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Cited by 276Bacterial Infections and VaccinesNeonatal and Maternal InfectionsMicrobial infections and disease research

The DOI matches its Crossref record; 17 of the 18 references it cites were found in a registry or an index.

Effectiveness and impact of a reduced infant schedule of 4CMenB vaccine against group B meningococcal disease in England: a national observational cohort study

Parikh, Sydel R, Andrews, Nick J, Beebeejaun, Kazim, Campbell, Helen, Ribeiro, Sonia, Ward, Charlotte, White, Joanne M, Borrow, Ray, Ramsay, Mary E, Ladhani, Shamez N·2016·The Lancet
DOI 10.1016/s0140-6736(16)31921-3
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Abstract

Background In September, 2015, the UK became the first country to introduce the multicomponent group B meningococcal (MenB) vaccine (4CMenB, Bexsero) into a publicly funded national immunisation programme. A reduced two-dose priming schedule was offered to infants at 2 months and 4 months, alongside an opportunistic catch-up for 3 month and 4 month olds. 4CMenB was predicted to protect against 73-88% of MenB strains. We aimed to assess the effectiveness and impact of 4CMenB in vaccine-eligible infants in England.Methods Public Health England (PHE) undertakes enhanced surveillance of meningococcal disease through a combination of clinical, public health, and laboratory reporting. Laboratory-confirmed cases of meningococcal disease are followed up with PHE local health protection teams, general practitioners, and hospital clinicians to collect demographic data, vaccination history, clinical presentation, and outcome. For cases diagnosed between Sept 1, 2015, and June 30, 2016, vaccine effectiveness was assessed using the screening method. Impact was assessed by comparing numbers of cases of MenB in vaccine-eligible children to equivalent cohorts in the previous 4 years and to cases in vaccine-ineligible children.Findings Coverage of 4CMenB in infants eligible for routine vaccination was high, achieving 95·5% for one dose and 88·6% for two doses by 6 months of age. Two-dose vaccine effectiveness was 82·9% (95% CI 24·1-95·2) against all MenB cases, equivalent to a vaccine effectiveness of 94·2% against the highest predicted MenB strain coverage of 88%. Compared with the prevaccine period, there was a 50% incidence rate ratio (IRR) reduction in MenB cases in the vaccine-eligible cohort (37 cases vs average 74 cases; IRR 0·50 [95% CI 0·36-0·71]; p=0·0001), irrespective of the infants' vaccination status or predicted MenB strain coverage. Similar reductions were observed even after adjustment for disease trends in vaccine-eligible and vaccine-ineligible children.Interpretation The two-dose 4CMenB priming schedule was highly effective in preventing MenB disease in infants. Cases in vaccine-eligible infants halved in the first 10 months of the programme. While ongoing national surveillance will continue to monitor the longer-term impact of the programme, these findings represent a step forward in the battle against meningococcal disease and will help reassure that the vaccine protects against this deadly infection.Funding Public Health England.

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Metadata

Authors
Parikh, S. R., Andrews, N. J., Beebeejaun, K., Campbell, H., Ribeiro, S., Ward, C., White, J. M., Borrow, R., Ramsay, M. E., & Ladhani, S. N.
Affiliations
Public Health England (GB)
Corresponding author
Ladhani, Shamez N
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2016-12
Volume
388
Issue
10061
Pages
2775-2782
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(16)31921-3
OpenAlex
W2540474236
Cited by
275
References
18
Citations by year
2026: 10 · 2025: 11 · 2024: 14 · 2023: 14 · 2022: 15 · 2021: 20 · 2020: 38 · 2019: 63 · 2018: 53 · 2017: 35 · 2016: 1
FWCI
51.87
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • St George's Online Research Archive (St George's University of London) (acceptedVersion)
Funders
Public Health England
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and Maternal Infections
  • Life Sciences › Immunology and Microbiology › Microbiology › Microbial infections and disease research
Keywords
4CMenB, infant vaccination schedule, catch-up vaccination, meningococcal disease incidence, vaccination coverage, meningococcal serogroups, national vaccination program, disease surveillance, vaccine impact, meningococcal serogroup B
MeSH terms
United Kingdom, Humans, Immunization Schedule, Infant, Meningococcal Infections, Public Health, Treatment Outcome, Immunization Programs, Meningococcal Vaccines

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