Athena Institute, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands
Invasive meningococcal disease (IMD) is a severe bacterial infectious disease with high mortality and morbidity rates worldwide. In recent years, industrialised countries have implemented vaccines targeting IMD in their National Immunisation Programmes (NIPs). In 2002, the Netherlands successfully implemented a single dose of meningococcal serogroup C conjugate vaccine at the age of 14 months and performed a single catch-up for children ≤18 years of age. Since then the disease disappeared in vaccinated individuals. Furthermore, herd protection was induced, leading to a significant IMD reduction in non-vaccinated individuals. However, previous studies revealed that the current programmatic immunisation strategy was insufficient to protect the population in the foreseeable future. In addition, vaccines that provide protection against additional serogroups are now available. This paper describes to what extent the current strategy to prevent IMD in the Netherlands is still sufficient, taking into account the burden of disease and the latest scientific knowledge related to IMD and its prevention. In particular, primary MenC immunisation seems not to provide long-term protection, indicating a risk for possible recurrence of the disease. This can be combatted by implementing a MenC or MenACWY adolescent booster vaccine. Additional health benefits can be achieved by replacing the primary MenC by a MenACWY vaccine. By implementation of a recently licensed MenB vaccine for infants in the NIP, the greatest burden of disease would be targeted. This paper shows that optimisation of the immunisation strategy targeting IMD in the Netherlands should be considered and contributes to create awareness concerning prevention optimisation in other countries.
Ali A, Jafri RZ, Messonnier N, et al. Global practices of meningococcal vaccine use and impact on invasive disease. Pathog Glob Health. 2014;108(1):11-20. doi:10.1179/2047773214Y.0000000126
McIntosh ED, Carey V, Toneatto D, Dull P, Wassil J. Prevention of rare diseases: how revolutionary techniques can help vulnerable individuals-the example of serogroup B meningococcal infection. Ther Adv Vaccines. 2015;3(1):13-23. doi:10.1177/2051013614557477
Whelan J, Bambini S, Biolchi A, Brunelli B, Robert-Du Ry van Beest Holle M. Outbreaks of meningococcal B infection and the 4CMenB vaccine: historical and future perspectives. Expert Rev Vaccines. 2015;14(5):713-736. doi:10.1586/14760584.2015.1004317
European Medicines Agency (EMA). European Medicines Agency recommends approval of first vaccine for meningitis B. Vaccine to provide broad coverage against meningococcal group B infections (press release); 2012.
Pace D, Pollard AJ. Meningococcal disease: clinical presentation and sequelae. Vaccine. 2012;30(suppl 2):B3-B9. doi:10.1016/j.vaccine.2011.12.062
Stephens DS, Greenwood B, Brandtzaeg P. Epidemic meningitis, meningococcaemia, and Neisseria meningitidis. Lancet. 2007;369(9580):2196-2210. doi:10.1016/S0140-6736(07)61016-2
European Centre for Disease Prevention and Control (ECDC). Surveillance of invasive bacterial disease in Europe, 2012. Invasive pneumococcal disease, invasive Haemophilus influenza disease and invasive meningococcal disease. Stockholm: ECDC; 2015.
Jorgensen JH, Crawford SA, Fiebelkorn KR. Susceptibility of Neisseria meningitidis to 16 antimicrobial agents and characterization of resistance mechanisms affecting some agents. J Clin Microbiol. 2005;43(7):3162-3171. doi:10.1128/JCM.43.7.3162-3171.2005
Lockyer K, Gao F, Derrick JP, Bolgiano B. Structural correlates of carrier protein recognition in tetanus toxoid-conjugated bacterial polysaccharide vaccines. Vaccine. 2015;33(11):1345-1352. doi:10.1016/j.vaccine.2015.01.046
de Voer RM, Mollema L, Schepp RM, et al. Immunity against Neisseria meningitidis serogroup C in the Dutch population before and after introduction of the meningococcal c conjugate vaccine. PLoS One. 2010;5(8):e12144. doi:10.1371/journal.pone.0012144
Broker M, Jacobsson S, DeTora L, Pace D, Taha MK. Increase of meningococcal serogroup Y cases in Europe: a reason for concern? Hum Vaccin Immunother. 2012;8(5):685-688. doi:10.4161/hv.20098
Broker M, Jacobsson S, Kuusi M, et al. Meningococcal serogroup Y emergence in Europe: update 2011. Hum Vaccin Immunother. 2012;8(12):1907-1911. doi:10.4161/hv.21794
Bijlsma MW, Bekker V, Brouwer MC, Spanjaard L, van de Beek D, van der Ende A. Epidemiology of invasive meningococcal disease in the Netherlands, 1960-2012: an analysis of national surveillance data. Lancet Infect Dis. 2014;14(9):805-812. doi:10.1016/S1473-3099(14)70806-0
Ruitenberg EJ, Houweling H. [Universal vaccination against group-C meningococci and pneumococci; summary of the advice from the Health Counsil of the Netherlands]. Ned Tijdschr Geneeskd. 2002;146(20):938-940.
Van der Ende A, Spanjaard L. Bacterial Meningitis in the Netherlands; Annual Report 2013. Amsterdam: Netherlands Reference Laboratory for Bacterial Meningitis (AMC/RIVM); 2014.
Hepkema H, Pouwels KB, van der Ende A, Westra TA, Postma MJ. Meningococcal serogroup A, C, W(1)(3)(5) and Y conjugated vaccine: a cost-effectiveness analysis in the Netherlands. PLoS One. 2013;8(5):e65036. doi:10.1371/journal.pone.0065036
van 't Schurink-van 't Klooster TM. The National Immunisation Programme in the Netherlands. Surveillance and developments in 2013-2014. National Institute for Public Health and the Environment (RIVM); 2014.
Stoof SP, van der Klis FR, van Rooijen DM, Knol MJ, Sanders EA, Berbers GA. Timing of an adolescent booster after single primary meningococcal serogroup C conjugate immunization at young age; an intervention study among Dutch teenagers. PLoS One. 2014;9(6):e100651. doi:10.1371/journal.pone.0100651
Mollema L, de Melker HE, Hahne SJM, van Weert JWM, Berbers GAM, van der Klis FRM. PIENTER 2-Project: second research project on the protection against infectious diseases offered by the national immunisation program in the Netherlands. National Institute for Public Health and the Environment (RIVM); 2009.
Kaaijk P, van der Ende A, Berbers G, van den Dobbelsteen GP, Rots NY. Is a single dose of meningococcal serogroup C conjugate vaccine sufficient for protection? experience from the Netherlands. BMC Infect Dis. 2012;12:35. doi:10.1186/1471-2334-12-35
Ishola DA, Andrews N, Waight P, et al. Randomized Trial to Compare the Immunogenicity and Safety of a CRM or TT Conjugated Quadrivalent Meningococcal Vaccine in Teenagers who Received a CRM or TT Conjugated Serogroup C Vaccine at Preschool Age. Pediatr Infect Dis J. 2015. doi:10.1097/INF.0000000000000750
Ladhani SN, Beebeejaun K, Lucidarme J, et al. Increase in endemic Neisseria meningitidis capsular group W sequence type 11 complex associated with severe invasive disease in England and Wales. Clin Infect Dis. 2015;60(4):578-585. doi:10.1093/cid/ciu881
Lucidarme J, Hill DM, Bratcher HB, et al. Genomic resolution of an aggressive, widespread, diverse and expanding meningococcal serogroup B, C and W lineage. J Infect. 2015. doi:10.1016/j.jinf.2015.07.007
Medini D, Stella M, Wassil J. MATS: Global coverage estimates for 4CMenB, a novel multicomponent meningococcal B vaccine. Vaccine. 2015;33(23):2629-2636. doi:10.1016/j.vaccine.2015.04.015
Drysdale SB, Pollard AJ. Group B meningococcal vaccine science and policy. J Infect. 2015;71(suppl 1):S15-S20. doi:10.1016/j.jinf.2015.04.021
Vogel U, Taha MK, Vazquez JA, et al. Predicted strain coverage of a meningococcal multicomponent vaccine (4CMenB) in Europe: a qualitative and quantitative assessment. Lancet Infect Dis. 2013;13(5):416-425. doi:10.1016/S1473-3099(13)70006-9
Christensen H, Hickman M, Edmunds WJ, Trotter CL. Introducing vaccination against serogroup B meningococcal disease: an economic and mathematical modelling study of potential impact. Vaccine. 2013;31(23):2638-2646. doi:10.1016/j.vaccine.2013.03.034
Christensen H, Trotter CL, Hickman M, Edmunds WJ. Re-evaluating cost effectiveness of universal meningitis vaccination (Bexsero) in England: modelling study. BMJ. 2014;349:g5725. doi:10.1136/bmj.g5725
Pouwels KB, Hak E, van der Ende A, Christensen H, van den Dobbelsteen GP, Postma MJ. Cost-effectiveness of vaccination against meningococcal B among Dutch infants: Crucial impact of changes in incidence. Hum Vaccin Immunother. 2013;9(5):1129-1138. doi:10.4161/hv.23888
Vesikari T, Esposito S, Prymula R, et al. Immunogenicity and safety of an investigational multicomponent, recombinant, meningococcal serogroup B vaccine (4CMenB) administered concomitantly with routine infant and child vaccinations: results of two randomised trials. Lancet. 2013;381(9869):825-835. doi:10.1016/S0140-6736(12)61961-8