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The serogroup C meningococcal immunisation programme was reviewed during 2012 by the Department of Health's Joint Committee on Vaccination and Immunisation (JCVI), and an adolescent booster has been recommended as a result of concerns over duration of immunity in the childhood population.1
During the 1990s, a clone of Neisseria meningitidis (sequence type 11; ST11) with a serogroup C polysaccharide capsule (repeating units of the sugar, α-2-9 N acetyl neuraminic acid) swept through the UK causing outbreaks of meningococcal disease in schools and universities, generating considerable media attention and anxiety for parents and those doctors, including paediatricians, in the front line of early diagnosis. The highest rates of disease were in the first 2 years of life, presumably as a result of immunological naivety, and among adolescents and young adults (see figure 1) as a result of various well known risk factors and behaviours (smoking, bar attendance, interpersonal proximity).2 ,3 The response to this serious public health problem, with some 955 microbiologically confirmed cases in the year from mid-1998, was the development, clinical testing and licensure of three serogroup C meningococcal (MenC) conjugate vaccines.4 These vaccines contain the MenC polysaccharide, chemically conjugated to a carrier protein (either tetanus toxoid or a mutant diphtheria toxoid, CRM197). The Department of Health launched an ambitious campaign of vaccination against MenC in the autumn of 19994 with the majority of infants, children and young people from 2 months to 19 years of age receiving MenC vaccine (see table 1) in a mass vaccination campaign over the next 12 months.5 Cases of disease caused by serogroup C meningococci plummeted over the next year, and continued to fall during the ensuing decade.6 Based on the prevaccination 1998 levels of disease, the vaccine may now have prevented more than 10 000 cases (see figure 2). …
Contributors All authors contributed equally in the formulation of the manuscript and the review of the final draft.
Competing interests AJP and MDS conduct clinical trials on behalf of Oxford University sponsored by manufacturers of meningococcal vaccines but do not receive any personal payments from them. Honoraria and travel reimbursement for attendance at conferences and advisory board meetings by MDS are paid to a fund held at the University. The University receives unrestricted educational grants from these manufacturers for organisation of conferences and symposia. AJP is a member of the meningococcal subcommittee of the Joint Committee of Vaccination and Immunisation.
Provenance and peer review Commissioned; externally peer reviewed.