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Evaluation of serogroup C and ACWY meningococcal vaccine programs: Projected impact on disease burden according to a stochastic two-strain dynamic model
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Evaluation of serogroup C and ACWY meningococcal vaccine programs: Projected impact on disease burden according to a stochastic two-strain dynamic model
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Journal Article
Evaluation of serogroup C and ACWY meningococcal vaccine programs: Projected impact on disease burden according to a stochastic two-strain dynamic model
2015
Overview
•Multi-strain dynamic models can be useful for meningococcal vaccine decision-making.•Monovalent C vaccine is predicted to cause strain replacement in the long-term.•Infant plus adolescent ACWY vaccination is predicted to be the most effective.
Advisory committees in Canada and the United States have updated recommendations for quadrivalent meningococcal conjugate vaccines against serogroups A, C, W135, and Y. Our objective was to evaluate optimally effective meningococcal vaccination policies using a stochastic dynamic model. Canada was used as an example.
Our stochastic dynamic model of Neisseria meningitidis (Nm) transmission in an age-structured population assumed partial cross-immunity among two aggregated serogroup categories: ‘AWY’ containing A, W135, and Y; and ‘Other’ containing B, C, and ungroupable types. We compared the impact of monovalent C versus quadrivalent ACWY vaccination on Nm carriage and invasive meningococcal disease (IMD). Our model was parameterized with Canadian epidemiological and demographic data and employed probabilistic sensitivity analysis.
Routine infant immunization at 12 months and boosting at 15 years with a quadrivalent vaccine is projected to have the largest impact on total IMD incidence: a 74% reduction over 40 years. Routine infant immunization with a monovalent vaccine at 12 months only has much less impact and also generates strain replacement appearing after approximately ten years of continuous use.
Immunizing infants at 12 months and boosting adolescents at 15 years with an ACWY vaccine is predicted to be most effective at reducing IMD incidence.
Publisher
Elsevier Ltd,Elsevier Limited
Subject
/ Adult
/ Age
/ Aged
/ Bacteremia - prevention & control
/ Canada
/ Female
/ Humans
/ Infant
/ Infants
/ Invasive meningococcal disease
/ Male
/ Meningitis, Bacterial - epidemiology
/ Meningitis, Bacterial - microbiology
/ Meningitis, Bacterial - prevention & control
/ Meningococcal Infections - epidemiology
/ Meningococcal Infections - microbiology
/ Meningococcal Infections - prevention & control
/ Meningococcal Vaccines - administration & dosage
/ Meningococcal Vaccines - immunology
/ Neisseria meningitidis - classification
/ Neisseria meningitidis - isolation & purification
/ Vaccines
