Vaccine · 2025
Knowledge, perception, and practice regarding meningococcal vaccination in infants 3-7 months of age: A nationwide cross-sectional study in China.
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Xia Yilan, Guo Xiang, Fu Xiaoya, Wang Fengge, Lu Yihan
Аннотация
BACKGROUND: Meningococcal serogroup distribution evolves globally. In China, meningococcal polysaccharide vaccine (MPSV)-A is included in the National Expanded Program on Immunization (EPI) for infants at 6 months of age, while meningococcal polysaccharide conjugate vaccines (MPCV)-AC/ACYW are classified as non-EPI (self-paid) vaccines administered starting at 3 months of age. This study aimed to investigate the knowledge, perception, and practice of meningococcal vaccines among healthcare practitioners (HCPs) at points of vaccination (POVs) and caregivers of infants aged 3-7 months.
METHODS: A cross-sectional survey was conducted between January 2023 and December 2024 across 29 provinces in China. A total of 5069 HCPs at POVs and 148,269 caregivers of infants aged 3-7 months were enrolled. Structured questionnaires were distributed to collect data on vaccine knowledge, perception, preferences, and vaccination practice.
FINDINGS: Most HCPs (91·9 %) acknowledged the substantial burden of meningococcal disease. However, 99·4 % of HCPs reported uncertainty in meningococcal disease prevention, primarily due to insufficient public awareness (85·3 %). When selecting self-paid meningococcal vaccines, HCPs prioritized protective efficacy (73·1 %) and serogroup coverage (70·5 %), aligning with the priorities of caregivers choosing MPCV-ACYW (78·2 %). Conversely, caregivers choosing MPSV-A or MPCV-AC prioritized safety (42·2 % and 50·6 %, respectively) and cost-effectiveness (52·6 % and 42·7 %, respectively). Moreover, caregivers reported infants receiving the MPCV-ACYW experienced milder irritability and crying, and exhibited better overall safety and tolerability, compared to MPCV-AC (each p < 0·001). Additionally, 35·4 % of infants received simultaneous administration of their first-dose meningococcal vaccine and other vaccines. Simultaneous administration patterns of meningococcal vaccines and other vaccines differed by age and vaccine type.
INTERPRETATION: This study is the first to systematically determine the perceptions and practices of meningococcal vaccination from both HCPs and caregivers across provinces in China. Most HCPs acknowledged the necessity of early meningococcal vaccination and MPCV-ACYW effectiveness. The findings indicate a need to strengthen public awareness of meningococcal disease, implement tailored health advocacy, and promote multivalent meningococcal vaccines.
METHODS: A cross-sectional survey was conducted between January 2023 and December 2024 across 29 provinces in China. A total of 5069 HCPs at POVs and 148,269 caregivers of infants aged 3-7 months were enrolled. Structured questionnaires were distributed to collect data on vaccine knowledge, perception, preferences, and vaccination practice.
FINDINGS: Most HCPs (91·9 %) acknowledged the substantial burden of meningococcal disease. However, 99·4 % of HCPs reported uncertainty in meningococcal disease prevention, primarily due to insufficient public awareness (85·3 %). When selecting self-paid meningococcal vaccines, HCPs prioritized protective efficacy (73·1 %) and serogroup coverage (70·5 %), aligning with the priorities of caregivers choosing MPCV-ACYW (78·2 %). Conversely, caregivers choosing MPSV-A or MPCV-AC prioritized safety (42·2 % and 50·6 %, respectively) and cost-effectiveness (52·6 % and 42·7 %, respectively). Moreover, caregivers reported infants receiving the MPCV-ACYW experienced milder irritability and crying, and exhibited better overall safety and tolerability, compared to MPCV-AC (each p < 0·001). Additionally, 35·4 % of infants received simultaneous administration of their first-dose meningococcal vaccine and other vaccines. Simultaneous administration patterns of meningococcal vaccines and other vaccines differed by age and vaccine type.
INTERPRETATION: This study is the first to systematically determine the perceptions and practices of meningococcal vaccination from both HCPs and caregivers across provinces in China. Most HCPs acknowledged the necessity of early meningococcal vaccination and MPCV-ACYW effectiveness. The findings indicate a need to strengthen public awareness of meningococcal disease, implement tailored health advocacy, and promote multivalent meningococcal vaccines.