Efficacy of Meningococcal Vaccine and Barriers to Vaccination

Rosenstein, Nancy E.; Levine, Orin S.; Taylor, Jeffery P.; Evans, Deborah; Plikaytis, Brian D.; Wenger, Jay D.; Perkins, Bradley A.

doi:10.1001/jama.279.6.435

Cited by 105 publications

(58 citation statements)

References 22 publications

(16 reference statements)

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“…A serogroup B meningococcal vaccine is not available. The immunnogenicity and clinical efficacy of serogroup A and C vaccines have been well established in young adults (9,10). The bivalent (A/C) or quadrivalent (A/C/Y/W135) meningococcal vaccine may be effective in the Korean Army.…”

Section: Discussionmentioning

confidence: 99%

Meningococcal Disease in the Republic of Korea Army: Incidence and Serogroups Determined by PCR

et al. 2003

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This study was performed to determine the incidence and serogroups of meningococcal disease in the Korean Army. From August 2000 to July 2001, we identified prospective cases in the Korean Army. Meningococcal disease was confirmed by isolation of Neisseria meningitidis or detection of its antigen by latex agglutination from cerebrospinal fluid (CSF) or blood. Polymerase chain reactions (PCRs) were performed in the crgA gene to identify N. meningitidis regardless of its serogroup, and then in orf-2 (serogroup A) and siaD (serogroups B, C, Y, and W135) respectively for serogroup prediction. During the study period, twelve patients (four meningitis and eight septicaemia) were identified. The annual incidence was 2.2 per 100,000 (95% confidence interval, 1.3-3.8) among 550,000 private soldiers. Latex agglutinations were positive to A/C/Y/W135 polyvalent latex, but not to B latex in all patients. PCRs of crgA gene were positive in ten patients, whose samples (2 isolates from CSF, 2 CSFs, and 6 sera) were stored. In PCRs for serogroup prediction, one isolate was serogroup A, and one isolate and two sera were serogroup C. The need for meningococcal vaccination would be considered in the Korean Army through the cost-benefit analysis based on the result of this study.

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Section: Discussionmentioning

confidence: 99%

Meningococcal Disease in the Republic of Korea Army: Incidence and Serogroups Determined by PCR

et al. 2003

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“…Due to that diversity and to the fact that in the United States it is mainly associated with sporadic meningococcal disease, PFGE analysis would not be particularly useful for epidemiological purposes. PFGE has been used as a tool to molecularly characterize NMSC isolates from sporadic cases of meningococcal disease and in NMSC outbreak investigations (3,7,8,18,28 We chose four well-described NMSC outbreaks occurring from 1993 to 1995 in Texas, New Mexico, Arizona, and California (15,22,26) to systematically evaluate the potential of PFGE to identify outbreak-associated isolates. We also included in the study 26 NMSC isolates, representing sporadic disease in the United States, collected through the active laboratory-based surveillance program from 1989 to 1996.…”

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confidence: 99%

Evaluation of Pulsed-Field Gel Electrophoresis in Epidemiological Investigations of Meningococcal Disease Outbreaks Caused by Neisseria meningitidis Serogroup C

et al. 2001

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Since 1990, the frequency of Neisseria meningitidis serogroup C (NMSC) outbreaks in the United States has increased. Based on multilocus enzyme electrophoresis (MEE), the current molecular subtyping standard, most of the NMSC outbreaks have been caused by isolates of several closely related electrophoretic types (ETs) within the ET-37 complex. We chose 66 isolates from four well-described NMSC outbreaks that occurred in the United States from 1993 to 1995 to evaluate the potential of pulsed-field gel electrophoresis (PFGE) to identify outbreak-related isolates specific for each of the four outbreaks and to differentiate between them and 50 sporadic isolates collected during the outbreak investigations or through active laboratory-based surveillance from 1989 to 1996. We tested all isolates collected during the outbreak investigations by four other molecular subtyping methods: MEE, ribotyping (ClaI), random amplified polymorphic DNA assay (two primers), and serotyping and serosubtyping. Among the 116 isolates, we observed 11 clusters of 39 NheI PFGE patterns. Excellent correlation between the PFGE and the epidemiological data was observed, with an overall sensitivity of 85% and specificity of 71% at the 95% pattern relatedness breakpoint using either 1.5 or 1.0% tolerance. For all four analyzed outbreaks, PFGE would have given public health officials additional support in declaring an outbreak and making appropriate public health decisions.

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“…Serogroup A and C polysaccharide vaccines have demonstrated estimated clinical efficacies of more than 85% in school-aged children and adults and are useful in controlling outbreaks. 16,17 Serogroup Y and W-135 polysaccharide vaccines are safe and immunogenic in children older than 2 years and adults, and although clinical efficacy has not been documented, immunization with these polysaccharide vaccines induces high titers of serum bactericidal antibodies, a correlate of protection. The antibody responses to each of the 4 polysaccharides in the tetravalent polysaccharide vaccine are serogroup-specific and independent.…”

Section: Immunogenicity and Efficacymentioning

confidence: 99%

Prevention and Control of Meningococcal Disease: Recommendations for Use of Meningococcal Vaccines in Pediatric Patients

2005

Pediatrics

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Two peaks in the incidence of invasive meningococcal disease (IMD) occur in pediatric patients: infants younger than 1 year and adolescents 15 to 18 years of age. Although the incidence of IMD is highest in infants, the case-fatality rate is highest in adolescents (∼20%). Epidemiologic studies also have demonstrated increased risk of IMD among college freshman living in dormitories compared with other college students and similarly aged persons in the general population. At least 75% of cases of IMD in 11- to 18-year-olds are caused by serogroups A, C, Y, and W-135; thus, IMD potentially is preventable by immunization with quadrivalent meningococcal vaccines. Meningococcal A, C, Y, W-135 conjugate vaccine (MCV4) was licensed in 2005 for use in people 11 to 55 years of age. On the basis of data indicating increased risk of meningococcal disease and fatality among certain adolescents and college students, the American Academy of Pediatrics recommends administration of MCV4 to young adolescents (at the 11- to 12-year visit), students entering high school or 15-year-olds, and college freshmen who will be living in dormitories. For pediatric patients 11 years and older who are at increased risk of meningococcal disease, MCV4 also is recommended. The purposes of this statement are to provide the rationale for routine use of MCV4 in adolescents and to update recommendations for use of the meningococcal polysaccharide vaccine in pediatric patients.

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Efficacy of Meningococcal Vaccine and Barriers to Vaccination

Cited by 105 publications

References 22 publications

Meningococcal Disease in the Republic of Korea Army: Incidence and Serogroups Determined by PCR

Meningococcal Disease in the Republic of Korea Army: Incidence and Serogroups Determined by PCR

Evaluation of Pulsed-Field Gel Electrophoresis in Epidemiological Investigations of Meningococcal Disease Outbreaks Caused by Neisseria meningitidis Serogroup C

Prevention and Control of Meningococcal Disease: Recommendations for Use of Meningococcal Vaccines in Pediatric Patients

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