Impact of an adolescent meningococcal ACWY immunisation programme to control a national outbreak of group W meningococcal disease in England : a national surveillance and modelling study
Crown Copyright © 2022 Published by Elsevier Ltd. All rights reserved..
BACKGROUND: In August, 2015, the UK implemented an emergency adolescent immunisation programme with the meningococcal ACWY conjugate vaccine to combat a national outbreak of meningococcal group W (MenW) disease due to a hypervirulent ST-11 complex strain, which is currently causing regional and national outbreaks worldwide. This immunisation programme specifically targeted adolescents aged 13-18 years, an age group with low disease incidence but high nasopharyngeal carriage, with the aim of interrupting transmission and providing indirect (herd) protection across the population. Here, we report the impact of the first 4 years of the programme in England.
METHODS: Public Health England conducts meningococcal disease surveillance in England. Laboratory-confirmed cases of invasive meningococcal disease during the academic years 2010-11 to 2014-15 (Sept 1 to Aug 31) were used to predict post-vaccination trends, based on the assumption that cases would plateau 1 year after vaccine implementation (conservative scenario) or that cases would continue to rise for 4 years after vaccine implementation (extreme scenario). Vaccine uptake evaluated in August, 2019, was 37-41% in adolescents aged 18 years immunised in primary care and 71-86% in younger teenagers routinely vaccinated in school. Vaccine effectiveness was estimated with the indirect screening method.
FINDINGS: MenW and MenY cases plateaued within 12 months and then declined, while MenC cases remained low throughout. Significant reductions were observed among adolescents aged 14-18 years for MenW (incidence rate ratio [IRR] 0·35 [95% CI 0·17-0·76]) and MenY (0·21 [0·07-0·59]) cases, with a non-significant reduction in MenC cases (0·11 [0·01-1·01]). Based on conservative and extreme scenarios, 205-1193 MenW cases were prevented through the indirect effects of the programme and 25 through direct protection. For MenY, an estimated 60-106 cases were prevented through the indirect effects of the programme and 19 through direct protection. Ignoring any residual effect from an earlier MenC-containing vaccine, the overall vaccine effectiveness against MenCWY disease combined was 94% (95% CI 80-99).
INTERPRETATION: A meningococcal immunisation programme specifically targeting adolescent carriers succeeded in rapidly controlling a national MenW outbreak, even with moderate initial vaccine uptake.
FUNDING: Public Health England.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
|---|---|
| Enthalten in: |
The Lancet. Child & adolescent health - 6(2022), 2 vom: 28. Feb., Seite 96-105 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Campbell, Helen [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 17.02.2022 Date Revised 17.02.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/S2352-4642(21)00335-7 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM334196523 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM334196523 | ||
| 003 | DE-627 | ||
| 005 | 20231225223207.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/S2352-4642(21)00335-7 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1113.xml |
| 035 | |a (DE-627)NLM334196523 | ||
| 035 | |a (NLM)34883094 | ||
| 035 | |a (PII)S2352-4642(21)00335-7 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Campbell, Helen |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of an adolescent meningococcal ACWY immunisation programme to control a national outbreak of group W meningococcal disease in England |b a national surveillance and modelling study |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 17.02.2022 | ||
| 500 | |a Date Revised 17.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Crown Copyright © 2022 Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: In August, 2015, the UK implemented an emergency adolescent immunisation programme with the meningococcal ACWY conjugate vaccine to combat a national outbreak of meningococcal group W (MenW) disease due to a hypervirulent ST-11 complex strain, which is currently causing regional and national outbreaks worldwide. This immunisation programme specifically targeted adolescents aged 13-18 years, an age group with low disease incidence but high nasopharyngeal carriage, with the aim of interrupting transmission and providing indirect (herd) protection across the population. Here, we report the impact of the first 4 years of the programme in England | ||
| 520 | |a METHODS: Public Health England conducts meningococcal disease surveillance in England. Laboratory-confirmed cases of invasive meningococcal disease during the academic years 2010-11 to 2014-15 (Sept 1 to Aug 31) were used to predict post-vaccination trends, based on the assumption that cases would plateau 1 year after vaccine implementation (conservative scenario) or that cases would continue to rise for 4 years after vaccine implementation (extreme scenario). Vaccine uptake evaluated in August, 2019, was 37-41% in adolescents aged 18 years immunised in primary care and 71-86% in younger teenagers routinely vaccinated in school. Vaccine effectiveness was estimated with the indirect screening method | ||
| 520 | |a FINDINGS: MenW and MenY cases plateaued within 12 months and then declined, while MenC cases remained low throughout. Significant reductions were observed among adolescents aged 14-18 years for MenW (incidence rate ratio [IRR] 0·35 [95% CI 0·17-0·76]) and MenY (0·21 [0·07-0·59]) cases, with a non-significant reduction in MenC cases (0·11 [0·01-1·01]). Based on conservative and extreme scenarios, 205-1193 MenW cases were prevented through the indirect effects of the programme and 25 through direct protection. For MenY, an estimated 60-106 cases were prevented through the indirect effects of the programme and 19 through direct protection. Ignoring any residual effect from an earlier MenC-containing vaccine, the overall vaccine effectiveness against MenCWY disease combined was 94% (95% CI 80-99) | ||
| 520 | |a INTERPRETATION: A meningococcal immunisation programme specifically targeting adolescent carriers succeeded in rapidly controlling a national MenW outbreak, even with moderate initial vaccine uptake | ||
| 520 | |a FUNDING: Public Health England | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a MenACWY-CRM vaccine |2 NLM | |
| 650 | 7 | |a Meningococcal Vaccines |2 NLM | |
| 650 | 7 | |a Vaccines, Conjugate |2 NLM | |
| 650 | 7 | |a tetravalent meningococcal serogroups A, C, W-135 and Y tetanus toxoid conjugate vaccine |2 NLM | |
| 700 | 1 | |a Andrews, Nick |e verfasserin |4 aut | |
| 700 | 1 | |a Parikh, Sydel R |e verfasserin |4 aut | |
| 700 | 1 | |a White, Joanne |e verfasserin |4 aut | |
| 700 | 1 | |a Edelstein, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Bai, Xilian |e verfasserin |4 aut | |
| 700 | 1 | |a Lucidarme, Jay |e verfasserin |4 aut | |
| 700 | 1 | |a Borrow, Ray |e verfasserin |4 aut | |
| 700 | 1 | |a Ramsay, Mary E |e verfasserin |4 aut | |
| 700 | 1 | |a Ladhani, Shamez N |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Lancet. Child & adolescent health |d 2017 |g 6(2022), 2 vom: 28. Feb., Seite 96-105 |w (DE-627)NLM27703082X |x 2352-4650 |7 nnns |
| 773 | 1 | 8 | |g volume:6 |g year:2022 |g number:2 |g day:28 |g month:02 |g pages:96-105 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/S2352-4642(21)00335-7 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 6 |j 2022 |e 2 |b 28 |c 02 |h 96-105 | ||