BACKGROUND: Invasive meningococcal disease (IMD) has a severe impact on infants and adolescents. In the United States, vaccination is targeted to adolescents. This study evaluated the public health impact (PHI) of introducing adolescent pentavalent (P, MenABCWY) vaccination and apotential infant meningococcal B (B, MenB) vaccination.
METHOD: An epidemiological model simulated the impact of adolescent P vaccination and infant B vaccination at 2, 4 and 12 months (2+1) or at 2, 4, 6 and 12 months (3+1) compared to the standard of care (SoC) over 60 years. SoC involved routine recommendation (RR) ofquadrivalent meningococcal (Q, MenACWY) vaccines to 11-years-old (yo) with a booster Q dose at 16 yo and a two-dose B vaccine under shared clinical decision-making. Modelled adolescent vaccination rates reflected 2021 uptake rates, whereas a constant 90% infantuptake rate was assumed.
RESULTS: Adolescent vaccination with Q vaccine at 11 yo, P at 16 yo and B vaccine as a second dose (QPB) averted 108 MenB and 0 MenACWY cases versus SoC. Administering Q at 11 yo and two-dose P at 16 yo (QPP) prevented 106 MenB and 53 MenACWY cases versus SoC. A2+1 infant schedule alongside adolescent vaccination prevented an additional 1,505 MenB cases, while a 3+1 schedule averted 1,531 MenB cases. Similar trends were observed with reduced time horizon or decreased infant vaccination coverage, with PHI improving ifMenB vaccine cross-protection against non-MenB serogroups was assumed.
CONCLUSIONS/LEARNING POINTS: Adolescent IMD vaccination following QPP offers the most improved PHI compared to SoC. Significant improvements in PHI can be observed with infant MenB vaccination following 2+1 or 3+1 schedule alongside adolescent vaccination in the US.
