"You're not done if you give just one."
That's the catchphrase of a new initiative aimed at encouraging physicians to "strongly recommend and administer the second (booster) dose of meningococcal ACWY vaccine (MenACWY or 'MCV4') at age 16." The AAFP has joined several other medical groups and the CDC in signing on to a "Dear Colleague" letter(www.immunize.org) promoting the campaign that the Immunization Action Coalition (IAC) distributed Nov. 11.
Teens, in particular, are at increased risk of meningococcal meningitis from engaging in common activities such as sharing utensils and water bottles, as well as from coughing or kissing. The disease has a 10 percent to 15 percent fatality rate and can rapidly infect and overcome an otherwise healthy young patient, causing severe illness and even death in as little as 24 hours after the first symptoms appear.
The letter explains that in May 2005, the CDC's Advisory Committee on Immunization Practices (ACIP) published its recommendation to vaccinate all patients ages 11-12 with MCV4. In 2006, only 11.7 percent of adolescents ages 13-17 had received a dose of the vaccine. By 2013, however, coverage had ballooned, with 78 percent of patients age 13 having received one dose of MCV4.
In January 2011, the ACIP recommended a booster dose of MCV4 at age 16 to enhance the protection the vaccine confers during a period when patients are most vulnerable to meningococcal disease (ages 16-21). The committee's decision was based on evidence of waning immunity five years after the initial MCV4 vaccination. Administration of the second dose was found to induce a robust immune response that persisted for three to five years.
But now, more than four years later, only 28.5 percent of patients age 17 have received two doses of the vaccine.
"By vaccinating fewer than one in three eligible teens, we are leaving millions of young adults without the protection they need," say the groups in their letter.
"A provider's endorsement of vaccination has long been recognized as a key factor in improving immunization rates," the letter adds. "You are therefore in a perfect position to improve coverage by offering a strong, unequivocal recommendation for vaccination with a second dose of MCV4."
The groups recommend that physicians approach these patients during well visits, camp and sports physicals, visits for acute or chronic illness, and visits for other recommended immunizations.
To further bolster the campaign, the IAC has created an online resource(www.give2mcv4.org) that features additional ideas for improving MCV4 second-dose rates. The website offers free, downloadable educational materials and tools, including fact sheets, talking points, an overview of adolescent immunization recommendations, Q&A documents and other useful resources.