Shamez N Ladhani1, Rebecca Cordery2, Sema Mandal3, Hannah Christensen4, Helen Campbell3, Ray Borrow5, Mary E Ramsay3. 1. Immunisation Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom; Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, United Kingdom. Electronic address: shamez.ladhani@phe.gov.uk. 2. South East London Health Protection Team, Public Health England, 1 Lower Marsh, London SE1 7NT, United Kingdom. 3. Immunisation Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom. 4. School of Social and Community Medicine, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom. 5. Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester M13 9WZ, United Kingdom.
Abstract
OBJECTIVES: To assess the potential use of a protein-based meningococcal group B (MenB) vaccine (Bexsero(®)) in addition to antibiotic chemoprophylaxis for preventing secondary cases. METHODS: Published studies on the risk of secondary meningococcal infections were used to estimate the numbers needed to vaccinate (NNV) with Bexsero(®) to prevent a secondary case in household and educational settings. RESULTS: Most secondary cases occur within a few days of diagnosis in the index case. Unlike conjugate vaccines, early protection offered after a single dose of Bexsero(®) is likely to be low, particularly in young children, who are at higher risk of secondary infection. NNV was dependent on predicted meningococcal strain coverage, estimated onset of protection after one Bexsero(®) dose and estimated vaccine efficacy. Even in the most favourable scenario where we assume the vaccine is administered within 4 days of the index case and prevents 90% of cases occurring after 14 days, the NNV for household contacts was >1000. NNV in educational settings was much higher. CONCLUSIONS: The estimated NNV should be taken into account when deciding policy to recommend Bexsero(®) for close contacts of single cases in household or educational settings. Bexsero(®) may have a protective role in clusters and outbreaks.
OBJECTIVES: To assess the potential use of a protein-based meningococcal group B (MenB) vaccine (Bexsero(®)) in addition to antibiotic chemoprophylaxis for preventing secondary cases. METHODS: Published studies on the risk of secondary meningococcal infections were used to estimate the numbers needed to vaccinate (NNV) with Bexsero(®) to prevent a secondary case in household and educational settings. RESULTS: Most secondary cases occur within a few days of diagnosis in the index case. Unlike conjugate vaccines, early protection offered after a single dose of Bexsero(®) is likely to be low, particularly in young children, who are at higher risk of secondary infection. NNV was dependent on predicted meningococcal strain coverage, estimated onset of protection after one Bexsero(®) dose and estimated vaccine efficacy. Even in the most favourable scenario where we assume the vaccine is administered within 4 days of the index case and prevents 90% of cases occurring after 14 days, the NNV for household contacts was >1000. NNV in educational settings was much higher. CONCLUSIONS: The estimated NNV should be taken into account when deciding policy to recommend Bexsero(®) for close contacts of single cases in household or educational settings. Bexsero(®) may have a protective role in clusters and outbreaks.
Authors: A J Turley; B Gathmann; C Bangs; M Bradbury; S Seneviratne; L I Gonzalez-Granado; S Hackett; N Kutukculer; H Alachkar; S Hambleton; H Ritterbusch; P Kralickova; L Marodi; M G Seidel; G Dueckers; J Roesler; A Huissoon; H Baxendale; J Litzman; P D Arkwright Journal: J Clin Immunol Date: 2015-02-08 Impact factor: 8.317
Authors: Jonathan Lawler; Jay Lucidarme; Sydel Parikh; Lorna Smith; Helen Campbell; Ray Borrow; Steve Gray; Kirsty Foster; Shamez Ladhani Journal: Euro Surveill Date: 2019-06