCP information (83.3% among 16- to 23-year-olds; 98.7% among parents). Barriers to vaccination included lack of HCP advice or awareness of meningococcal vaccines, and income level and out-of-pocket costs for parents.
CONCLUSIONS: Adolescents/young adults and parents demonstrated a significant preference for a meningococcal vaccine that is more convenient (such as combined MenABCWY). Parents\' vaccination preferences differed by income level and out-of-pocket costs, suggesting financial barriers to vaccination may exist which could result in IMD prevention inequalities. Findings from this study provide important information to support patient-facing informed policy discussions. A simplified vaccination schedule and strong recommendation could help improve vaccine uptake, schedule compliance, disease prevention, and reduce inequalities in IMD risk and prevention. A graphical abstract is available with this article.
摘要：
背景：侵袭性脑膜炎球菌病（IMD）是一种严重且危及生命的疾病。在美国（US），MenACWY和MenB脑膜炎球菌疫苗的疫苗覆盖率在16-23岁的青少年/年轻成年人中并不理想.联合脑膜炎球菌疫苗(MenABCWY)可以增加便利性(例如，减少注射)并提高覆盖率。目的是量化青少年/年轻人和父母对假设的脑膜炎球菌疫苗谱的偏好。
方法：在16至23岁的青少年中进行了在线离散选择实验，和16至18岁的父母。属性（3×4）和级别（1×2）基于文献和焦点组。参与者做出了十个成对强制权衡选择，使用D-最优设计系统地改变。随机参数logit量化了疫苗接种属性的相对重要性，并估计了权衡。评估了各亚组的偏好差异。
结果：共有300名青少年和年轻人（中位年龄20岁）和300名父母（中位年龄46岁）完成了调查。总的来说,89.6%的16至23岁儿童和69.1%的父母更喜欢简化的假设脑膜炎球菌疫苗接种概况。例如，注射次数较少(3vs.4）和更少的医疗保健提供者（HCP）访问（2-3vs.4).有HCP的建议和明确的疾病控制和预防中心的建议影响了疫苗接种的选择，两组均报告对HCP信息的信任度较高(16至23岁人群为83.3%;父母为98.7%).疫苗接种的障碍包括缺乏HCP建议或对脑膜炎球菌疫苗的认识，以及父母的收入水平和自付费用。
结论：青少年/年轻人和父母对更方便的脑膜炎球菌疫苗（如联合MenABCWY）有显著的偏好。父母的疫苗接种偏好因收入水平和自付费用而异，提示可能存在疫苗接种的财务障碍，这可能导致IMD预防不平等。这项研究的结果为支持面向患者的知情政策讨论提供了重要信息。简化的疫苗接种时间表和强有力的建议可以帮助提高疫苗的吸收，遵守时间表，疾病预防,减少IMD风险和预防方面的不平等。本文提供了图形摘要。
方法：在16至23岁的青少年中进行了在线离散选择实验，和16至18岁的父母。属性（3×4）和级别（1×2）基于文献和焦点组。参与者做出了十个成对强制权衡选择，使用D-最优设计系统地改变。随机参数logit量化了疫苗接种属性的相对重要性，并估计了权衡。评估了各亚组的偏好差异。
结果：共有300名青少年和年轻人（中位年龄20岁）和300名父母（中位年龄46岁）完成了调查。总的来说,89.6%的16至23岁儿童和69.1%的父母更喜欢简化的假设脑膜炎球菌疫苗接种概况。例如，注射次数较少(3vs.4）和更少的医疗保健提供者（HCP）访问（2-3vs.4).有HCP的建议和明确的疾病控制和预防中心的建议影响了疫苗接种的选择，两组均报告对HCP信息的信任度较高(16至23岁人群为83.3%;父母为98.7%).疫苗接种的障碍包括缺乏HCP建议或对脑膜炎球菌疫苗的认识，以及父母的收入水平和自付费用。
结论：青少年/年轻人和父母对更方便的脑膜炎球菌疫苗（如联合MenABCWY）有显著的偏好。父母的疫苗接种偏好因收入水平和自付费用而异，提示可能存在疫苗接种的财务障碍，这可能导致IMD预防不平等。这项研究的结果为支持面向患者的知情政策讨论提供了重要信息。简化的疫苗接种时间表和强有力的建议可以帮助提高疫苗的吸收，遵守时间表，疾病预防,减少IMD风险和预防方面的不平等。本文提供了图形摘要。
