Serious BCG vaccine-associated complications continue to occur in Canada. The numbers of FNI children with disseminated disease was greater than expected from reported rates in the literature.

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The HSV-2 seroprevalence among pregnant women in British Columbia is similar to that in the United States and other countries. Seroprevalence continues to rise through the later reproductive years. This observation may relate to continued transmission, an age cohort effect, or both.

Objectives: 1) To examine trends in serogroup-specific invasive meningococcal disease (IMD) incidence associated with the protein-polysaccharide conjugate C vaccine (MCC) program in BC; 2) To assess for evidence of capsule switching and serogroup replacement; 3) To discuss whether recent data support modification of the current MCC program to include the quadrivalent protein-polysaccharide conjugate vaccine (MCV-4). Methods: Information on IMD cases since 1998 were extracted from surveillance databases. Annual IMD incidence rates and corresponding three-year moving averages were calculated. Data management was performed using Microsoft® Office Excel 2003. Time trends were analyzed using chi-square test for linear trend. Results: For 2003-2006, no significant trends were found in rates of serogroup-specific or total IMD in the overall BC population. Among children <18 years, average annual incidence of serogroup-C IMD has declined with a downward trend (p=0.05). Median age of serogroup-C IMD increased from 16 years (2003) to 42 years (2006). No significant change in incidence rates of pediatric IMD from any non-C serogroup was detected. Discussion: We document a decreasing trend of pediatric serogroup-C IMD and an increase in median age of serogroup-C IMD cases since 2003, most likely explained by protection from immunization. While the proportion of serogroup-Y IMD has increased, incidence rates of non-C vaccine-preventable IMD have not increased in BC. While incorporation of MCV-4 in routine childhood immunization is desirable to address the few residual cases of non-C vaccine-preventable IMD, it would take several decades to appreciate a benefit from a modified childhood program.

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