The Relationship Between Income Per Capita and Meningococcal Serogroup B Vaccination Rates in Greece: An Ecological Correlation Analysis

Author(s)

Nikitas G1, Akratos A2, Allmon AG3, Dalla Riva A2, Zacharioudaki M4, Lymperopoulou C5, Papagiannopoulou V2, Marijam A1
1GSK, Wavre, Belgium, 2GSK, Athens, Greece, 3GSK, Durham, NC, USA, 4IQVIA, Munich, Germany, 5IQVIA, Athens, Greece

OBJECTIVES: Annual Greek incidence of invasive meningococcal disease in children aged 0–4 years from 2004–2019 was 4.78 cases/100,000 population, with most cases caused by serogroup B. In Greece, the four-component meningococcal serogroup B vaccine (4CMenB), protecting against meningococcal serogroup B (MenB), is included in the national immunisation program for high-risk individuals only. As 4CMenB is not funded for the whole population, access to vaccination may vary due to socioeconomic factors. This study estimated 4CMenB vaccination rates across Greece and their association with gross domestic product (GDP) per capita (socioeconomic status proxy).

METHODS: In this retrospective, ecological correlation study, 4CMenB vaccination rate was estimated from an aggregated IQVIA sell-out database panel, covering ≥21% of pharmacies. Socioeconomic data was obtained from Eurostat and the National Statistical Institute. 4CMenB vaccination rate was estimated as total percentage of 4CMenB regimens (2 or 3 doses distributed between March 2019–February 2020), divided by doses required for a complete 2+1 schedule (2 doses for newborns, one dose for 1-year-olds). The correlation between regional 4CMenB vaccination rates and 2019 GDP per capita was investigated using Spearman’s correlation.

RESULTS: 4CMenB infant vaccination rate (40.2% national) was highest in South Aegean (47.3%) and Crete (45.2%), and lowest in Eastern Macedonia & Thrace (30.9%) and North Aegean (27.6%). There was a positive, statistically significant correlation between 4CMenB vaccination rates and GDP per capita (regional level: r=0.77, 95% CI 0.23–0.95 [p=0.005]; territorial level: r=0.39, 95% CI 0.07–0.64 [p=0.016]). This analysis was repeated and revealed no correlation between coverage and socioeconomic status for 3 fully reimbursed DtaP-IPV-HBV-Hib hexavalent vaccines.

CONCLUSIONS: This analysis shows that socioeconomic status may negatively impact vaccination rates of non-publicly funded vaccines, such as 4CMenB, at regional and territorial levels across Greece. Inclusion of 4CMenB into the National Immunisation Program could reduce the inequity seen in vaccination rates.

Conference/Value in Health Info

2024-11, ISPOR Europe 2024, Barcelona, Spain

Value in Health, Volume 27, Issue 12, S2 (December 2024)

Code

HPR118

Topic

Health Policy & Regulatory, Patient-Centered Research

Topic Subcategory

Health Disparities & Equity, Patient Behavior and Incentives

Disease

Pediatrics, Vaccines

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