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Published on: November 5, 2019
Changing patterns of invasive meningococcal disease and future immunization strategies
Muhamed-Kheir Taha1, Rafik Bekkat-Berkani2, Véronique Abitbol3
1Institut Pasteur, Invasive Bacterial Infections Unit, National Reference Centre for Meningococci and Haemophilus Influenza, Paris, France.
Abstract:
Invasive meningococcal disease (IMD) is a life-threatening disease caused by Neisseria meningitidis and has high mortality rates. Survivors often exhibit long-term sequelae and reduced life expectancy. Disease incidence is highest in infants and toddlers, with a resurgence of cases in adolescents and older adults (>50 years of age). Substantial heterogeneity exists in the recommendations of meningococcal vaccines included in National Immunization Programs (NIPs) across countries. Recommendations are usually based on infant/toddler immunization, with some countries recommending immunization only for toddlers. While existing recommendations have led to a reduced incidence of IMD in children <5 years of age, there has been an increase in cases among adolescents and older adults. Currently, older adults are not included in the recommendations. The higher healthcare burden and the economic costs associated with IMD in these age groups suggest that it is time to consider including adolescents and older adults in NIPs to protect against IMD caused by the five most prevalent serogroups. Currently, the lack of equity of access to vaccines in the immunization programs is a glaring gap in the betterment of public health, and a broader meningococcal strategy is recommended to provide optimal protection for all age groups.
Insights
Invasive meningococcal disease (IMD) impacts all ages, with rising cases in adolescents and older adults. Expanding national immunization programs to include these groups is crucial for comprehensive public health protection.
Area of Science:
- Public Health
- Epidemiology
- Vaccinology
Background:
- Invasive meningococcal disease (IMD) caused by *Neisseria meningitidis* presents significant mortality and long-term health consequences.
- IMD incidence peaks in infants/toddlers and resurges in adolescents and adults over 50.
- Current national immunization programs (NIPs) show heterogeneity in meningococcal vaccine recommendations, primarily focusing on young children.
Purpose of the Study:
- To evaluate the current landscape of meningococcal vaccine recommendations within NIPs.
- To highlight the increasing burden of IMD in adolescents and older adults.
- To advocate for the inclusion of adolescents and older adults in NIPs for broader protection against prevalent serogroups.
Main Methods:
- Review of existing national immunization program recommendations for meningococcal vaccines.
- Analysis of IMD incidence trends across different age demographics.
- Assessment of healthcare burden and economic costs associated with IMD.
Main Results:
- Existing NIPs have reduced IMD in children under 5 but have not curbed the rise in adolescents and older adults.
- Older adults are currently excluded from most NIP recommendations.
- Significant healthcare burden and economic costs are linked to IMD in unvaccinated adolescent and adult populations.
Conclusions:
- Current meningococcal vaccination strategies are insufficient, leading to inequities in protection.
- Adolescents and older adults represent a vulnerable population requiring targeted immunization.
- A broader public health strategy, including expanded NIPs, is necessary for optimal protection against IMD across all age groups.
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