{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:27:36Z","timestamp":1787855256383,"version":"build-2784847793"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Meningococcal disease is a serious but rare disease in the United States. Prior publications suggest incidence differs among privately vs publicly-insured persons, and that incidence is higher among persons experiencing homelessness (PEH) than persons not known to be experiencing homelessness (non-PEH). Using insurance claims data for persons aged &lt;1 to 64 years, we calculated meningococcal disease incidence among a population with employer-sponsored commercial insurance and persons enrolled in state Medicaid programs nationwide. We also examined meningococcal disease incidence by PEH status in Medicaid data. From 2016 through 2019, persons who met our study inclusion criteria contributed a total of 84,460,548 person-years (PYs) to our analysis of commercial insurance data and 253,496,622 PYs to our analysis of Medicaid data. Incidence was higher among persons enrolled in Medicaid (0.12 cases per 100,000 PYs) than persons with commercial insurance (0.06 cases per 100,000 PYs). Incidence was 3.17 cases per 100,000 PYs among PEH in Medicaid, 27 times higher than among non-PEH in Medicaid. Understanding the underlying drivers of the higher meningococcal disease incidence among PEH and persons enrolled in Medicaid may inform prevention strategies for populations experiencing a higher burden of disease.<\/jats:p>","DOI":"10.1371\/journal.pone.0293070","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T17:48:42Z","timestamp":1697737722000},"page":"e0293070","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Differences in meningococcal disease incidence by health insurance type and among persons experiencing homelessness\u2014United States, 2016\u20132019"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0998-8444","authenticated-orcid":true,"given":"Cheryl J.","family":"Isenhour","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel J.","family":"Crowe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy A.","family":"McNamara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,10,19]]},"reference":[{"key":"pone.0293070.ref001","year":"2022","journal-title":"Centers for Disease Control and Prevention Meningococcal Disease Surveillance"},{"issue":"9","key":"pone.0293070.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6909a1","article-title":"Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020.","volume":"69","author":"SA Mbaeyi","year":"2020","journal-title":"MMWR Recomm Rep."},{"issue":"10","key":"pone.0293070.ref003","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1097\/00006454-199710000-00015","article-title":"Tobacco smoke as a risk factor for meningococcal disease.","volume":"16","author":"M Fischer","year":"1997","journal-title":"Pediatr Infect Dis J"},{"issue":"8","key":"pone.0293070.ref004","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.4161\/hv.29303","article-title":"Burden of vaccine-preventable disease in adult Medicaid and commercially insured populations: analysis of claims-based databases, 2006\u20132010.","volume":"10","author":"G Krishnarajah","year":"2014","journal-title":"Hum Vaccin Immunother"},{"issue":"Supplement_3","key":"pone.0293070.ref005","doi-asserted-by":"crossref","first-page":"S322","DOI":"10.1093\/infdis\/jiac230","article-title":"Invasive Meningococcal Disease Among People Experiencing Homelessness-United States, 2016\u20132019","volume":"226","author":"KC Rudmann","year":"2022","journal-title":"J Infect Dis"},{"key":"pone.0293070.ref006","journal-title":"Centers for Medicare & Medicaid Services, Transofrmed Medicaid Statistical Information System (T-MSIS)"},{"key":"pone.0293070.ref007","year":"2022","journal-title":"Merative MarketScan Research Databases"},{"key":"pone.0293070.ref008","journal-title":"Title XXI-State Children\u2019s Health Insurance Program"},{"key":"pone.0293070.ref009","year":"1900","journal-title":"Title XIX-Grants to States for Medical Assistance Programs"},{"key":"pone.0293070.ref010","journal-title":"About the Affordable Care Act"},{"key":"pone.0293070.ref011","journal-title":"Centers for Medicare and Medicaid Services, Medicaid Eligibility"},{"key":"pone.0293070.ref012","year":"2022","journal-title":"National Notifiable Diseases Surveillance System (NNDSS)"},{"issue":"4","key":"pone.0293070.ref013","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1177\/003335490712200413","article-title":"Medicaid\/State Children\u2019s Health Insurance Program patients and infectious diseases treated in emergency departments: U.S., 2003","volume":"122","author":"N. 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