Persistence of immunity after vaccination with a capsular group B meningococcal vaccine in 3 different toddler schedules

Sadarangani, Manish; Sell, Tim; Iro, Mildred A; Snape, Matthew D.; Voysey, Merryn; Finn, Adam; Heath, Paul T; Bona, Gianni; Esposito, Susanna; Díez-Domingo, Javier; Prymula, Roman; Odueyungbo, Adefowope; Toneatto, Daniela; Pollard, Andrew J.

doi:10.1503/cmaj.161288

Cited by 13 publications

(6 citation statements)

References 28 publications

(31 reference statements)

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“…Invasive meningococcal disease in fully and partially immunized children caused by strains expected to be neutralized by vaccine-induced antibodies was rare in this study (occurred in only 1 child). 16 Among children with invasive meningococcal disease, none of the 11 children who received any 4CMenB vaccine died or were left with reported sequelae, compared with 26% of unimmunized children. The numbers of cases with MenY disease and partially immunized cases in this study are too small to draw firm conclusions.…”

Section: Discussionmentioning

confidence: 99%

Association of Use of a Meningococcus Group B Vaccine With Group B Invasive Meningococcal Disease Among Children in Portugal

Rodrigues

Marlow

Simões

et al. 2020

JAMA

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IMPORTANCE A 4-component meningococcus group B vaccine (4CMenB) is the only vaccine in use to prevent group B invasive meningococcal disease in young children, but no matched controlled studies have evaluated it. OBJECTIVE To determine the association between receipt of 4CMenB and invasive group B meningococcal disease. DESIGN, SETTING, AND PARTICIPANTS Matched incidence density case-control study. Patients presenting from October 2014 to March 2019 were ascertained, with follow-up until death or discharge (last follow-up in June 2019) in 31 pediatric services in Portugal. Children and adolescent residents in Portugal with laboratory-confirmed invasive meningococcal disease were included. Controls, usually 2 per case, with unrelated conditions who were at the same hospital at the same time were matched for sex, age, and residence. EXPOSURES Immunization with 4CMenB, ascertained from the national database (2-4 doses are recommended, depending on age). MAIN OUTCOMES AND MEASURESThe primary outcome was group B invasive meningococcal disease in fully vaccinated cases compared with controls. The secondary outcomes were all serogroup invasive meningococcal disease in fully vaccinated cases compared with controls and group B and all serogroup invasive meningococcal disease in cases compared with controls who received at least 1 vaccine dose. RESULTSOf 117 patients with invasive meningococcal disease, 98 were eligible for inclusion and 82 had group B invasive meningococcal disease; 69 were old enough to have been fully vaccinated and considered protected. Among these 69 cases, the median (interquartile range) age was 24 (4.5-196) months, 42 were male, and the median (interquartile range) duration of hospitalization was 8 (0-86) days. Five of 69 cases (7.2%) and 33 of 142 controls (23.1%) were fully vaccinated (difference, −16.0% [95% CI, −26.3% to −5.7%]; odds ratio [OR], 0.21 [95% CI, 0.08-0.55]). For all serogroup invasive meningococcal disease, 6 of 85 cases (7.1%) and 39 of 175 controls (22.3%) were fully vaccinated (difference, −15.2% [95% CI, −24.3% to −6.1%]; OR, 0.22 [95% CI, 0.09-0.53]). For group B disease, 8 of 82 cases (9.8%) and 50 of 168 controls (29.8%) received at least 1 vaccine dose (difference, −20.0% [95% CI, −30.3% to −9.7%]; OR, 0.18 [95% CI, 0.08-0.44]) and for all serogroup invasive meningococcal disease, 11 of 98 cases (11.2%) and 61 of 201 controls (30.3%) received at least 1 vaccine dose (difference, −19.1% [95% CI, −28.8% to −9.5%]; OR, 0.23 [95% CI, 0.11-0.49]). CONCLUSIONS AND RELEVANCEDuring the first 5 years of vaccine availability in Portugal, vaccination with 4CMenB was less likely among children who developed invasive meningococcal disease compared with matched controls without invasive meningococcal disease. These findings may help inform the use of the 4CMenB vaccine in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Association of Use of a Meningococcus Group B Vaccine With Group B Invasive Meningococcal Disease Among Children in Portugal

Rodrigues

Marlow

Simões

et al. 2020

JAMA

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“…77 In children vaccinated between 12 and 24 months of age waning of hSBA titers was also observed by 4 years of age, with a robust response after a booster dose at 40 months of age. 78 For adolescents, protective hSBA titers 18-24 months after completing a two-dose vaccine schedule with the 4CMenB vaccine were detected in 64% for all vaccine-related antigens and in 85% for two of the three target antigens; a third dose did not provide additional benefit. 79 Antibody persistence after the bivalent rLP2086 vaccine was assessed in an open-label, follow-up study of subjects previously enrolled in a primary study.…”

Section: Group B Meningococcal Vaccinesmentioning

confidence: 91%

“…57 Studies of antibody persistence revealed a bactericidal activity lasting 18-24 months in over 64% of adolescents for all three tested 4CMenB vaccinerelated antigens 79 and a sharp decline for antigens expressing fHbp subfamilies A and B ranging from near 25% to 60% in the percentage of subjects with protective antibodies since 12 to 48 months after priming with rLP2086 80 ; indicating that immunity wanes for both vaccines. In children, a recently published metaanalysis assessed 4CMenB persistence of immunogenicity against the four reference strains finding that it remained high 6 months after the booster dose just for NadA and NHBA reference strains and then decreased till values obtained before booster dose 69,75,78 The potential for cross-protection against non-B meningococcal strains has been described for 4CMenB, specifically for C, W, Y and X strains, but not yet for rLP2086. For both vaccines, the impact of vaccination on nasopharyngeal carriage is uncertain.…”

Section: Group B Meningococcal Vaccinesmentioning

confidence: 99%

Global epidemiology of serogroup B meningococcal disease and opportunities for prevention with novel recombinant protein vaccines

Villena

Sáfadi

Valenzuela

et al. 2018

Human Vaccines & Immunotherapeutics

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Meningococcal disease (MD) is a major cause of meningitis and sepsis worldwide, with a high case fatality rate and frequent sequelae. Neisseria meningitidis serogroups A, B, C, W, X and Y are responsible for most of these life-threatening infections, and its unpredictable epidemiology can cause outbreaks in communities, with significant health, social and economic impact. Currently, serogroup B is the main cause of MD in Europe and North America and one of the most prevalent serogroups in Latin America. Mass vaccination strategies using polysaccharide vaccines have been deployed since the 1970s and the use of conjugate vaccines has controlled endemic and epidemic disease caused by serogroups A, C, W and Y and more recently serogroup B using geographically-specific outer membrane vesicle based vaccines. Two novel protein-based vaccines are a significant addition to our armamentarium against N. meningitidis as they provide broad coverage against highly diverse strains in serogroup B and other groups. Early safety, effectiveness and impact data of these vaccines are encouraging. These novel serogroup B vaccines should be actively considered for individuals at increased risk of disease and to control serogroup B outbreaks occurring in institutions or specific regions, as they are likely to save lives and prevent severe sequelae. Incorporation into national programs will require thorough country-specific analysis.

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“…Similarly, after MenB-4C vaccination in infants, toddlers, and children, injection site tenderness, pain, and erythema were the most commonly reported local reactions, and irritability was the more frequently reported systemic reaction [151,[156][157][158][159][160]. Of note, a systematic review of 14 studies describing adverse events following MenB-4C vaccination showed that fever was reported in 48% of the infants after MenB-4C vaccination [161].…”

Section: Safetymentioning

confidence: 99%

Translating meningococcal serogroup B vaccines for healthcare professionals

Sáfadi

Martinón-Torres

Serra

2021

Expert Review of Vaccines

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Introduction:Vaccination is an effective strategy to combat invasive meningococcal disease (IMD). Vaccines against the major disease-causing meningococcal serogroups are available; however, development of vaccines against serogroup B faced particular challenges, including the inability to target traditional meningococcal antigens (i.e. polysaccharide capsule) and limited alternative antigens due to serogroup B strain diversity. Two different recombinant, protein-based, serogroup B (MenB) vaccines that may address these challenges are currently available. These vaccines have been extensively evaluated in pre-licensure safety and immunogenicity trials, and recently in real-world studies on effectiveness, safety, and impact on disease burden. Areas covered: This review provides healthcare professionals, particularly pediatricians, an overview of currently available MenB vaccines, including development strategies and evaluation of coverage. Expert opinion: Overall, recombinant MenB vaccines are valuable tools for healthcare professionals to protect patients against IMD. Their development required innovative design approaches that overcame challenging hurdles and identified novel protein antigen targets; however, important distinctions in the approaches used in their development, evaluation, and administration exist and many unanswered questions remain. Healthcare providers frequently prescribing MenB vaccines are challenged to keep abreast of these differences to ensure patient protection against this serious disease.

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Persistence of immunity after vaccination with a capsular group B meningococcal vaccine in 3 different toddler schedules

Cited by 13 publications

References 28 publications

Association of Use of a Meningococcus Group B Vaccine With Group B Invasive Meningococcal Disease Among Children in Portugal

Association of Use of a Meningococcus Group B Vaccine With Group B Invasive Meningococcal Disease Among Children in Portugal

Global epidemiology of serogroup B meningococcal disease and opportunities for prevention with novel recombinant protein vaccines

Translating meningococcal serogroup B vaccines for healthcare professionals

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