scholarly journals A re-assessment of 4CMenB vaccine effectiveness against serogroup B invasive meningococcal disease in England based on an incidence model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lorenzo Argante ◽  
Victoria Abbing-Karahagopian ◽  
Kumaran Vadivelu ◽  
Rino Rappuoli ◽  
Duccio Medini
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Disease Incidence ◽  
Screening Method ◽  
Vaccine Effectiveness ◽  
Vaccine Uptake ◽  
Invasive Meningococcal Disease ◽  
Time Data ◽  
Immunization Program ◽  
4Cmenb Vaccine

Abstract Background The four-component serogroup B meningococcal 4CMenB vaccine (Bexsero, GSK) has been routinely given to all infants in the United Kingdom at 2, 4 and 12 months of age since September 2015. After 3 years, Public Health England (PHE) reported a 75% [95% confidence interval 64%; 81%] reduction in the incidence of serogroup B invasive meningococcal disease (IMD) in age groups eligible to be fully vaccinated. In contrast, vaccine effectiveness (VE) evaluated in the same immunization program applying the screening method was not statistically significant. We re-analyzed the data using an incidence model. Methods Aggregate data—stratified by age, year and doses received—were provided by PHE: serogroup B IMD case counts for the entire population of England (years 2011–2018) and 4CMenB vaccine uptake in infants. We combined uptake with national population estimates to obtain counts of vaccinated and unvaccinated person-time by age and time. We re-estimated VE comparing incidence rates in vaccinated and non-vaccinated subjects using a Bayesian Poisson model for case counts with person-time data as an offset. The model was adjusted for age, time and number of doses received. Results The incidence model showed that cases decreased until 2013–2014, followed by an increasing trend that continued in the non-vaccinated population during the immunization program. VE in fully vaccinated subjects (three doses) was 80.1% [95% Bayesian credible interval (BCI): 70.3%; 86.7%]. After a single dose, VE was 33.5% [12.4%; 49.7%]95%BCI and after two doses, 78.7% [71.5%; 84.5%]95%BCI. We estimated that vaccination averted 312 cases [252; 368]95%BCI between 2015 and 2018. VE was in line with the previously reported incidence reduction. Conclusions Our estimates of VE had higher precision than previous estimates based on the screening method, which were statistically not significant, and in line with the 75% incidence reduction previously reported by PHE. When disease incidence is low and vaccine uptake is high, the screening method applied to cases exclusively from the population eligible for vaccination may not be precise enough and may produce misleading point-estimates. Precise and accurate VE estimates are fundamental to inform public health decision making. VE assessment can be enhanced using models that leverage data on subjects not eligible for vaccination.

scholarly journals Characterization of Serogroup ANeisseria meningitidisfrom Invasive Meningococcal Disease Cases in Canada Between 1979 and 2006: Epidemiological Links to Returning Travellers

2008 ◽  
Vol 19 (3) ◽  
pp. 227-232 ◽  
Author(s):  
Angela M Sloan ◽  
Averil M Henderson ◽  
Raymond SW Tsang
Keyword(s):  
Meningococcal Disease ◽  
Clonal Complex ◽  
Disease Incidence ◽  
Developing Nations ◽  
Invasive Meningococcal Disease ◽  
Protein Antigens ◽  
Genes Encoding ◽  
Returning Travellers ◽  
The 1960S

INTRODUCTION: Serogroup ANeisseria meningitidishas repeatedly caused epidemics of invasive meningococcal disease (IMD) in developing nations since the 1960s. The present study is the first detailed study of serogroup A bacteria isolated in Canada.METHODS: Thirty-four serogroup A meningococcal isolates collected from individuals with IMD in Canada between 1979 and 2006 were characterized by serology and multilocus sequence typing of seven housekeeping enzyme genes and genes encoding three outer membrane protein antigens.RESULTS: Isolates were assigned to either the sequence type (ST)-1 or the ST-5 clonal complex. Clones within the ST-1 complex were recovered between 1979 and 1992, while clones of the ST-5 complex were isolated between 1987 and 2006; respectively, they accounted for 70.6% and 29.4% of all isolates studied. Isolates of the ST-1 complex were characterized by serosubtype antigen P1.3 or P1.3,6 with PorB allele 60 (serotype 4) and FetA sequence F5-1, while isolates of the ST-5 complex were characterized by serosubtype antigen P1.9 with PorB allele 47 (also serotype 4) and FetA sequence F3-1.CONCLUSIONS: The Canadian serogroup A IMD isolates likely originated in travellers returning from hyperendemic or epidemic areas of the globe where serogroup A bacteria circulate. Although the Canadian cases of serogroup A IMD were caused by clones known to have caused epidemics in developing countries, disease incidence remained low in Canada.

Predicted coverage by 4CMenB vaccine against invasive meningococcal disease cases in the Netherlands

Vaccine ◽  
2020 ◽  
Vol 38 (49) ◽  
pp. 7850-7857
Author(s):  
W. Freudenburg-de Graaf ◽  
M.J. Knol ◽  
A. van der Ende
Keyword(s):  
The Netherlands ◽  
Meningococcal Disease ◽  
Invasive Meningococcal Disease ◽  
4Cmenb Vaccine

scholarly journals The Cost and Public Health Burden of Invasive Meningococcal Disease Outbreaks: A Systematic Review

2013 ◽  
Vol 31 (7) ◽  
pp. 563-576 ◽  
Author(s):  
Andrea Anonychuk ◽  
Gloria Woo ◽  
Andrew Vyse ◽  
Nadia Demarteau ◽  
Andrea C. Tricco
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Meningococcal Disease ◽  
Disease Outbreaks ◽  
Invasive Meningococcal Disease ◽  
Public Health Burden ◽  
Health Burden ◽  
The Cost

Estimating vaccine effectiveness against severe influenza in England and Scotland 2011/2012: applying the screening method to data from intensive care surveillance systems

2013 ◽  
Vol 142 (1) ◽  
pp. 126-133 ◽  
Author(s):  
H. L. THOMAS ◽  
N. ANDREWS ◽  
H. K. GREEN ◽  
N. L. BODDINGTON ◽  
H. ZHAO ◽  
...  
Keyword(s):  
Intensive Care ◽  
Screening Method ◽  
Risk Groups ◽  
Vaccine Effectiveness ◽  
Vaccine Uptake ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Icu Admission ◽  
Severe Influenza ◽  
Routine Monitoring

SUMMARYMethods for estimating vaccine effectiveness (VE) against severe influenza are not well established. We used the screening method to estimate VE against influenza resulting in intensive care unit (ICU) admission in England and Scotland in 2011/2012. We extracted data on confirmed influenza ICU cases from severe influenza surveillance systems, and obtained their 2011/2012 trivalent influenza vaccine (TIV) status from primary care. We compared case vaccine uptake with population vaccine uptake obtained from routine monitoring systems, adjusting for age group, specific risk group, region and week. Of 60 influenza ICU cases reported, vaccination status was available for 56 (93%). Adjusted VE against ICU admission for those aged ⩾65 years was −10% [95% confidence interval (CI) −207 to 60], consistent with evidence of poor protection from the 2011/2012 TIV in 2011/2012. Adjusted VE for those aged <65 years in risk groups was −296% (95% CI −930 to −52), suggesting significant residual confounding using the screening method in those subject to selective vaccination.

scholarly journals Acquisition of Meningococcal Serogroup W-135 Carriage in Turkish Hajj Pilgrims Who Had Received the Quadrivalent Meningococcal Polysaccharide Vaccine

2012 ◽  
Vol 20 (1) ◽  
pp. 66-68 ◽  
Author(s):  
M. Ceyhan ◽  
M. Celik ◽  
E. T. Demir ◽  
V. Gurbuz ◽  
A. E. Aycan ◽  
...  
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Health Problem ◽  
Family Members ◽  
Public Health Problem ◽  
Polysaccharide Vaccine ◽  
Invasive Meningococcal Disease ◽  
Household Contacts ◽  
To Receive ◽  
Close Contacts

ABSTRACTInvasive meningococcal disease is a recognized public health problem worldwide, with a dynamic and changeable epidemiology. In Turkey, the second most common pathogenic meningococcal serogroup (after serogroup B) is W-135, including an epidemic in 2005, which has been strongly associated with Hajj pilgrims and their close contacts. In two studies conducted in 2010, we assessed meningococcal carriage in intending Turkish pilgrims to the Hajj when they attended to receive a plain polysaccharide vaccine against serogroups A, C, W-135, and Y and, upon their return, to determine the acquisition of meningococcal carriage by the pilgrims themselves and subsequently their household contacts. Nasopharyngeal swabs were obtained from pilgrims before the Hajj and upon their return. Swabs were then obtained from 39 household contacts of pilgrims who were shown to have acquired carriage during the Hajj. Of the 472 pilgrims before the Hajj, 63 (13%) were positive for meningococcal carriage, of which 52 cases (83%) were serogroup W-135. In the 296 pilgrims tested after the Hajj, 81 (27%) were positive for meningococcal carriage, including 74 (91%) with W-135. In 11 family members of pilgrims who acquired W-135 carriage at the Hajj, 10 (91%) had acquired carriage of serogroup W-135. This study illustrates the acquisition of meningococcal carriage, predominantly of serogroup W-135 by pilgrims attending the Hajj, and the transmission of this carriage to their family members on their return, explaining the source of W-135 meningococcal disease in Turkey.

scholarly journals Lesson learned from an outbreak of invasive meningococcal disease: how HTA could have provided an evidence-based approach for public health response

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Miglietta
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Central Italy ◽  
Invasive Meningococcal Disease ◽  
Evidence Based ◽  
Public Health Response ◽  
Population Groups ◽  
Response Planning ◽  
Health Response ◽  
Immunization Campaign

Abstract During 2015-2016 an outbreak of invasive meningococcal disease due to Neisseria meningitidis serogroup C ST-11 (cc11) occurred in Tuscany, a Region in Central Italy. Sixty-two cases with 13 deaths (13%) were recorded. Regional Authorities responded through a mass immunization campaign targeting all the age groups by offering free of charge a single dose of the tetravalent (ACWY) meningococcal conjugate vaccine or monovalent meningococcal C conjugate (MCC) vaccine. Nevertheless, the response was fragmented and the campaign did not reach the risk-population groups (i.e. men who have sex with men), that were identified only when a Regional outbreak investigation was implemented. Also linkage between cases (i.e. attending the same gay-venue) were identified at a second stage, not allowing prompt max-prophylaxis interventions. In such a situation, an evidence-based approach as Health Technology Assessment, could have informed public health emergency preparedness and response planning processes, i.e. by identifying through early warning alert systems similar ongoing clusters in Europe among specific population-groups and consequently better targeting the immunization campaign. The objective of this presentation is to explore through a practical example how HTA could provide an evidence-based approach for public health response during a real outbreak underlining lesson learned.

scholarly journals Evaluation of the surveillance system for invasive meningococcal disease (IMD) in the Netherlands, 2004 – 2016

2019 ◽  
Author(s):  
Diederik A.H. Brandwagt ◽  
Arie van der Ende ◽  
Helma (W.) L.M. Ruijs ◽  
Hester E. de Melker ◽  
Mirjam J. Knol
Keyword(s):  
Public Health ◽  
The Netherlands ◽  
Meningococcal Disease ◽  
Surveillance System ◽  
National Level ◽  
Vaccination Status ◽  
Invasive Meningococcal Disease ◽  
Reference Laboratory ◽  
Public Health Response ◽  
Notification Data

Abstract Background Enhanced surveillance for confirmed cases of invasive meningococcal disease (IMD) was introduced in the Netherlands in 2003, in which reference laboratory data (NRLBM) are linked with notification data (OSIRIS). The quality of surveillance information is important for public health decision making. Our objective was to describe the system and evaluate it for data completeness and timeliness.
Methods
Cases reported in the surveillance system from 2004 to 2016 were included. For the notification data, we used information on serogroup, vaccination status, mortality, and country of infection as indicators for record completeness. Notification times to regional and national level were calculated using the reported dates available in the notification database. 
Results
A total of 2,123 cases were reported in the years 2004-2016, of which 1.968 (93%) were reported by the reference laboratory and 1.995 (94%) in the notification system. Of all cases, 1.840 cases (87%) were reported in both systems and could be linked. The serogroup was known in 86% of the notified cases, and was significantly higher (94%) in the years 2013-2016. Information on vaccination status, mortality and country of infection was available in 88%, 99% and 97% of notified cases, respectively. Regional notification of cases occurred within one working day for 86% of cases and 98% were notified nationally within three days. 
Conclusions
A well performing IMD surveillance system was demonstrated and serogroup completeness has improved over the years. Underlining the need for reporting to both the clinical and laboratory surveillance system remains important to further improve the overall performance in supporting public health response and vaccination policy.

scholarly journals Invasive meningococcal disease with fatal outcome in a Swiss student visiting Berlin

2008 ◽  
Vol 13 (45) ◽  
Author(s):  
I Zuschneid ◽  
A Witschi ◽  
L Quaback ◽  
W Hellenbrand ◽  
N Kleinkauf ◽  
...  
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
National Level ◽  
Fatal Outcome ◽  
Relevant Information ◽  
Invasive Meningococcal Disease ◽  
Contact Tracing ◽  
Post Exposure Prophylaxis ◽  
Disease Notification ◽  
Public Health Action

Following the fatal invasive meningococcal disease in a Swiss student who had been visiting Berlin, several public health institutions on local, regional and national level cooperated to ensure that the appropriate measures such as contact tracing and post exposure prophylaxis were taken to prevent further cases. The incidence highlighted the importance of early disease notification and showed that if an infectious disease requiring public health action occurs in an international context, it is vital that relevant information is communicated to all levels of the public health systems of the countries involved.

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