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Mortality from group C meningococcal disease: a case for a conjugate vaccine?
F A Riordan1, O Marzouk, A P Thomson
1Institute of Child Health, Alder Hey Children's Hospital, Liverpool, UK.
Insights
A meningococcal group C conjugate vaccine could prevent most group C infections and reduce meningococcal disease mortality by 30%. This vaccine is effective in young children, unlike current options.
Area of Science:
- Pediatrics
- Infectious Diseases
- Vaccinology
Background:
- Meningococcal disease (MCD) remains a significant public health concern in children.
- Serogroup C strains have historically contributed to MCD incidence and mortality.
- The efficacy of existing vaccines in young children is limited.
Purpose of the Study:
- To evaluate the mortality attributed to meningococcal serogroup C (MCD) over a 17-year period.
- To assess the potential impact of a serogroup C conjugate vaccine on MCD cases and fatalities.
- To inform vaccination strategies for preventing MCD in pediatric populations.
Main Methods:
- Retrospective review of 449 pediatric MCD cases admitted between 1977 and 1993.
- Analysis of disease incidence, serogroup distribution, and mortality rates.
- Modeling the potential impact of a conjugate vaccine administered at 2-4 months of age.
Main Results:
- Serogroup C accounted for 78 MCD cases, with 11 deaths.
- A significant increase in the proportion of serogroup C cases (10% to 21%) and total MCD cases was observed from 1986.
- A conjugate vaccine could have prevented 68 serogroup C cases, including all fatalities, and could reduce overall MCD mortality by up to 30%.
Conclusions:
- The rise in MCD is partly driven by an increase in serogroup C infections.
- A meningococcal group C conjugate vaccine shows high potential for preventing infections and reducing mortality in children.
- Early administration of a conjugate vaccine could significantly mitigate the burden of meningococcal disease.
Abstract:
This 17-year retrospective review of children with meningococcal disease (MCD) has determined the mortality due to serogroup C, in order to assess the potential impact of a group C conjugate vaccine. Four hundred and forty-nine cases of MCD were admitted to our hospitals during 1977-1993; 78 due to group C, 11 of whom died. There was a significant increase in the proportion of cases due to group C from 1986 onwards (10% vs 21%), and an increase in the total number of cases of MCD (151 vs 298). The currently available group C polysaccharide vaccine has low efficacy below 2 years of age and could not have prevented 54 cases of group C disease. A conjugate group C vaccine administered between 2 and 4 months of age could have prevented 68 cases, including all fatal cases. The recent increase in MCD is partly due to an increase in group C disease. A meningococcal group C conjugate vaccine could prevent most cases of infection due to group C, and decrease the mortality from MCD by up to 30%.