Implementation and impact of a meningococcal C conjugate vaccination program in 13- to 25-year-old individuals in Galicia, Spain

Abstract

BackgroundIn response to increased case numbers of meningococcal group C disease, catch-up vaccination strategies have been shown to be successful. This paper describes the results of a repeat vaccination program in Galicia, Spain, and the strategy used for it.Methods and resultsThree vaccination waves were performed: first, in 1996/1997 with a meningococcal group A and C polysaccharide vaccine in individuals aged 18 months to 19 years; second, in 2000 with a conjugate serogroup C polysaccharide vaccine in children born since 1993 and all children and adolescents up to 19 years not previously vaccinated; third, a campaign in 2006 that became necessary because of the development of a new Neisseria strain and an increase in both the incidence and lethality of meningococcal C disease. The conjugate vaccine de-O-acetylated group C meningococcal polysaccharide coupled to tetanus toxoid was used (GCMP-TT; brand name, NeisVac-C). Results: Applying a strategy based on model calculations derived from the UK setting and focusing on a population aged 13–25 years, including students, employees of companies, and underage individuals, a total of 286,000 subjects were vaccinated, resulting in global vaccination coverage of 82.2% (all age groups over 74%). Only 17 adverse events in 17 individuals were reported, which all were mild. Incidence of meningococcal disease serogroup C by season was reduced from 0.84 cases per 100,000 in 2004/05 to 0.76 cases per 100,000 in 2005/2006 to 0.18/100,000 in 2007/08. In parallel, mortality was also decreased from 8 cases during 2005/06 (0.29 per 100,000) to 1 case in 2007/2008 (0.03 per 100,000). No cases of breakthrough disease occurred in the vaccinated population.ConclusionIn Galicia, a series of vaccination campaigns, particularly focusing on high-risk groups, has shown high effectiveness, with a marked reduction in the disease incidence in the vaccination cohort accompanied by a relevant reduction in the overall population.

Systematic literature review of the impact and effectiveness of monovalent meningococcal C conjugated vaccines when used in routine immunization programs

“…A total of 30 studies reported impact of MCCV vaccination programs and 17 studies reported vaccine effectiveness (direct effect) of MCCV. Studies came from 9 different countries; 11 from England and Wales/UK [20][21][22][23][24][25][26][27][28][29][30], 10 from Spain [31][32][33][34][35][36][37][38][39][40], 5 from Canada [41][42][43][44][45], 4 each from Brazil [46][47][48][49] and Italy [50][51][52][53], 2 each from Australia [54,55] and the Netherlands [56,57], and one each from Germany [58] and Belgium [59]. The MCCV were introduced as part of the routine childhood NIP in all these countries.…”

“…Since 2008 the vaccine coverage has remained > 95% for infant and > 94% for the booster dose [ 32 ]. There was a total of 7 studies from Spain (3 national studies [ 31 – 33 ], and one study each for Navarra [ 34 ], Galicia [ 35 ], Andalusia [ 36 ] and Catalonia regions [ 37 ]). Regardless of studies and study periods, the largest decrease of MenC cases was observed in children, with a decrease of 90–100% and 88–100% in < 1 and 1–4 years old respectively.…”