Changes in meningococcal C epidemiology and vaccine effectiveness after vaccine introduction and schedule modification

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• 作者：M. Garrido-Estepa^a ; ^{mgarrido@isciii.es" class="auth_mail} ; ^{macarena.gaes@gmail.com" class="auth_mail} ; I. Leó ; n-Gó ; mez^a ; R. Herruzo^b ; R. Cano^a
• 关键词：Logistic regression ; meningococcal disease ; serogroup C ; vaccine effectiveness
• 刊名：Vaccine
• 出版年：7 May, 2014
• 年：2014
• 卷：32
• 期：22
• 页码：2604-2609
• 全文大小：771 K

文摘

Purpose

Meningococcal C conjugate vaccine was included in December 2000 in the Spanish childhood vaccination at 2, 4 and 6 months of age. In 2006, routine vaccination was modified to two doses at 2 and 4-6 months and a booster dose during the second year of age. Additionally, successive catch-up campaigns were launched to extend protection to older groups. This study provides long-term information about the vaccine effectiveness (VE) and the impact of vaccination in meningococcal C disease epidemiology in Spain.

Methods

We assessed surveillance data from season 1996/97 to season 2012/13 to describe changes in incidence and lethality of the disease. The vaccine-effectiveness study covered all cases notified from January 1st of 2001 onwards and evaluated vaccine effectiveness in both routines and in catch-up campaigns. To investigate the decline in protection over time, we compared the vaccine effectiveness within 1 year and more than one year since vaccination.

Results

The incidence of meningococcal serogroup C disease decreased first in those age-groups targeted for vaccination. But after 2006/07 season the decrease in incidence was generalised. Vaccine effectiveness was high in all vaccination programmes, although 2, 4-6 months (+ booster dose) routine showed higher overall vaccine effectiveness than 2, 4 and 6 months routine (99.3% vs. 90.2%). VE >1 year since vaccination was lower in 2, 4 and 6 months compared to 2 and 4-6 months (+ booster) routine (81.4% vs. 89.1%). For catch-up campaigns, VE increased and loss of VE decreased with the age of administration. Overall VE was 94.83 (CI95%: 93.37, 95.97), 98.82 (CI95%: 97.96, 99.31) and 90.89 (CI95%: 87.79, 93.21) for 鈮? and >1 year since vaccination, respectively.

Conclusions

The meningococcal C conjugate vaccination programme has been extremely successful in controlling the disease and continues to be evaluated and adapted to the changes in the epidemiology of the disease to ensure long-term vaccine protection.