Open Access Open Badges Research article

Uptake of meningococcal conjugate vaccine among adolescents in large managed care organizations, United States, 2005: Demand, supply and seasonality

Suchita A Lorick12*, Daniel Fishbein13, Eric Weintraub4, Pascale M Wortley1, Grace M Lee5, Fangjun Zhou1 and Robert Davis46

Author Affiliations

1 Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control & Prevention, 1600 Clifton Road, MS E-52, Atlanta, Georgia, 30333, USA

2 Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-52, Atlanta, GA 30333, USA

3 Division of Global Migration and Quarantine, National Center for Preparedness, Detection, and Control of Infectious Diseases, Center for Disease Control and Prevention, 1600 Clifton Road, MS E-03, Atlanta, GA 30333, USA

4 Immunization Safety Office, Centers for Disease Control and Prevention, 1600 Clifton Road, MS D-26, Atlanta, GA 30333, USA

5 Department of Ambulatory Care & Prevention, Harvard Medical School & Harvard Pilgrim Health Care, Department of Population Medicine, 133 Brookline Avenue, 6th floor, Boston, MA 02215, USA

6 Center for Health Research, Southeast, Kaiser Permanente, Center for Health Research, Southeast, 10 Piedmont Center, 3495 Piedmont Road NE, Suite 205, Atlanta, GA 30305, USA

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BMC Infectious Diseases 2009, 9:175  doi:10.1186/1471-2334-9-175

Published: 3 November 2009



In February 2005, the US Advisory Committee on Immunization Practices recommended the new meningococcal conjugate vaccine (MCV4) for routine use among 11- to 12-year-olds (at the preadolescent health-care visit), 14- to 15-year-olds (before high-school entry), and groups at increased risk. Vaccine distribution started in March; however, in July, the manufacturer reported inability to meet demand and widespread MCV4 shortages were reported. Our objectives were to determine early uptake patterns among target (11-12 and 14-15 year olds) and non-target (13- plus 16-year-olds) age groups. A post hoc analysis was conducted to compare seasonal uptake patterns of MCV4 with polysaccharide meningococcal (MPSV4) and tetanus diphtheria (Td) vaccines.


We analyzed data for adolescents 11-16 years from five managed care organizations participating in the Vaccine Safety Datalink (VSD). For MCV4, we estimated monthly and cumulative coverage during 2005 and calculated risk ratios. For MPSV4 and Td, we combined 2003 and 2004 data and compared their seasonal uptake patterns with MCV4.


Coverage for MCV4 during 2005 among the 623,889 11-16 years olds was 10%. Coverage for 11-12 and 14-15 year olds was 12% and 11%, respectively, compared with 8% for 13- plus 16-year-olds (p < 0.001). Of the 64,272 MCV4 doses administered from March-December 2005, 73% were administered June-August. Fifty-nine percent of all MPSV4 doses and 38% of all Td doses were administered during June-August.


A surge in vaccine uptake between June and August was observed among adolescents for MCV4, MPSV4 and Td vaccines. The increase in summer-time vaccinations and vaccination of non-targeted adolescents coupled with supply limitations likely contributed to the reported shortages of MCV4 in 2005.