Impact of the meningococcal C conjugate vaccine in Spain: an epidemiological and microbiological decision

Abstract

The new meningococcal C conjugate vaccine became available in Spain and was included in the infant vaccination schedule in 2000. A catch-up campaign was carried out in children under six years of age. As a consequence, the incidence of meningococcal disease caused by serogroup C has fallen sharply during the last three epidemiological years in Spain. The risk of contracting serogroup C disease in 2002/2003 fell by 58% when compared with the season before the conjugate vaccine was introduced. There was also an important decrease in mortality. Three deaths due to serogroup C occurred in the age groups targeted for vaccination in 2002/2003, compared with 30 deaths in the same age groups in the season before the launch of the vaccine campaign. In the catch-up campaign the vaccine coverage reached values above 92%. For the 2001, 2002 and 2003 routine childhood immunisation programme coverage values ranged from 90% to 95%. During the past three years a total of 111 cases of serogroup C disease have been reported in patients in the vaccine target group. Most of the vaccination failures occurred during the epidemiological year 2002/2003. Eight (53%) vaccine failures occurred in children who had been routinely immunised in infancy, and could be related to a lost of protection with time since vaccination. The isolation of several B:2a:P1.5 strains (ST-11 lineage) is noteworthy. These may have their origin in C:2a:P1.5 strains which, after undergoing genetic recombination at the capsular operon level, express serogroup B. These strains could have relevant epidemic potential.

Reduction inNeisseria meningitidisinfection in Italy after Meningococcal C conjugate vaccine introduction: A time trend analysis of 1994–2012 series

“…[11][12][13][14] As also observed by Mooney et al 14 , the reversal of the increasing trend of serogroup C related IMD was simultaneous with the timing of MCC introduction and, therefore, likely attributable to it. The impact of MCC was investigated in many other European and Italian regional studies [14][15][16][17][18][19][20][21][22][23][24][25] which showed an important decrease in N. meningitidis C related IMD and a vaccine effectiveness as high as 100% depending on the age group and on the time elapsed from vaccination. A downward trend in serogroup C related IMD was also confirmed by the European Center for Disease Prevention and Control (ECDC) in countries with MCC vaccination.…”

Potential of Recombinant Opa Proteins as Vaccine Candidates against Hyperinvasive Meningococci

“…With the widespread use of vaccines based on the A, C, Y, and W-135 capsular polysaccharides, capsule replacement could be an important mechanism of meningococcal escape from vaccine-induced antibody responses in the future. For example, meningococci from the hyperinvasive ST-11 complex expressing the serogroup B polysaccharide have been isolated from patients following a serogroup C conjugated-polysaccharide vaccination campaign (7). Furthermore, the invasiveness of this clonal complex has been shown to remain unchanged after it switched from expression of a serogroup C capsule to serogroup B (22).…”

Multilocus Sequence Typing of Neisseria meningitidis Directly from Clinical Samples and Application of the Method to the Investigation of Meningococcal Disease Case Clusters

“…Vaccination has been shown to be the most successful prevention strategy for the control of meningococcal infection, as demonstrated by the success of MCC vaccination programs in the United Kingdom (4) and other countries (7,12), along with the mandatory vaccination since 2002 of all pilgrims traveling to Saudi Arabia for the Hajj with the A, C, Y, W135 quadrivalent vaccine (18,42). Work is proceeding to develop possible vaccine candidates for serogroup B meningococcal (MenB) disease (15,25,27), as it accounts for over 80% of all meningococcal disease in England, Wales, and Northern Ireland.…”