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Vaccine, Vol. 19 (31) (2001) pp. 4566 - 4575
Published by Elsevier Science B.V.
PII: S0264-410X(01)00209-2
Centers for Disease
Control and Prevention, Mailstop C-09, 1600 Clifton Road, NE, Atlanta, GA
30333, USA
Received 30 November 2000; received
in revised form 3 April 2001; accepted 12 April 2001
Background: Neisseria meningitidis is a leading cause of bacterial
meningitis in US; new capsular type-specific conjugate vaccines offer an
opportunity for improved control of meningococcal disease. We evaluated the
relative burdens of invasive meningococcal disease in US and examined the
projected impact of various meningococcal conjugate vaccination strategies on
rates of meningococcal disease. Methods: meningococcal disease incidence
rates were determined from active, population-based surveillance in selected US
areas. Models were created to determine impact of vaccination of infants,
toddlers, adolescents or college students with meningococcal conjugate
vaccines, with assumptions for vaccine coverage, efficacy and duration of
protection. Although we examined possible conjugate vaccine formulations
including serogroups A, C, Y and W-135, the final vaccine impact analysis
excluded serogroups A and W-135. Outcome measures were cumulative meningococcal
disease incidence, and incidence 10 years after initiating vaccination among
0-22-year-olds. Results: in models of serogroup C+Y meningococcal
conjugate vaccination of infants, toddlers and adolescents, the cumulative
incidence of meningococcal disease was reduced by 54, 48 and 25%, respectively;
the toddler strategy had the greatest impact per dose. After 10 years of
routine meningococcal conjugate vaccination, meningococcal disease could be
reduced by 50% and deaths by 64%. Conclusions: use of meningococcal
conjugate vaccine could markedly reduce meningococcal disease incidence. Our
data, along with vaccine formulation and vaccination program considerations,
will be important in determining the optimal choice of vaccination strategy.
Keywords: Neisseria meningitidis; Meningococal;
Conjugate vaccine
*Corresponding author. Tel.: +1-404-639-3292; fax:
+1-404-639-3059
1The participants in the ABCs Team are listed in the appendix A.
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