Incidence of Meningococcal Disease Before and After Implementation of Quadrivalent Meningococcal Conjugate Vaccine in the United States

Mbaeyi, Sarah; Pondo, Tracy; Blain, Amy; Yankey, David; Cubeñas-Potts, Caelin; Cohn, Amanda C.; Hariri, Susan; Shang, Nong; MacNeil, Jessica R.

doi:10.1001/jamapediatrics.2020.1990

Cited by 32 publications

(19 citation statements)

References 28 publications

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“…Measuring the association between adolescent MenACWY vaccination on rates of meningococcal disease has been challenging because of the low and decreasing incidence of meningococcal disease among all age groups. However, from MenACWY introduction through 2017, adolescents experienced the greatest percentage decreases (>90%) in meningococcal disease incidence due to serogroups C, W, or Y combined compared with other age groups (179). In the setting of 85% coverage with at least 1 dose of MenACWY-D or MenACWY-CRM among U.S. adolescents aged 13-17 years and 44% coverage with at least 2 doses among adolescents aged 17 years by 2017, a twofold to threefold increase in the rate of decline in incidence was observed during the postvaccination period compared with the prevaccination period among adolescents, suggesting that vaccination with MenACWY-D or MenACWY-CRM is associated with reductions in disease rates in adolescents (179,180).…”

Section: Vaccination and Meningococcal Disease Incidencementioning

confidence: 99%

Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020

Mbaeyi¹,

Bozio²,

Duffy³

et al. 2020

MMWR Recomm. Rep.

Self Cite

159

169

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This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of meningococcal vaccines in the United States. As a comprehensive summary and update of previously published recommendations, it replaces all previously published reports and policy notes. This report also contains new recommendations for administration of booster doses of serogroup B meningococcal (MenB) vaccine for persons at increased risk for serogroup B meningococcal disease. These guidelines will be updated as needed on the basis of availability of new data or licensure of new meningococcal vaccines. ACIP recommends routine vaccination with a quadrivalent meningococcal conjugate vaccine (MenACWY) for adolescents aged 11 or 12 years, with a booster dose at age 16 years. ACIP also recommends routine vaccination with MenACWY for persons aged ≥2 months at increased risk for meningococcal disease caused by serogroups A, C, W, or Y, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]); persons who have anatomic or functional asplenia; persons with human immunodeficiency virus infection; microbiologists routinely exposed to isolates of Neisseria meningitidis; persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroups A, C, W, or Y; persons who travel to or live in areas in which meningococcal disease is hyperendemic or epidemic; unvaccinated or incompletely vaccinated first-year college students living in residence halls; and military recruits. ACIP recommends MenACWY booster doses for previously vaccinated persons who become or remain at increased risk. In addition, ACIP recommends routine use of MenB vaccine series among persons aged ≥10 years who are at increased risk for serogroup B meningococcal disease, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor; persons who have anatomic or functional asplenia; microbiologists who are routinely exposed to isolates of N. meningitidis; and persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroup B. ACIP recommends MenB booster doses for previously vaccinated persons who become or remain at increased risk. In addition, ACIP recommends a MenB series for adolescents and young adults aged 16-23 years on the basis of shared clinical decision-making to provide short-term protection against disease caused by most strains of serogroup B N. meningitidis.

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Section: Vaccination and Meningococcal Disease Incidencementioning

confidence: 99%

Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020

Mbaeyi¹,

Bozio²,

Duffy³

et al. 2020

MMWR Recomm. Rep.

Self Cite

159

169

View full text Add to dashboard Cite

show abstract

“…A potential limitation of this analysis is that assumptions for MenABCWY vaccination coverage rely on historical data for individual MenB and MenACWY vaccines [9,10,13,[19][20][21]23,26,[28][29][30][31][32][33][34][35][36]59]. There are some hSBA data showing that sera from MenB-vaccinated adolescents have bactericidal activity against non-serogroup B meningococcal strains [60]; however, the majority of the benefit from a MenABCWY vaccine would likely stem from the highly efficacious protection provided by the MenACWY conjugate component [61][62][63]. Definitive estimates of vaccine efficacy await clinical trials and real-world data.…”

Section: Discussionmentioning

confidence: 99%

Potential public health impact of a Neisseria meningitidis A, B, C, W, and Y pentavalent vaccine in the United States

Huang

Snedecor

Balmer

et al. 2021

Postgraduate Medicine

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Objective: Globally, 5 serogroups (A, B, C, W, and Y) cause the majority of invasive meningococcal disease (IMD). Vaccines targeting these serogroups are currently part of the US adolescent immunization platform, which includes 1 + 1 dosing of a MenACWY vaccine routinely at ages 11 and 16 years and 2 doses of a MenB vaccine at age 16-23 years under shared clinical decision-making between the patient and healthcare provider. In 2018, MenACWY vaccination coverage was 86.6% for ≥1 dose and 50.8% for ≥2 doses, whereas MenB vaccination coverage was 17.2% for ≥1 dose and <50% for completion of the multidose series. A pentavalent MenABCWY vaccine could simplify immunization schedules and improve vaccination coverage. We estimated the public health impact of a pentavalent MenABCWY vaccine using a model that considers meningococcal carriage and vaccination coverage. Methods: A population-based dynamic model estimated the 10-year reduction in IMD from implementing a MenABCWY vaccine within the existing US meningococcal immunization platform. Five vaccination schedules (4 new, 1 existing) were examined to estimate the impact of different recommendations on the overall reduction in the number of IMD cases. Sensitivity analyses were performed by varying vaccination coverage at age 16 years. Results: The existing schedule and coverage of MenACWY and MenB vaccines (total 4 doses) could potentially avert 165 IMD cases over 10 years versus no vaccination. Assuming similar MenABCWY and MenACWY vaccination coverage rates at age 16 years, replacing 1 or more MenACWY and/or MenB doses with MenABCWY could avert more cases, ranging from 189 to 256. The most beneficial MenABCWY vaccine schedule was 2 doses at age 11 years and 1 dose at age 16 years. Conclusions: Replacing one or more MenACWY/MenB vaccine doses with MenABCWY could reduce IMD caused by all 5 meningococcal serogroups among the US adolescent population, while also reducing the number of injections required.

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“…Mbaeyi et al demonstrated that even if infants <1 year of age have experienced the greatest absolute decline in disease incidence due to serogroups C, W, and Y, adolescents aged 11–15 years have shown the greatest percentage decrease in disease incidence due to serogroups C, W, and Y during the post-vaccination period (a 67.0% reduction in the disease incidence during the post-primary dose period; 88.8% during the post-booster dose period) [ 42 ].…”

Section: Vaccinesmentioning

confidence: 99%

Meningococcal Disease in Pediatric Age: A Focus on Epidemiology and Prevention

Pietro

Biffi

Castellazzi

et al. 2022

IJERPH

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Meningococcal disease is caused by Neisseria meningitidis; 13 serogroups have been identified and differentiated from each other through their capsular polysaccharide. Serotypes A, B, C, W, X, and Y are responsible for nearly all infections worldwide. The most common clinical manifestations are meningitis and invasive meningococcal disease, both characterized by high mortality and long-term sequelae. The infection rate is higher in children younger than 1 year and in adolescents, who are frequently asymptomatic carriers. Vaccination is the most effective method of preventing infection and transmission. Currently, both monovalent meningococcal vaccines (against A, B, and C serotypes) and quadrivalent meningococcal vaccines (against serogroups ACYW) are available and recommended according to local epidemiology. The purpose of this article is to describe the meningococcal vaccines and to identify instruments that are useful for reducing transmission and implementing the vaccination coverage. This aim could be reached by switching from the monovalent to the quadrivalent vaccine in the first year of life, increasing vaccine promotion against ACYW serotypes among adolescents, and extending the free offer of the anti-meningococcal B vaccine to teens, co-administering it with others proposed in the same age group. Greater awareness of the severity of the disease and increased health education through web and social networks could represent the best strategies for promoting adhesion and active participation in the vaccination campaign. Finally, the development of a licensed universal meningococcal vaccine should be another important objective.

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Incidence of Meningococcal Disease Before and After Implementation of Quadrivalent Meningococcal Conjugate Vaccine in the United States

Cited by 32 publications

References 28 publications

Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020

Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020

Potential public health impact of a Neisseria meningitidis A, B, C, W, and Y pentavalent vaccine in the United States

Meningococcal Disease in Pediatric Age: A Focus on Epidemiology and Prevention

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