Encouraging results for long-term efficacy of meningitis C vaccine

Four-year results assessing the efficacy of the UK meningitis C vaccine programme are reported in a research letter in this week's issue of THE LANCET. The vaccine is now showing long-term efficacy, except for infants initially vaccinated younger than 5 months of age.

The meningococcal serogroup C conjugate (MCC) vaccine programme was introduced in November 1999 and has successfully controlled the incidence of meningitis C--a result of high short-term vaccine effectiveness and substantial herd (population) immunity. However, the long-term effectiveness of the vaccine remains unknown.

Caroline Trotter (UK Health Protection Agency) and colleagues assessed surveillance data from the 4 years since the introduction of the vaccination programme. Vaccine effectiveness remained high in children vaccinated in the catch-up campaign (aged 5 months to 18 years) at around 90%. However, overall vaccine effectiveness was only 66% for children vaccinated in early infancy. the vaccine offered high levels of protection (>93% effectiveness) for one year, regardless of the age of the child at vaccination; however this protection rapidly diminished for children who were vaccinated in early infancy (younger than 5 months of age). With regard to this reduced protection, the authors comment: 'The number of cases of serogroup C disease in these cohorts remains low, but alternative routine immunisation schedules should be considered to ensure high levels of protection are sustained.'

Paul A Offit (University of Pennsylvania School of Medicine, Philadelphia, USA) gives an overall perspective on the UK MCC vaccination programme in an accompanying commentary (p 309): "The UK Department of Health showed how to efficiently implement an effective mass-immunisation programme with a conjugate meningococcal vaccine. The Department characterised the burden of serogroup C meningococcal infections, identified a vaccine to solve the problem, actively engaged several drug companies in the programme, and negotiated an affordable price, launched a media campaign to educate citizens about the disease and the vaccine, and immunised a remarkably high percentage of children within a year. For their efforts, the Department of Health deserves the gratitude of children and their parents throughout the world".

Contact: Health Protection Agency Press Office; T) 44-208-327-6647; hqpressofice@hpa.org.uk

Dr Paul A Offit, Childrens Hospital of Philadelphia, University of Pennsylvania, USA;
T) 215-590-2020; offit@email.chop.edu

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