Mass Vaccination Campaign Following Community Outbreak of Meningococcal Disease

Abstract

During December 12–29, 1998, seven patients ages 2–18 years were diagnosed with serogroup C meningococcal disease in two neighboring Florida towns with 33,000 residents. We evaluated a mass vaccination campaign implemented to control the outbreak. We maintained vaccination logs and recorded the resources used in the campaign that targeted 2- to 22-year-old residents of the two towns. A total of 13,148 persons received the vaccinations in 3 days. Vaccination coverage in the target population was estimated to be 86% to 99%. Five additional cases of serogroup C meningococcal disease occurred in the community during the year after the campaign began, four in patients who had not received the vaccine. The cost of control efforts was approximately $370,000. Although cases continued to occur, the vaccination campaign appeared to control the outbreak. Rapid implementation, a targeted approach, and high coverage were important to the campaign's success.

The Cost and Public Health Burden of Invasive Meningococcal Disease Outbreaks: A Systematic Review

“…The respective hospitalization rate was 55.6 % in an outbreak of mostly high school students in the USA [15] and 100 % in outbreaks that occurred among boys aged 3–6 years in the USA [14], secondary school students in Canada [32], and children and adolescents from Switzerland [35]. Seven of the studies reported the number of deaths [15, 16, 29–33], which ranged from zero among secondary school students in Canada [32] to nine among socially disadvantaged individuals in Washington state, USA [29]. The respective case fatality ratio ranged from 0 % among secondary school students in Canada [32] to 50 % among adolescents in the Ottawa, Ontario, and Hull, Quebec [30].…”

“…CPT was offered as part of the containment strategy in three of the outbreaks [14, 15, 33]. However, only one study reported the number offered rifampicin, ciprofloxacin, or ceftriaxone (484 individuals) after an outbreak involving 7 youth cases [33]. The costs associated with CPT were not reported in any of the studies, nor was any additional information on antibiotic administration.…”

“…The average number of vaccinees across these outbreaks was 18,316 (201,479 in 11 outbreaks). Of these, 9 reported costs associated with vaccination [13, 15, 33, 35, 42, 43]. The average vaccination cost per large containment strategy was $783,640 ($7,052,756 in 9 outbreaks, range $230,361–$1,477,511) and the average vaccination cost per IMD case was $73,931 (range $26,327–$164,168).…”

“…Medical staff costs were reported as $98,995 [33] and $54,483 [35] in two of the large containment strategies occurring in HIC. Public health costs were only reported in one study, which totaled $29,431 [33].…”

Pediatricians’ Preferences for Infant Meningococcal Vaccination

“…Furthermore, 11% to 19% of the survivors have permanent sequelae, such as hearing loss, neurologic damage, or loss of a limb [1,4]. Because of the rapid progression of the disease and its severe outcomes, meningococcal disease can cause considerable anxiety among parents and health care providers, and both sporadic cases and outbreaks can place a significant burden on health services (see, e.g., Krause et al [5] and Osterholm [6]). …”