Control of invasive meningococcal disease: is it achievable?

被引：10

作者：

Marshall, Helen ^{[1
,2
,3
,4
,5
]}

Wang, Bing ^{[1
,2
,3
,4
]}

Wesselingh, Steve ^{[5
]}

Snape, Matthew ^{[6
,7
]}

Pollard, Andrew J. ^{[6
,7
]}

机构：

[1] Womens & Childrens Hosp, Vaccinol & Immunol Res Trials Unit, Adelaide, SA 5006, Australia

[2] Univ Adelaide, Sch Paediat & Reprod Hlth, Adelaide, SA 5005, Australia

[3] Univ Adelaide, Robinson Res Inst, Adelaide, SA 5005, Australia

[4] Univ Adelaide, Sch Populat Hlth, Adelaide, SA 5005, Australia

[5] South Australian Hlth & Med Res Inst, Adelaide, SA, Australia

[6] Univ Oxford, Dept Paediat, Oxford Vaccine Grp, Oxford OX1 2JD, England

[7] Oxford Univ Hosp NHS Trust, Oxford NIHR Biomed Res Ctr, Oxford, England

来源：

INTERNATIONAL JOURNAL OF EVIDENCE-BASED HEALTHCARE | 2016年 / 14卷 / 01期

关键词：

carriage; herd immunity; immunization policy; invasive meningococcal disease; meningococcal B vaccines; SEROGROUP-B VACCINE; BIVALENT RLP2086 VACCINE; C CONJUGATE VACCINATION; OUTER-MEMBRANE VESICLES; PHASE; 1/2; TRIAL; NEISSERIA-MENINGITIDIS; BACTERICIDAL ANTIBODY; NEW-ZEALAND; OPEN-LABEL; INVESTIGATIONAL MULTICOMPONENT;

D O I：

10.1097/XEB.0000000000000048

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Neisseria meningitidis still leads to deaths and severe disability in children, adolescents and adults. Six different capsular groups of N. meningitidis cause invasive meningococcal disease in the form of meningitis and septicaemia in humans. Although conjugate meningococcal vaccines have been developed to provide protection against four of the capsular groups causing most diseases in humans, vaccines against capsular group B, which causes 85% of cases in Australia and the United Kingdom, have only recently been developed. A capsular group B meningococcal vaccine - 4CMenB (Bexsero) - has recently been licensed in the European Union, Canada and Australia. In Australia, a submission for inclusion of 4CMenB in the funded national immunization programme has recently been rejected. The vaccine will now be introduced into the national immunization programme in the United Kingdom following negotiation of a cost-effective price. With the current low incidence of invasive meningococcal disease in many regions, cost-effectiveness of a new capsular group B meningococcal vaccine is borderline in both the United Kingdom and Australia. Cost-effectiveness of an infant programme is determined largely by the direct protection of those vaccinated and is driven by the higher rate of disease in this age group. However, for an adolescent programme to be cost-effective, it must provide both long-term protection against both disease and carriage. The potential of vaccination to reduce the rate of severe invasive disease is a real possibility. A dual approach using both an infant and adolescent immunization programme to provide direct protection to those age groups at highest risk of meningococcal disease and to optimize the potential herd immunity effects is likely to be the most effective means of reducing invasive meningococcal disease. This commentary aims to describe the known disease burden and consequences of meningococcal disease, and the development and potential effectiveness of new capsular group B meningococcal vaccines.

引用

页码：3 / 14

页数：12

共 111 条

[41] Immunogenicity and tolerability of a multicomponent meningococcal serogroup B (4CMenB) vaccine in healthy adolescents in Chile: a phase 2b/3 randomised, observer-blind, placebo-controlled study [J].