Risk of Invasive Meningococcal Disease in Children Aged 11 Years in the United States

Abstract Background Invasive meningococcal disease (IMD) is associated with high case-fatality rates and severe long-term sequelae. In the United States (US), IMD incidence rate (IR) is highest among infants aged 1 year, with most cases occurring in infants aged 6 months. This study estimated IMD incidence in commercially- and Medicaid-insured infants, toddlers, and children aged 11 years. Methods This retrospective claims analysis utilized real-world data (1/1/2005–12/31/2022) from the MarketScan® Commercial and Multi-State Medicaid Research Databases of infants (aged 1 year), toddlers (aged 1–4 years), and children (aged 5–10 years). IMD incidence, time at risk for IMD, IR, and IR ratio (IRR) were evaluated overall and by demographic/clinical characteristics. Results Within the commercially- and Medicaid-insured cohorts, 21 and 115 infants, 34 and 80 toddlers, and 36 and 37 children with IMD were identified, respectively. Overall IMD IRs in infants, toddlers, and children were 0.45, 0.17, and 0.11 per 100,000 person-years (PY; commercially-insured) and 1.97, 0.45, and 0.18 per 100,000 PYs (Medicaid-insured), respectively. IRs were highest in infants aged 4 months (1.03 and 4.65 per 100,000 PY for infants aged 2–3 months commercially-insured and 1–2 months Medicaid-insured, respectively). Significantly elevated IRRs were observed among infants and children with specific demographic and clinical characteristics, including residence in rural counties, immunocompromised status, and complement component deficiency. Conclusion IMD incidence is low in the US, but varies by age, insurance type, and demographic/clinical characteristics. Timely preventative interventions, such as early vaccination, may reduce the incidence, risk, and associated burden of IMD.