The Epidemiological Impact of Antimeningococcal B Vaccination in Cuba

Abstract

The incidence of invasive meningococcal disease (IMD) before (1984-1988) and after (1989-1994), a nationwide intervention with VA-MENGOC-BC vaccination started in 1989, was compared. The prevaccination period incidence density was higher than the postvaccination ID (ID< 6.5/ 10 5 ID between 1989 and 1990 in children under 1 year old, 5-9, 10-14, 15-19 and 50-54 year-person). The percentage proportional differences from the start to the end of each period of ID in the vaccinal period was higher (87%) than the prevaccinal (37%) with significant differences among vaccinated groups (< 25 years old). A break-point (Chow test) was confirmed by the decrease in the

Clonal Distribution of Disease-Associated and Healthy Carrier Isolates ofNeisseria meningitidisbetween 1983 and 2005 in Cuba

“…Serogroup W135 and Z isolates were obtained only from carriers. These results corroborate previous findings that serogroup B was dominant in Cuba before and after the introduction of a serogroup B and C vaccine (31,41).…”

“…The epidemiological impact of VA-MENGOC-BC vaccination has previously been reported to be a reduction in morbidity from meningococcal disease in Cuba (41) We illustrate here the changes in the structure of the meningococcal population that occurred during the same period of time, in terms of the variation of MLST genes and its associations. In agreement with the results obtained by the phenotypic characterization of carrier strains (31), our molecular study demonstrates that VA-MENGOC-BC affected the genetic composition of the carrier-associated meningococcal isolates.…”

“…The prevalence of this phenotype after the introduction of the Cuban vaccine has previously been reported in Cuba (40) and Brazil (3,13). However, in Cuba, where VA-MENGOC-BC is used systematically, the vaccine has had a dramatic impact on the morbidity and mortality from the disease (41). In Brazil, only a proportion of the population was vaccinated in response to specific epidemiological situations (14,33,38), a fact that could explain the persistence of antigenic variants of the ST-33 epidemic strain.…”

“…MD in Cuba has not been considered a public health prob-lem since the introduction of an outer membrane vesicle (OMV)-based vaccine (VA-MENGOC-BC) in the 1980s (16,41,46). The incidence of MD in the country slowly increased from a reported figure of 0.1 cases per 100,000 inhabitants in 1962 to 1.8 cases per 100,000 inhabitants in 1978, with most cases caused by serogroup C isolates.…”

Comparison and Correlation of Neisseria meningitidis Serogroup B Immunologic Assay Results and Human Antibody Responses following Three Doses of the Norwegian Meningococcal Outer Membrane Vesicle Vaccine MenBvac

“…These findings may be of particular importance in countries where MenB disease is of a multiclonal nature such as in The Netherlands and the United Kingdom. How-ever, OMV vaccination has successfully contributed to the control of a clonal MenB epidemic in Cuba (39,42) and subsequent outbreaks in Brazil (10). Furthermore, the introduction of a "tailor-made" OMV vaccine is hoped to curtail the continuing clonal MenB epidemic in New Zealand (35).…”