Public Health Impact and Cost-Effectiveness Analysis of Routine Infant 4CMenB Vaccination in Germany to Prevent Serogroup B Invasive Meningococcal Disease

Scholz, Stefan; Schwarz, Magdalena; Beck, Ekkehard; Meszaros, Kinga; Schneider, Melanie; Ultsch, B.; Greiner, Wolfgang

doi:10.1007/s40121-021-00573-w

Cited by 9 publications

(9 citation statements)

References 48 publications

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“…For instance, Scholz et al. reported an NNV of 12,080 for routine infant MenB vaccination [ 38 ], while Christensen et al. reported NNV values exceeding 30,000 for various MenB strategies targeting infants to adolescents in Germany [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Employing the official population projections from the German Federal Statistical Office ensures data accuracy. However, during model development, these forecasts spanned only until 2060, providing a shorter extrapolation period than other comparable models [ 38 , 44 , 47 ]. Considering the observed IMD infection trajectories, notably the increased prevention of IMD cases towards the end of the extrapolation period, such a restricted time horizon may underestimate the public health benefits of MenACWY adolescent vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…Based on sales data for MenB vaccine doses, we applied an annual vaccine coverage that started at 2.5% in 2014, increased to 14.5% by 2020, and remained constant thereafter. Assumed protection duration was 33 months for individuals aged up to one year and 38 months for those older than one year [ 38 ]. Vaccine effectiveness against MenB IMD was estimated to be 58% [ 39 , 40 ].…”

Section: Methodsmentioning

confidence: 99%

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Modelling the Public Health Impact of MenACWY and MenC Adolescent Vaccination Strategies in Germany

Gruhn,

Batram,

Wick

et al. 2024

Infect Dis Ther

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Introduction Invasive meningococcal disease (IMD) causes significant mortality and long-term sequelae. This study assesses the potential public health impact of adolescent vaccination strategies employing MenACWY and MenC vaccines in Germany, where the existing meningococcal immunisation programme predominantly involves MenC administration in toddlers. Methods A dynamic transmission model was developed to simulate the carriage of five meningococcal serogroup compartments (AY/B/C/W/Other) from 2019 until 2060 within 1-year age groups from 0 to 99 years of age. IMD cases were estimated based on case-carrier ratios. The model considered vaccine effectiveness against carriage acquisition and IMD. Results The model predicts that introducing MenACWY adolescent vaccination could lead to a considerable reduction in IMD incidence, with the potential to prevent up to 65 cases per year and a cumulative total of 1467 cases by 2060. This decrease, mainly driven by herd effects, would result in a reduction of IMD incidence across all age groups, regardless of vaccination age. Furthermore, implementing MenACWY vaccination in adolescents is projected to decrease annual MenACWY-related IMD mortality by up to 64%, equating to an overall prevention of 156 IMD deaths by 2060. These protective outcomes are expected to culminate in approximately 2250 life years gained (LYG) throughout the model's projected time horizon. In contrast, the adoption of MenC vaccination in adolescents is predicted to have minimal influence on both IMD incidence and mortality, as well as on LYG. Conclusion The results of this study demonstrate that implementing MenACWY vaccination for adolescents in Germany is likely to notably reduce IMD incidence and mortality across age groups. However, the introduction of MenC adolescent vaccination shows only limited impact. Considering the extensive healthcare resources typically required for IMD management, these findings suggest the potential for economic benefits associated with the adoption of MenACWY adolescent vaccination, warranting further cost-effectiveness analysis. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-024-00958-7.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Modelling the Public Health Impact of MenACWY and MenC Adolescent Vaccination Strategies in Germany

Gruhn,

Batram,

Wick

et al. 2024

Infect Dis Ther

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“…Additionally, due to the uncommon nature of IMD, UK-specific inputs were not always available with the degree of granularity permitted in the model (e.g., breakdown of case fatality rates by serogroup or utility decrements by manifestation). Approaches to estimating and incorporating more innovative broader value elements, such as caregiver QALY losses due to IMD deaths or long-term sequelae, are included in the model but have not been fully aligned on and robustly reported in the literature [ 9 , 52 ]. Furthermore, projecting the impact of such changes over a long-time horizon encompasses substantial uncertainty for an unpredictable disease, such as IMD.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Role of Infant and Toddler MenACWY Immunisation in the UK: Does the Adolescent MenACWY Programme Provide Sufficient Protection?

Schley

Kowalik

Sullivan³

et al. 2023

Vaccines

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A combined Haemophilus influenzae type b (Hib)/meningococcal serogroup C (MenC) vaccine will soon be unavailable in the UK immunisation schedule due to discontinuation by the manufacturer. An interim statement by the Joint Committee on Vaccination and Immunisation (JCVI) advises stopping MenC immunisation at 12 months of age when this occurs. We undertook an analysis of the public health impact of various potential meningococcal vaccination strategies in the UK in the absence of the Hib/MenC vaccine. A static population-cohort model was developed evaluating the burden of IMD (using 2005–2015 epidemiological data) and related health outcomes (e.g., cases, cases with long-term sequelae, deaths), which allows for the comparison of any two meningococcal immunisation strategies. We compared potential strategies that included different combinations of infant and/or toddler MenACWY immunisations with the anticipated future situation in which a 12-month MenC vaccine is not used, but the MenACWY vaccine is routinely given in adolescents. The most effective strategy is combining MenACWY immunisation at 2, 4, and 12 months of age with the incumbent adolescent MenACWY immunisation programme, resulting in the prevention of an additional 269 IMD cases and 13 fatalities over the modelling period; of these cases, 87 would be associated with long-term sequelae. Among the different vaccination strategies, it was observed that those with multiple doses and earlier doses provided the greatest protection. Our study provides evidence suggesting that the removal of the MenC toddler immunisation from the UK schedule would potentially increase the risk of unnecessary IMD cases and have a detrimental public health impact if not replaced by an alternate infant and/or toddler programme. This analysis supports that infant and toddler MenACWY immunisation can provide maximal protection while complementing both infant/toddler MenB and adolescent MenACWY immunisation programmes in the UK.

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“…N . meningitidis is classified into 12 serogroups with six (A, B, C, W, X and Y) responsible for the majority of IMD cases worldwide and an average notification rate of around 0.6/100,000 people in European countries [ 1 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

FHbp variants among meningococci of serogroup B in Italy: Evolution and selective pressure, 2014–2017

et al. 2023

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Background Neisseria meningitidis (meningococcus) is the causative agent of invasive meningococcal disease (IMD). Meningococcus of serogroup B (MenB) is one of the main serogroup causing IMD. MenB strains may be prevented by meningococcal B vaccines. In particular, vaccines with Factor H-binding protein (FHbp), classified into two subfamilies (A or B) or in three variants (v1, v2 or v3), are those available. The objective of the study was to investigate the phylogenetic relationships of FHbp subfamilies A and B (variants v1, v2 or v3) genes and proteins, together with their evolution patterns and selective pressure. Materials and methods Overall, alignments of FHbp nucleotide and protein sequence from 155 MenB samples collected in different parts of Italy, from 2014 to 2017, were analyzed by ClustalW. JModeltest and the Smart Model Selection software were used for the statistical selection of the best-fit substitution models for nucleotide and protein alignments. Site-specific positive and negative selection were estimated through the HYPHY package. The phylogenetic signal was investigated with the likelihood mapping method. The Maximum Likelihood (ML) phylogenetic reconstructions were performed with Phyml. Results The phylogenic analysis identified different clusters within the FHbp subfamily A and B variants, confirming sequence diversity. The pattern of selective pressure in our study indicated that subfamily B FHbp sequences are subjected to greater variations and positive selective pressure respect to subfamily A, with 16 positively supported selected sites identified. Conclusion The study pointed out the need for continued genomic surveillance for meningococci to monitor selective pressure and amino acidic changes. Monitoring the genetic diversity and molecular evolution of FHbp variants may be useful to investigate genetic diversity which may emerge over time.

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Public Health Impact and Cost-Effectiveness Analysis of Routine Infant 4CMenB Vaccination in Germany to Prevent Serogroup B Invasive Meningococcal Disease

Cited by 9 publications

References 48 publications

Modelling the Public Health Impact of MenACWY and MenC Adolescent Vaccination Strategies in Germany

Modelling the Public Health Impact of MenACWY and MenC Adolescent Vaccination Strategies in Germany

Assessing the Role of Infant and Toddler MenACWY Immunisation in the UK: Does the Adolescent MenACWY Programme Provide Sufficient Protection?

FHbp variants among meningococci of serogroup B in Italy: Evolution and selective pressure, 2014–2017

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