Impact of an Immunization Campaign to Control an Increased Incidence of Serogroup B Meningococcal Disease in One Region of Quebec, Canada

Wals, Philippe De; Deceuninck, Geneviève; Lefebvre, Brigitte; Tsang, Raymond S. W.; Law, Dennis K. S.; Serres, Gaston De; Gîlca, Vladimir; Gilca, Rodica; Boulianne, Nicole

doi:10.1093/cid/cix154

Cited by 61 publications

(62 citation statements)

References 10 publications

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“…The 75% uptake rate was estimated from immunization rates reported for school vaccination programs in Ontario for the 2012 to 2013 school year (Ontario Agency for Health Protection and Promotion (Public Health Ontario) 2014). The 30% uptake rate for 17-year-olds was an assumption for vaccination outside of a school setting for older adolescents and is consistent with the 34% uptake rate observed among 17-to 20-year-olds during the 2014 Saguenay Lac St-Jean immunization campaign (De Wals et al 2017). All adolescents in the target groups were assumed to receive 2 doses of the MenB-FHbp vaccine.…”

Section: Vaccination Scenariossupporting

confidence: 69%

“…IMD is endemic in Canada and the majority of cases are caused by serogroup B (MnB) (National Advisory Committee on Immunization 2014; Li et al 2014), including the recent outbreak in Nova Scotia, as well as the prolonged increased incidence in the province of Quebec (De Wals et al 2017;Langley et al 2016;Nova Scotia Department of Health and Wellness 2015). Serogroup B meningococcus was responsible for 63% of all IMD cases in Canada between 2011 and 2015 (Public Health Agency of Canada 2017).…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness of alternative strategies for vaccination of adolescents against serogroup B IMD with the MenB-FHbp vaccine in Canada

Breton

Huang

Snedecor

et al. 2020

Can J Public Health

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Objective Serogroup B meningococci (MnB) are now the largest cause of invasive meningococcal disease (IMD) in Canada. We assessed the clinical and economic impact of 3 adolescent MenB-FHbp immunization strategies. Methods A population-based dynamic transmission model was developed to simulate the transmission of MnB among the entire Canadian population over a 30-year time horizon. Age group-based IMD incidence, bacterial carriage and transmission, disease outcomes, costs, and impact on quality of life were obtained from Canadian surveillance data and published literature. The vaccine was assumed to provide 85% protection against IMD and 26.6% against carriage acquisition. The model estimated the impact of routine vaccination with MenB-FHbp in 3 strategies: (1) age 14, along with existing school-based programs, with 75% uptake; (2) age 17 with 75% uptake, assuming school vaccination; and (3) age 17 with 30% uptake, assuming vaccination outside of school. Costs were calculated from the Canadian societal perspective. Results With no vaccination, an estimated 3974 MnB cases would be expected over 30 years. Vaccination with strategies 1-3 were estimated to avert 688, 1033, and 575 cases, respectively. These outcomes were associated with incremental costs per quality-adjusted life-year of $976,000, $685,000, and $490,000.Conclusions Our model indicated that if the vaccine reduces risk of carriage acquisition, vaccination of older adolescents, even at lower uptake, could have a significant public health impact. Due to low disease incidence, MnB vaccination is unlikely to meet widely accepted cost-effectiveness thresholds, but evaluations of new programs should consider the overall benefits of the vaccination. en milieu scolaire, à un taux de vaccination de 75 %; (2) immunisation à l'âge de 17 ans, en milieu scolaire, à un taux de vaccination de 75 %; et (3) immunisation à l'âge de 17 ans, à un taux de vaccination de 30 %, en contexte extrascolaire. Les coûts ont été calculés en fonction de la perspective sociétale canadienne. Résultats Sans immunisation, le nombre estimé de cas de méningococcie du sérogroupe B serait de 3974 sur une période de 30 ans. Selon le modèle, les stratégies de vaccination 1 à 3 préviendraient respectivement 688, 1033 et 575 cas. Ces résultats ont été associés à des coûts différentiels par année de vie gagnée ajustée par la qualité (QALY) de 976 000 $, 685 000 $ et 490 000 $. Conclusions Le modèle utilisé dans le cadre de l'analyse a permis d'indiquer que si le vaccin réduisait le risque d'acquisition du portage, la vaccination des adolescents plus vieux, même en présence de taux de vaccination plus faibles, pouvait avoir des répercussions significatives sur la santé publique. En raison de la faible incidence de la maladie, il est peu probable que la vaccination contre le MnB respecte les seuils généralement acceptés en matière de coût-efficacité, mais l'évaluation de nouveaux programmes devrait tenir compte de l'ensemble des bienfaits associés à la vaccination.

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Section: Vaccination Scenariossupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of alternative strategies for vaccination of adolescents against serogroup B IMD with the MenB-FHbp vaccine in Canada

Breton

Huang

Snedecor

et al. 2020

Can J Public Health

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“…Of 59,000 target residents aged under 20-years 82% were vaccinated in the 7 months to 31 December 2014. There were four cases in unvaccinated persons and none among the vaccinated, 25 providing early indications of vaccine effectiveness.…”

Section: Norwaymentioning

confidence: 90%

Impact of meningococcal group B OMV vaccines, beyond their brief

Petousis‐Harris

2017

Human Vaccines & Immunotherapeutics

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Meningococcal group B outer membrane vesicle vaccines have been used widely in Cuba, New Zealand, and Brazil. They are immunogenic and initially assessed largely by their ability to induce serum bactericidal activity. Measures of efficacy indicate good protection against homologous strains in older children and adults. Effectiveness appears broader than predicted by immunogenicity and efficacy studies. The recent discovery that meningococcal group B OMVs may protect against the related Neisseria species N.gonorrhoeae suggests more to these interesting antigen collections than meets the eye. Currently there are two OMV-containing group B vaccines available, the new recombinant protein-based Bexsero® developed by Novartis and VA-MENGOC-BC® developed by the Finlay institute in Cuba. Also, a third group B vaccine based on two recombinant factor H binding proteins (Trumenba®, Pfizer), has recently been licenced but it does not include OMV. This commentary explores the population impact that group B OMV vaccines have had on meningococcal and gonorrhoea diseases. Given the heterologous effect against diverse strains of the meningococcus observed in older children and adults, and recent evidence to suggest moderate protection against gonorrhoea, there may be a role for these vaccines in programmes targeting adolescents and groups high at risk for both meningococcal disease and gonorrhoea.

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“…Data on the effectiveness of 4CMenB continue to accumulate as vaccination programs are implemented across various countries and in different age groups. In individuals 2 months to 20 years of age, 4CMenB vaccination led to a significant reduction in relative disease risk (0.22), at 2 years after the start of a mass vaccination campaign in the Saguenay-Lac-Saint-Jean region of Canada (De Wals et al, 2017). A two-dose vaccine effectiveness of 82.9% was also estimated following the implementation of 4CMenB in the national immunization program in the UK, over 10 months of use in infants (Parikh et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Potential benefits of using a multicomponent vaccine for prevention of serogroup B meningococcal disease

Watson

Novy

Friedland

2019

International Journal of Infectious Diseases

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Impact of an Immunization Campaign to Control an Increased Incidence of Serogroup B Meningococcal Disease in One Region of Quebec, Canada

Abstract: Results suggest a high level of protection provided by MenB-4C following mass vaccination at regional level. This, along with reassuring safety data, supports the current recommendations for MenB-4C use for controlling outbreaks caused by clones covered by the vaccine.

Cited by 61 publications

References 10 publications

Cost-effectiveness of alternative strategies for vaccination of adolescents against serogroup B IMD with the MenB-FHbp vaccine in Canada

Cost-effectiveness of alternative strategies for vaccination of adolescents against serogroup B IMD with the MenB-FHbp vaccine in Canada

Impact of meningococcal group B OMV vaccines, beyond their brief

Potential benefits of using a multicomponent vaccine for prevention of serogroup B meningococcal disease

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