B Part of It School Leaver Study: A Repeat Cross-Sectional Study to Assess the Impact of Increasing Coverage With Meningococcal B (4CMenB) Vaccine on Carriage of Neisseria meningitidis

Mark McMillan; Ann P Koehler; Andrew Lawrence; Thomas R Sullivan; Jana Bednarz; Jenny M MacLennan; Martin C J Maiden; Shamez N Ladhani; Mary E Ramsay; Caroline Trotter; Ray Borrow; Adam Finn; Charlene M Kahler; Jane Whelan; Kumaran Vadivelu; Peter C Richmond; Helen S Marshall

doi:10.1093/infdis/jiab444

B Part of It School Leaver Study: A Repeat Cross-Sectional Study to Assess the Impact of Increasing Coverage With Meningococcal B (4CMenB) Vaccine on Carriage of Neisseria meningitidis

J Infect Dis. 2022 Feb 15;225(4):637-649. doi: 10.1093/infdis/jiab444.

Authors

Mark McMillan^{1

2}, Ann P Koehler³, Andrew Lawrence⁴, Thomas R Sullivan^{5

6}, Jana Bednarz⁶, Jenny M MacLennan⁷, Martin C J Maiden⁷, Shamez N Ladhani⁸, Mary E Ramsay⁸, Caroline Trotter^{8

9}, Ray Borrow¹⁰, Adam Finn¹¹, Charlene M Kahler¹², Jane Whelan¹³, Kumaran Vadivelu¹⁴, Peter C Richmond^{15

16

17}, Helen S Marshall^{1

2}

Affiliations

¹ Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.
² Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
³ Communicable Disease Control Branch, SA Health, Adelaide, South Australia, Australia.
⁴ SA Pathology, Adelaide, South Australia, Australia.
⁵ South Australian Health and Medical Research Institute (SAHMRI Women and Kids), Adelaide, Australia.
⁶ School of Public Health, University of Adelaide, Adelaide, South Australia, Australia.
⁷ Department of Zoology, University of Oxford, Oxford, United Kingdom.
⁸ Immunisation Department, Public Health England, London, United Kingdom.
⁹ Departments of Pathology and Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
¹⁰ Meningococcal Reference Unit, Public Health England, Manchester, United Kingdom.
¹¹ Bristol Children's Vaccine Centre, Schools of Cellular and Molecular Medicine and Population Health Sciences, University of Bristol, Bristol, England.
¹² Marshall Centre for Infectious Disease Research and Training, School of Biomedical Science, University of Western Australia, Perth, Western Australia, Australia.
¹³ GSK, Amsterdam, The Netherlands.
¹⁴ GSK, Siena, Italy.
¹⁵ Vaccine Trials Group, Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.
¹⁶ Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.
¹⁷ Departments of Immunology and General Paediatrics, Perth Children's Hospital, Perth, Western Australia, Australia.

PMID: 34487174
DOI: 10.1093/infdis/jiab444

Abstract

Background: Recombinant protein-based vaccines targeting serogroup B meningococci protect against invasive disease but impacts on carriage are uncertain. This study assessed carriage prevalence of disease-associated meningococci in 2018-2020 as the proportion of vaccinated adolescents increased following introduction of a school-based 4CMenB immunization program.

Methods: Eligible participants who completed high school (aged 17-25) in South Australia in the previous year had an oropharyngeal swab taken and completed a risk factor questionnaire. Disease-associated meningococci (genogroups A, B, C, W, X, Y) were detected by meningococcal and genogroup-specific polymerase chain reaction.

Results: The analysis included 4104 participants in 2018, 2690 in 2019, and 1338 in 2020. The proportion vaccinated with 4CMenB increased from 43% in 2018, to 78% in 2019, and 76% in 2020. Carriage prevalence of disease-associated meningococci in 2018 was 225/4104 (5.5%). There was little difference between carriage prevalence in 2019 (134/2690, 5.0%; adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], .64-1.05) and 2020 (68/1338, 5.1%; aOR, 0.82; 95% CI, .57-1.17) compared to 2018.

Conclusions: Increased 4CMenB uptake in adolescents was not associated with decline in carriage of disease-associated meningococci. 4CMenB immunization programs should focus on direct (individual) protection for groups at greatest risk of disease.

Clinical trials registration: NCT03419533.

Keywords: Neisseria meningitidis; 4CMenB; carriage; herd protection; meningococcal.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Cross-Sectional Studies
Humans
Meningococcal Infections* / epidemiology
Meningococcal Infections* / prevention & control
Meningococcal Vaccines*
Neisseria meningitidis*
Neisseria meningitidis, Serogroup B*

Substances

Meningococcal Vaccines

Associated data

ClinicalTrials.gov/NCT03419533