Meningococcal disease in adolescents and young adults: a review of the rationale for prevention through vaccination

Abstract

Invasive meningococcal disease (IMD) caused by Neisseria meningitidis is characterized by high mortality and morbidity. While IMD incidence peaks in both infants and adolescents/young adults, carriage rates are often highest in the latter age groups, increasing IMD risk and the likelihood of transmission. Effective vaccines are available for 5 of 6 disease-causing serogroups. Because adolescents/young adults represent a significant proportion of cases, often have the highest carriage rate, and have characteristically low vaccination adherence, efforts should be focused on educating this population regarding long-term consequences of infection and the importance of meningococcal vaccination in prevention. This review describes the role of adolescents/young adults in meningococcal transmission and the clinical consequences and characteristics of IMD in this population. With a focus on countries with advanced economies that have specific meningococcal vaccination recommendations, the epidemiology of meningococcal disease and vaccination recommendations in adolescents/young adults will also be discussed.

Immunogenicity and safety of a quadrivalent meningococcal tetanus toxoid-conjugate vaccine (MenACYW-TT)vs. a licensed quadrivalent meningococcal tetanus toxoid-conjugate vaccine in meningococcal vaccine-naïve and meningococcal C conjugate vaccine-primed toddlers: a phase III randomised study

“…Invasive meningococcal disease (IMD) is characterised by high mortality and morbidity, particularly in children [ 1 , 2 ]. The incidence of IMD peaks in children under 5 years of age and in adolescents and young adults, with the greatest mortality in the elderly [ 3 , 4 ].…”

The epidemiology of invasive meningococcal disease and the utility of vaccination in Malta

“…However, the reduction in MenB disease has had no effect on the overall incidence of IMD in Malta since it was offset by the persistence of MenC disease and the appearance of MenW and Men Y disease since 2011. In contrast, the incidence rates of MenC IMD in the EU were significantly reduced (from 0.22/ 100,000, 95% CI, 0.14-0.31 in 2000-2008 down to 0.10/ 100,000, 95% CI, 0.09-0.11 in 2009-2017; p = 0.003) as a result of the introduction of MenC vaccination programmes in several European countries, many after catch-up campaigns targeting adolescents, and the introduction of routine adolescent vaccination [33,34]. In the USA, the incidence of MenC and Y disease was reduced through the introduction of routine adolescent MenACWY vaccination since 2007 [35].…”

Social and behavioral predictors of two-doses 4CMenB vaccine series among adolescents enrolled in a cluster randomized controlled trial in Australia

“…14 While the recommendation for specific meningococcal vaccine use in each country depends on the predominant disease-causing serogroups, 15 low completion of multidose schedules is common among adolescents and young adults. 16 Although barriers and facilitators to vaccine uptake among adolescents have been extensively reviewed, 10,[17][18][19][20] there is no comprehensive assessment of social and behavioral factors influencing nonvaccination or incompletion of MenB vaccine dose series in this group. This study aimed to determine demographic, social and behavioral predictors of non-vaccination or noncompletion of the recommended two-dose of MenB vaccine series among adolescents aged 15-19 years.…”