Since 2011, the Advisory Committee on Immunization Practices (ACIP) guidelines for regular MenACWY immunization in the United States have included a main dose before the age of 16, ideally between the ages of 11 and 12, followed by a booster dose at the age of 16. There is a scarcity of data on the rates and factors influencing meningococcal vaccination completion and adherence to recommendations at the state level. This study examined the rates and determinants of MenACWY vaccine completion and compliance in teenagers aged 17 years. Individual- and state-level factors of completion and compliance were studied using univariable and multivariable regression models. The national average rates for completion and compliance were 23.2 percent and 12.1 percent, respectively, with significant inter-state variance. Aside from state of residence, variables linked with a higher chance of completion and compliance were being male, being up-to-date on other regular vaccinations, having private or hospital-based vaccine providers, and having more than one kid in the home. Having >1 yearly health-care visit and the availability of a booster-dose vaccination requirement were particularly related with completion, whereas a history of asthma and high-risk health problems were associated with compliance.

The pediatrician-to-child ratio and the proportion of teenagers using the Immunization Information System were state-level predictors of completion and compliance, respectively. The findings of this study might assist drive clinical, policy, and educational efforts to enhance MenACWY completion rates and minimize vaccination inequalities.