Mark McMillan1,2, Ann P Koehler3, Andrew Lawrence4, Thomas R Sullivan5,6, Jana Bednarz6, Jenny M MacLennan7, Martin C J Maiden7, Shamez N Ladhani8, Mary E Ramsay8, Caroline Trotter8,9, Ray Borrow10, Adam Finn11, Charlene M Kahler12, Jane Whelan13, Kumaran Vadivelu14, Peter C Richmond15,16,17, Helen S Marshall1,2. 1. Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia. 2. Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia. 3. Communicable Disease Control Branch, SA Health, Adelaide, South Australia, Australia. 4. SA Pathology, Adelaide, South Australia, Australia. 5. South Australian Health and Medical Research Institute (SAHMRI Women and Kids), Adelaide, Australia. 6. School of Public Health, University of Adelaide, Adelaide, South Australia, Australia. 7. Department of Zoology, University of Oxford, Oxford, United Kingdom. 8. Immunisation Department, Public Health England, London, United Kingdom. 9. Departments of Pathology and Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom. 10. Meningococcal Reference Unit, Public Health England, Manchester, United Kingdom. 11. Bristol Children's Vaccine Centre, Schools of Cellular and Molecular Medicine and Population Health Sciences, University of Bristol, Bristol, England. 12. Marshall Centre for Infectious Disease Research and Training, School of Biomedical Science, University of Western Australia, Perth, Western Australia, Australia. 13. GSK, Amsterdam, The Netherlands. 14. GSK, Siena, Italy. 15. Vaccine Trials Group, Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia. 16. Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia. 17. Departments of Immunology and General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia.
Abstract
BACKGROUND: Recombinant protein-based vaccines targeting serogroup B meningococci protect against invasive disease but impacts on carriage are uncertain. This study assessed carriage prevalence of disease-associated meningococci in 2018-2020 as the proportion of vaccinated adolescents increased following introduction of a school-based 4CMenB immunization program. METHODS: Eligible participants who completed high school (aged 17-25) in South Australia in the previous year had an oropharyngeal swab taken and completed a risk factor questionnaire. Disease-associated meningococci (genogroups A, B, C, W, X, Y) were detected by meningococcal and genogroup-specific polymerase chain reaction. RESULTS: The analysis included 4104 participants in 2018, 2690 in 2019, and 1338 in 2020. The proportion vaccinated with 4CMenB increased from 43% in 2018, to 78% in 2019, and 76% in 2020. Carriage prevalence of disease-associated meningococci in 2018 was 225/4104 (5.5%). There was little difference between carriage prevalence in 2019 (134/2690, 5.0%; adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], .64-1.05) and 2020 (68/1338, 5.1%; aOR, 0.82; 95% CI, .57-1.17) compared to 2018. CONCLUSIONS: Increased 4CMenB uptake in adolescents was not associated with decline in carriage of disease-associated meningococci. 4CMenB immunization programs should focus on direct (individual) protection for groups at greatest risk of disease. CLINICAL TRIALS REGISTRATION: NCT03419533.
BACKGROUND: Recombinant protein-based vaccines targeting serogroup B meningococci protect against invasive disease but impacts on carriage are uncertain. This study assessed carriage prevalence of disease-associated meningococci in 2018-2020 as the proportion of vaccinated adolescents increased following introduction of a school-based 4CMenB immunization program. METHODS: Eligible participants who completed high school (aged 17-25) in South Australia in the previous year had an oropharyngeal swab taken and completed a risk factor questionnaire. Disease-associated meningococci (genogroups A, B, C, W, X, Y) were detected by meningococcal and genogroup-specific polymerase chain reaction. RESULTS: The analysis included 4104 participants in 2018, 2690 in 2019, and 1338 in 2020. The proportion vaccinated with 4CMenB increased from 43% in 2018, to 78% in 2019, and 76% in 2020. Carriage prevalence of disease-associated meningococci in 2018 was 225/4104 (5.5%). There was little difference between carriage prevalence in 2019 (134/2690, 5.0%; adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], .64-1.05) and 2020 (68/1338, 5.1%; aOR, 0.82; 95% CI, .57-1.17) compared to 2018. CONCLUSIONS: Increased 4CMenB uptake in adolescents was not associated with decline in carriage of disease-associated meningococci. 4CMenB immunization programs should focus on direct (individual) protection for groups at greatest risk of disease. CLINICAL TRIALS REGISTRATION: NCT03419533.
Authors: Mark McMillan; Jana Bednarz; Lex E X Leong; Andrew Lawrence; Helen S Marshall Journal: Pediatr Infect Dis J Date: 2022-07-27 Impact factor: 3.806