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Increase in Meningococcal Disease Among Persons With HIV

Core Concepts
Low MenACWY vaccine coverage among persons with HIV leads to an increase in meningococcal disease cases.
The content discusses the rise in meningococcal disease cases among individuals with HIV in the United States, particularly focusing on the year 2022. It highlights the importance of MenACWY vaccination for this population and the concerning low coverage rates. The report emphasizes the need for healthcare providers to ensure proper vaccination and vigilance for symptoms of meningococcal disease in persons with HIV. Meningococcal disease is a life-threatening illness caused by Neisseria meningitidis. Symptoms of meningitis and meningococcemia include fever, headache, stiff neck, chills, fatigue, vomiting, diarrhea, cold hands and feet, and severe aches or pain. MenACWY vaccination is recommended for adolescents and individuals at risk for meningococcal disease, including those with HIV. Only 16.3% of persons with HIV received ≥1 doses of MenACWY vaccine within 2 years after diagnosis. A significant increase in meningococcal disease cases among persons with HIV was reported in 2022. Data is based on preliminary information, and case counts may rise with final reporting. MenACWY vaccine coverage among persons with HIV is low, necessitating healthcare providers to ensure vaccination adherence. A large serogroup C outbreak primarily affected men who have sex with men, but a notable increase in cases among persons with HIV remained. A single strain of N. meningitidis serogroup Y caused nine cases among persons with HIV in 2022, predominantly in Black or African American individuals and MSM. Healthcare providers are advised to screen all persons with HIV for meningococcal disease symptoms and ensure proper vaccination.
In a study from January 2016 to March 2018, only 16.3% of persons with HIV received ≥1 doses of MenACWY vaccine within 2 years after their diagnosis. 29 meningococcal disease cases have been reported among persons with HIV in 2022, accounting for 9.8% of all cases. Among the 29 cases in 2022, 22 had not received MenACWY vaccine, six had unknown vaccination history, and one had received the vaccine, but the number of doses was unknown.
"MenACWY vaccine coverage among persons with HIV is low." "Health care providers should ensure that all persons with HIV are up to date with MenACWY vaccination per ACIP recommendations."

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by Amy B. Rubis at 08-28-2023
Increase in Meningococcal Disease Among Persons With HIV

Deeper Inquiries

How can public health campaigns be improved to increase MenACWY vaccine coverage among persons with HIV?

To enhance MenACWY vaccine coverage among persons with HIV, public health campaigns should focus on targeted outreach efforts within the HIV community. This can involve collaborating with HIV clinics, support groups, and community organizations to raise awareness about the importance of vaccination. Tailored educational materials should be developed to address specific concerns or misconceptions that individuals with HIV may have regarding vaccines. Utilizing social media platforms and other digital communication channels can also help reach a wider audience and provide easily accessible information about MenACWY vaccination. Additionally, offering vaccination clinics at HIV care facilities or during routine medical appointments can streamline the vaccination process and improve accessibility for individuals with HIV.

What are the potential barriers to vaccination adherence in this population, and how can they be addressed?

Several barriers may contribute to low vaccination adherence among persons with HIV, including lack of awareness about the need for vaccines, concerns about vaccine safety and efficacy, limited access to healthcare services, and stigma associated with HIV status. To address these barriers, healthcare providers should engage in proactive discussions with patients about the importance of vaccination as part of their overall healthcare management. Providing clear and accurate information about the benefits of vaccination in preventing serious diseases like meningococcal disease is crucial. Offering vaccination services at no cost or through insurance coverage can help mitigate financial barriers. Addressing stigma through education and community support can also encourage individuals with HIV to prioritize their health through vaccination.

How can the healthcare system better integrate vaccination protocols for individuals with HIV to prevent diseases like meningococcal disease?

To improve the integration of vaccination protocols for individuals with HIV, healthcare systems should implement standardized screening processes to identify vaccination needs based on individual risk factors, including HIV status. Electronic health records can be utilized to track vaccination history and send reminders for upcoming or overdue vaccinations. Healthcare providers should receive training on the latest vaccination recommendations for persons with HIV and be equipped to address any concerns or questions that patients may have. Collaborative efforts between primary care providers, infectious disease specialists, and public health agencies can help ensure comprehensive vaccination coverage for individuals with HIV. Additionally, establishing partnerships with community resources and advocacy groups can support ongoing vaccination initiatives and promote a culture of preventive healthcare within the HIV population.