MenB vaccine works

Making an effective vaccine against group B meningococcal disease (MenB) has been a challenge, and although rates of meningococcal disease have fallen since the introduction of the Group C vaccine in 1999, the B-strain was always more prevalent. It is antigenically very complex, and it required the development of a multicomponent protein-based vaccine, known as 4CMenB or ‘Bexsero’ to produce any significant protection in initial trials. The UK was the first country to introduce 4CMenB into its routine infant schedule, after much debate over cost-effectiveness and haggling with the manufacturer over price. The first study to show its ‘real world’ effectiveness was carried out by Public Health England (Parikh S, et al. Lancet 2016. doi.org/10.1016/S0140-6736(16)31921–3). The vaccine was introduced as two-dose schedule, given at 2 and 4 months, in September 2015. Uptake was good (95.5% for one and 88.6% for two doses), perhaps reflecting public anxiety about this disease. Enhanced national surveillance confidently picked up all laboratory-confirmed cases.

The authors examined all cases reported in England from September 2015 to June 2016. From the historical precedent there should have been 74 cases but they found only 37, giving an incidence risk ratio reduction of 50% (IRR 0·50 [95% CI …