From Qualitative Research to Quantitative Preference Elicitation: An Example in Invasive Meningococcal Disease.

BACKGROUND: Qualitative research is fundamental for designing discrete choice experiments (DCEs) but is often underreported in the preference literature. We developed a DCE to elicit preferences for vaccination against invasive meningococcal disease (IMD) among adolescents and young people (AYP) and parents and legal guardians (PLG) in the United States. This article reports the targeted literature review and qualitative interviews that informed the DCE design and demonstrates how to apply the recent reporting guidelines for qualitative developmental work in preference studies. METHODS: This study included two parts: a targeted literature review and qualitative interviews. The Medline and Embase databases were searched for quantitative and qualitative studies on IMD and immunization. The results of the targeted literature review informed a qualitative interview guide. Sixty-minute, online, semi-structured interviews with AYP and PLG were used to identify themes related to willingness to be vaccinated against IMD. Participants were recruited through a third-party recruiter's database and commercial online panels. Interviews included vignettes about IMD and vaccinations and three thresholding exercises examining the effect of incidence rate, disability rate, and fatality rate on vaccination preferences. Participant responses related to the themes were counted. RESULTS: The targeted literature review identified 31 concepts that were synthesized into six topics for the qualitative interviews. Twenty AYP aged 16-23 years and 20 PLG of adolescents aged 11-17 years were interviewed. Four themes related to willingness to be vaccinated emerged: attitudes towards vaccination, knowledge and information, perception of IMD, and vaccine attributes. Most participants were concerned about IMD (AYP 60%; PLG 85%) and had positive views of vaccination (AYP 80%; PLG 60%). Ninety percent of AYP and 75% of PLG always chose vaccination over no vaccination, independent of IMD incidence rate, disability rate, or fatality rate. CONCLUSION: Willingness to be vaccinated against IMD was affected by vaccine attributes but largely insensitive to IMD incidence and severity. This article provides an example of how to apply the recent reporting guidelines for qualitative developmental work in preference studies, with 21 out of 22 items in the guidelines being considered.

Epidemiological burden of meningococcal disease in Latin America: A systematic literature review.

OBJECTIVE: To evaluate the epidemiological profile of invasive meningococcal disease (IMD), meningococcal meningitis, and Neisseria meningitidis carriers in Latin America. METHODS: A systematic review was conducted to identify and analyze studies published in 2008-2018. Incidence rates, case fatality rates (CFRs), and the relative distribution of cases per serogroup by country were assessed. RESULTS: Meningococcal surveillance in Latin America differs among countries, and most systems are based on passive sentinel surveillance. Thirty-nine studies were selected. In 2006, the incidence rate of IMD per 100 000 inhabitants was highest in Brazil (1.9), followed by Uruguay (1.3), Chile (0.8), Argentina (0.7), Colombia and Venezuela (0.3 each), and Mexico (0.06). Brazil reported the highest CFR (20%), followed by Uruguay (15%), Chile (11%), and Venezuela and Argentina (10% each). In 2012, the CFR in Chile increased to approximately 27%. The most frequent serogroups among IMD cases were C in Brazil (2007-2010) and Mexico (2005-2016), W in Chile (2012-2018), and B in Argentina (2012-2015). However, the true burden of IMD in Latin America is probably underestimated due to underreporting of cases. CONCLUSIONS: Improvements in IMD notification, IMD registration, national surveillance programs (including active surveillance systems), diagnostic tools, and characterization of isolates may better elucidate the true epidemiological burden of IMD in Latin America.