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• Is Bexsero® (MenB vaccine) effective in preventing invasive meningococcal disease? Experience of a tertiary hospital in the UK
  Arindam Mukherjee, Ahmed Qamruddin and Demetria Theodorou
  Published on: 20 September 2017

• Published on: 20 September 2017

  Is Bexsero® (MenB vaccine) effective in preventing invasive meningococcal disease? Experience of a tertiary hospital in the UK

  • Arindam Mukherjee, Consultant Neonatologist and Honorary Senior Lecturer St Marys Hospital, Manchester
  • Other Contributors:
    • Ahmed Qamruddin, Consultant Microbiologist
    • Demetria Theodorou, ST Trainee

  Is Bexsero® (MenB vaccine) effective in preventing invasive meningococcal disease? Experience of a tertiary hospital in the UK. Novel meningococcus serogroup B vaccine (Bexsero®) was introduced in UK national immunisation programme on 1 September 2015. All babies born from July 2015 were offered the vaccine alongside other routine immunisations and all babies born in May 2015 were offered Bexsero® as a one-off catch-up. Bexsero® is estimated to protect against 73–88% of MenB strains causing invasive meningococcal disease (IMD) in England and Wales1,2. Among the diseases preventable by immunisation, IMD remains a high public profile illness deserving the most rigorous consideration because of its rapid and severe onset, high mortality rate and burden of sequelae. Epidemiological data suggest that infants in the first year of life experience the highest risk of infection peaking at around 5 months and declining thereafter. We continue to observe IMD in the first year of life despite the introduction of Bexsero® in our national immunisation programme (Table 1). This retrospective data was obtained as part of service evaluation at Central Manchester University Hospital Foundation Trust from our microbiology department. We are one of the biggest integrated Children's hospitals in the UK providing a wide range of services for the North West region and have over 220,000 patient visits each year. The epidemiological year starts from July to June, rath...

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  Is Bexsero® (MenB vaccine) effective in preventing invasive meningococcal disease? Experience of a tertiary hospital in the UK. Novel meningococcus serogroup B vaccine (Bexsero®) was introduced in UK national immunisation programme on 1 September 2015. All babies born from July 2015 were offered the vaccine alongside other routine immunisations and all babies born in May 2015 were offered Bexsero® as a one-off catch-up. Bexsero® is estimated to protect against 73–88% of MenB strains causing invasive meningococcal disease (IMD) in England and Wales1,2. Among the diseases preventable by immunisation, IMD remains a high public profile illness deserving the most rigorous consideration because of its rapid and severe onset, high mortality rate and burden of sequelae. Epidemiological data suggest that infants in the first year of life experience the highest risk of infection peaking at around 5 months and declining thereafter. We continue to observe IMD in the first year of life despite the introduction of Bexsero® in our national immunisation programme (Table 1). This retrospective data was obtained as part of service evaluation at Central Manchester University Hospital Foundation Trust from our microbiology department. We are one of the biggest integrated Children's hospitals in the UK providing a wide range of services for the North West region and have over 220,000 patient visits each year. The epidemiological year starts from July to June, rather than January to December. Most forms of IMD, like many infectious diseases, display seasonal variation and reach a peak during the winter. Looking at epidemiological years means that every winter peak always falls within one year rather than being divided between two consecutive calendar years. ‘Unvaccinated’ cases (Table 1) had all routine vaccinations apart from Bexsero® (before September 2015). The ‘Vaccinated’ group includes those who ‘supposedly’ received Bexsero® (after September 2015). The assumption was made that all patients born from July 2015, received Bexsero®; their vaccination records were not checked. There are uncertainties about how effective it will be in protecting against invasive meningococcal disease3. Good active population-based sentinel surveillance would allow gathering important information also about the capability of the new vaccine to disrupt carrier chain and reach herd immunity.

  

  REFERENCES

  1.Frosi G, et al., Bactericidal antibody against a representative epidemiological meningococcal serogroup B panel confirms that MATS underestimates 4CMenB vaccine strain coverage. Vaccine, 2013.

  2.Vogel, U., et al., Predicted strain coverage of a meningococcal multicomponent vaccine (4CMenB) in Europe: a qualitative and quantitative assessment. Lancet Infect Dis, 2013. 13(5): p. 416-25.

  3.Andrews SM, Pollard AJ. A vaccine against serogroup B Neisseria meningitidis: dealing with uncertainty. The Lancet infectious diseases. 2014;14(5): 426–34. doi: 10.1016/S1473-3099(13)70341-4 [PubMed]

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  Conflict of Interest:
  None declared.

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