Department of Pediatrics, Santa Casa de São Paulo School of Medicine, São Paulo, Brazil.
Expert Rev Vaccines. 2011 Dec;10(12):1717-30. doi: 10.1586/erv.11.159.
Meningococcal disease is characterized by a marked variation in incidence and serogroup distribution by region and over time. In several European countries, Canada and Australia, immunization programs, including universal vaccination of infants or toddlers with catch-up campaigns in children and adolescents, aimed at controlling disease caused by meningococcal serogroup C have been successful in reducing disease incidence through direct and indirect protection. More recently, meningococcal conjugate vaccines targeting disease caused by serogroups A, C, W-135 and Y have been licensed and are being used in adolescent programs in the USA and Canada while a mass immunization campaign against serogroup A disease has been implemented in Africa. Positive results from clinical trials using vaccines against serogroup B disease in various age groups suggest the possibility of providing broader protection against serogroup B disease than is provided by the currently used outer membrane vesicle vaccines. The purpose of our review of meningococcal epidemiology and assessment of existing policies is to set the stage for future policy decisions. Vaccination policies to prevent meningococcal disease in different regions of the world should be based on quality information from enhanced surveillance systems.
脑膜炎球菌病的发病率和血清型分布在不同地区和不同时间存在明显差异。在一些欧洲国家、加拿大和澳大利亚，免疫规划包括对婴儿和幼儿进行普遍接种，以及对儿童和青少年进行补种运动，旨在控制由脑膜炎球菌 C 血清群引起的疾病，通过直接和间接保护成功降低了疾病发病率。最近，针对 A、C、W-135 和 Y 血清群引起的疾病的脑膜炎球菌结合疫苗已经获得许可，并正在美国和加拿大的青少年计划中使用，而针对 A 血清群疾病的大规模免疫接种运动已经在非洲实施。在不同年龄组使用针对 B 血清群疾病的疫苗进行临床试验的积极结果表明，有可能提供比目前使用的外膜囊泡疫苗更广泛的针对 B 血清群疾病的保护。我们对脑膜炎球菌流行病学的审查和对现有政策的评估旨在为未来的政策决策奠定基础。预防世界各地脑膜炎球菌病的疫苗接种政策应基于强化监测系统提供的高质量信息。
