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      Enter B and W: two new meningococcal vaccine programmes launched

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          Abstract

          In 2015, the UK became the first country in the world to have a comprehensive routine meningococcal vaccine programme targeting all of the main capsular groups of N. meningitidis. 1 An infant vaccine programme against meningococcal capsular group B Neisseria meningitidis (MenB) was launched from 1st September with an aim to reduce endemic MenB disease in early childhood. On 1st August 2015, an adolescent programme against groups A, C, W and Y meningococci (MenACWY) was rolled out to halt a growing outbreak of capsular group W disease (MenW) caused by a hypervirulent clone of N. meningitidis, in addition to maintaining control against MenC disease provided by the current adolescent programme. 2

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          Meningococcal carriage by age: a systematic review and meta-analysis.

          Hannah Christensen, Margaret May, Leah Bowen … (2010)
          Neisseria meningitidis is an important cause of meningitis and septicaemia, but most infected individuals experience a period of asymptomatic carriage rather than disease. Previous studies have shown that carriage rates vary by age and setting; however, few have assessed carriage across all ages. We aimed to estimate the age-specific prevalence of meningococcal carriage. We searched Embase, Medline, Web of Science, the Cochrane Library, and grey literature for papers reporting carriage of N meningitidis in defined age groups in European countries or in countries with a similar epidemiological pattern (where disease caused by serogroups B and C predominates). We used mixed-effects logistic regression with a natural cubic spline to model carriage prevalence as a function of age for studies that were cross-sectional or serial cross-sectional. The model assessed population type, type of swab used, when swabs were plated, use of preheated plates, and time period (decade of study) as fixed effects, with country and study as nested random effects (random intercept). Carriage prevalence increased through childhood from 4·5% in infants to a peak of 23·7% in 19-year olds and subsequently decreased in adulthood to 7·8% in 50-year olds. The odds of testing positive for carriage decreased if swabs were not plated immediately after being taken compared with if swabs were plated immediately (odds ratio 0·46, 95% CI 0·31-0·68; p = 0·0001). This study provides estimates of carriage prevalence across all ages, which is important for understanding the epidemiology and transmission dynamics of meningococcal infection. None. Copyright © 2010 Elsevier Ltd. All rights reserved.
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            Planning, registration, and implementation of an immunisation campaign against meningococcal serogroup C disease in the UK: a success story.

            E. Miller, D Salisbury, M Ramsay (2001)
            The introduction of meningococcal C conjugate (MCC) vaccine in the UK in November 1999 as a routine 3 dose infant immunisation course, with a single catch-up dose for all children aged between 12 months and 17 years, was the result of an intensive 5 year collaborative research programme funded by the Department of Health for England and involving public bodies, academia and vaccine manufacturers. The research programme established the safety and immunogenicity of MCC vaccines in infants, toddlers, pre-school and school-aged children. The nature and frequency of common adverse events in school-aged children was similar to that after a booster dose of diphtheria and tetanus vaccine given to the same age groups. The recommendation that a single dose was adequate for children aged 12 months and above was based on antibody levels measured by serum bactericidal assay and evidence of induction of immunological memory as shown by maturation of antibody avidity. Licensure by the Medicines Control Agency was based on serological criteria alone without direct evidence of efficacy and has set a precedent for other meningococcal conjugate polysaccharide vaccines. Vaccine coverage of around 85% was achieved in the targeted age groups and has resulted in a drop in the incidence of serogroup C disease in these groups of over 80% within 18 months of the start of the vaccination programme. Early post-licensure efficacy estimates for toddlers and teenagers (88 and 96%, respectively, in the first 16 months after vaccination) validate the serological criteria used for licensure. Surveillance of the prevalent serogroups and serosubtypes among invasive case isolates has shown no evidence of any capsular switching to serogroup B during the first 18 months of the MCC vaccination programme.
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              Increase in endemic Neisseria meningitidis capsular group W sequence type 11 complex associated with severe invasive disease in England and Wales.

              Shamez Ladhani, Kazim Beebeejaun, Jay Lucidarme … (2015)
              In England and Wales, the incidence of invasive meningococcal disease has been declining for more than a decade, but meningococcal group W (MenW) cases have been increasing since 2009.
              Article 0 comments Cited 85 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Arch Dis Child
                Journal ID (iso-abbrev): Arch. Dis. Child
                Journal ID (hwp): archdischild
                Journal ID (publisher-id): adc
                Title: Archives of Disease in Childhood
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Print): 0003-9888
                ISSN (Electronic): 1468-2044
                Publication date (Print): January 2016
                Volume: 101
                Issue: 1
                Pages: 91-95
                Affiliations
                [1 ]Immunisation Department, Public Health England , London, UK
                [2 ]Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary , Manchester, UK
                [3 ]Department of Infectious Diseases and Immunology, Alder Hey Children's Hospital , Liverpool, UK
                [4 ]Department of Health, London, UK
                [5 ]Department of Paediatrics, University of Oxford, Children's Hospital , Oxford, UK
                Author notes
                [Correspondence to ] Professor Andrew J Pollard, Department of Paediatrics, University of Oxford, Level 2, Children's Hospital, Oxford OX3 9DU, UK; andrew.pollard@ 123456paediatrics.ox.ac.uk
                Author information
                http://orcid.org/0000-0002-0856-2476
                Article
                Publisher ID: archdischild-2015-308928
                DOI: 10.1136/archdischild-2015-308928
                PMC ID: 4717420
                PubMed ID: 26672098
                SO-VID: d1120aa4-ef33-4aec-8bc7-daee6060eb8f
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
                License:

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Date received : 25 August 2015
                Date accepted : 23 October 2015
                Categories
                Subject: 1506
                Subject: Review
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                ScienceOpen disciplines: Medicine
                Keywords: infectious diseases,immunisation
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: infectious diseases, immunisation

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