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Is group-specific meningococcal vaccination resulting in epidemics caused by groups of virulent meningococci?

J Nikoskelainen, A Leino, E Lähtönen

    Lancet (London, England)
    |August 19, 1978
    PubMed

    Insights

    Routine vaccination against Neisseria meningitidis serogroups A and C in the Finnish military coincided with a rise in group Y infections. This suggests that A and C vaccinations may have inadvertently increased the prevalence of meningococcus group Y.

    Area of Science:

    • Microbiology
    • Epidemiology
    • Vaccinology

    Background:

    • Routine vaccination against Neisseria meningitidis serogroups A and C was implemented in the Finnish Armed Forces in 1976.
    • A severe case of pneumonia caused by group Y meningococcus occurred in a vaccinated recruit.

    Observation:

    • A study investigated meningococcal group distribution among recruits in the same unit.
    • 14 out of 31 isolates (46%) from 84 recruits were identified as group Y.
    • Group Y meningococcus was infrequently found in unvaccinated control individuals.

    Findings:

    • The widespread vaccination against serogroups A and C appears correlated with an increased frequency of Neisseria meningitidis group Y.
    • This observation suggests a potential serogroup replacement phenomenon following mass vaccination efforts.

    Implications:

    • The findings highlight the importance of monitoring meningococcal group epidemiology post-vaccination.
    • Further research is needed to understand the mechanisms behind this potential serogroup shift and its impact on public health.
    • Consideration of broader-spectrum meningococcal vaccines may be warranted to address emerging serogroup prevalence.

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