Meningococcal vaccines in Australia: a 2019 update

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SUMMARY

Invasive meningococcal disease is a rare but serious infection caused by Neisseria meningitidis

Serogroup B was the predominant serogroup causing invasive meningococcal disease in Australia until 2015. Serogroup W disease has increased substantially since 2014, and in 2017, serogroups B and W caused similar numbers of invasive disease cases

Vaccines against serogroups A, C, W, Y and B are available for anyone who wishes to reduce the risk of meningococcal disease

Vaccination is strongly recommended for people in high-risk age or population groups. These are children under 2 years, 15–19 year olds, Aboriginal and Torres Strait Islander children, and people with medical, occupational, behavioural or travel-related risk factors for invasive meningococcal disease

Meningococcal ACWY vaccine is funded under the National Immunisation Program for babies aged 12 months. Since April 2019, it has been funded for year 10 students through a school program. There are additional state and territory-based programs for both meningococcal ACWY and meningococcal B vaccines

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Most cited references 9

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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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Meningococcal carriage and disease—Population biology and evolution

Dominique Caugant, Martin C.J. Maiden (2009)

Meningococcal disease occurs worldwide with incidence rates varying from 1 to 1000 cases per 100,000. The causative organism, Neisseria meningitidis, is an obligate commensal of humans, which normally colonizes the mucosa of the upper respiratory tract without causing invasive disease, a phenomenon known as carriage. Studies using molecular methods have demonstrated the extensive genetic diversity of meningocococci isolated from carriers, in contrast to a limited number of genetic types, known as the hyperinvasive lineages, associated with invasive disease. Population and evolutionary models that invoke positive selection can be used to resolve the apparent paradox of virulent lineages persisting during the global spread of a non-clonal and normally commensal bacterium. The application of insights gained from studies of meningococcal population biology and evolution is important in understanding the spread of disease, as well as in vaccine development and implementation, especially with regard to the challenge of producing comprehensive vaccines based on sub-capsular antigens and measuring their effectiveness.

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Effectiveness and impact of a reduced infant schedule of 4CMenB vaccine against group B meningococcal disease in England: a national observational cohort study.

Sydel R. Parikh, Nick Andrews, Kazim Beebeejaun … (2016)

In September, 2015, the UK became the first country to introduce the multicomponent group B meningococcal (MenB) vaccine (4CMenB, Bexsero) into a publicly funded national immunisation programme. A reduced two-dose priming schedule was offered to infants at 2 months and 4 months, alongside an opportunistic catch-up for 3 month and 4 month olds. 4CMenB was predicted to protect against 73-88% of MenB strains. We aimed to assess the effectiveness and impact of 4CMenB in vaccine-eligible infants in England.

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Author and article information

Contributors

Ketaki Sharma: Role: Clinical fellow[1]

Clayton Chiu: Role: Public health physician[1] and Conjoint lecturer[2]

Nicholas Wood: Role: Senior clinical research fellow[1] and Associate professor[2]

Journal

Journal ID (nlm-ta): Aust Prescr

Journal ID (iso-abbrev): Aust Prescr

Journal ID (publisher-id): AP

Title: Australian Prescriber

Publisher: NPS MedicineWise

ISSN (Print): 0312-8008

ISSN (Electronic): 1839-3942

Publication date (Electronic): 01 August 2019

Publication date (Print): August 2019

Volume: 42

Issue: 4

Pages: 131-135

Affiliations

[[1] ]National Centre for Immunisation Research and Surveillance for Vaccine Preventable Diseases, The Children’s Hospital at Westmead , Sydney

[[2] ]Discipline of Child and Adolescent Health, University of Sydney

Article

Publisher ID: austprescr-42-131

DOI: 10.18773/austprescr.2019.042

PMC ID: 6698237

PubMed ID: 31427844

SO-VID: d7ee2949-9af3-4dc0-b7c7-fe565dc96369

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND) 4.0 License.

Meningococcal vaccines in Australia: a 2019 update

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SUMMARY

Invasive meningococcal disease is a rare but serious infection caused by Neisseria meningitidis

Serogroup B was the predominant serogroup causing invasive meningococcal disease in Australia until 2015. Serogroup W disease has increased substantially since 2014, and in 2017, serogroups B and W caused similar numbers of invasive disease cases

Vaccines against serogroups A, C, W, Y and B are available for anyone who wishes to reduce the risk of meningococcal disease

Meningococcal ACWY vaccine is funded under the National Immunisation Program for babies aged 12 months. Since April 2019, it has been funded for year 10 students through a school program. There are additional state and territory-based programs for both meningococcal ACWY and meningococcal B vaccines

Related collections

Vaccines

Most cited references 9

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

Meningococcal carriage and disease—Population biology and evolution

Effectiveness and impact of a reduced infant schedule of 4CMenB vaccine against group B meningococcal disease in England: a national observational cohort study.

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