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Vaccination of Infants with Meningococcal Group B Vaccine (4CMenB) in England.

Ladhani, SN; Andrews, N; Parikh, SR; Campbell, H; White, J; Edelstein, M; Bai, X; Lucidarme, J; Borrow, R; Ramsay, ME (2020) Vaccination of Infants with Meningococcal Group B Vaccine (4CMenB) in England. N Engl J Med, 382 (4). pp. 309-317. ISSN 1533-4406 https://doi.org/10.1056/NEJMoa1901229
SGUL Authors: Ladhani, Shamez Nizarali

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Abstract

BACKGROUND: In September 2015, the United Kingdom introduced the multicomponent meningococcal group B vaccine (4CMenB, Bexsero) into its publicly funded national immunization program at a reduced two-dose priming schedule for infants, with a 12-month booster. METHODS: Using data from enhanced national surveillance of invasive meningococcal disease in England, we evaluated the effect of vaccination on the incidence of meningococcal group B disease during the first 3 years of the program. The effect of vaccination was assessed by comparing the observed incidence of disease with the expected incidence based on the incidence during the 4-year prevaccination period in equivalent cohorts and with the use of disease trends in cohorts of children younger than 5 years of age who were not eligible to receive the vaccine. Vaccine effectiveness was estimated with the use of the indirect screening method. RESULTS: 4CMenB uptake in England remained consistently high; data from the first 3 months of 2018 showed that 92.5% of children had completed the primary immunizations by their first birthday and 87.9% had received all three doses by 2 years. From September 2015 through August 2018, the incidence of meningococcal group B disease in England (average annual birth cohort, approximately 650,000 infants) was significantly lower in vaccine-eligible cohorts than the expected incidence (63 observed cases as compared with 253 expected cases; incidence rate ratio, 0.25; 95% confidence interval [CI], 0.19 to 0.36), with a 75% reduction in age groups that were fully eligible for vaccination. The adjusted vaccine effectiveness against meningococcal group B disease was 52.7% (95% CI, -33.5 to 83.2) with a two-dose priming schedule for infants and 59.1% (95% CI, -31.1 to 87.2) with a two-dose priming schedule plus a booster at 1 year). Over the 3-year period, there were 169 cases of meningococcal group B disease in the vaccine-eligible cohorts, and an estimated 277 cases (95% CI, 236 to 323) were prevented. CONCLUSIONS: The 4CMenB program was associated with continued positive effect against meningococcal group B disease in children in England, and protection after three doses of the vaccine was sustained for at least 2 years. (Funded by Public Health England.).

Item Type: Article
Additional Information: From New England Journal of Medicine, Shamez N. Ladhani, M.R.C.P.C.H.(U.K.), Ph.D., Nick Andrews, Ph.D., Sydel R. Parikh, M.Sc., Helen Campbell, Ph.D., Joanne White, B.Sc., Michael Edelstein, F.F.P.H., Xilian Bai, Ph.D., Jay Lucidarme, Ph.D., Ray Borrow, F.R.C.Path., Ph.D., and Mary E. Ramsay, F.F.P.H, Vaccination of Infants with Meningococcal Group B Vaccine (4CMenB) in England, 382, 309-317. Copyright © 2020 Massachusetts Medical Society. Reprinted with permission.
Keywords: 11 Medical and Health Sciences, General & Internal Medicine
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: N Engl J Med
ISSN: 1533-4406
Language: eng
Dates:
DateEvent
23 January 2020Published
1 October 2019Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
UNSPECIFIEDPublic Health Englandhttp://dx.doi.org/10.13039/501100002141
PubMed ID: 31971676
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111330
Publisher's version: https://doi.org/10.1056/NEJMoa1901229

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