Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom.
Immunisation Department, Public Health England, Colindale, London, United Kingdom.
Euro Surveill. 2019 Jan;24(1). doi: 10.2807/1560-7917.ES.2019.24.1.1700818.
BackgroundIn 1999, the United Kingdom (UK) was the first country to introduce meningococcal group C (MenC) conjugate vaccination. This vaccination programme has evolved with further understanding, new vaccines and changing disease epidemiology.AimTo characterise MenC disease and population protection against MenC disease in England.MethodsBetween 1998/99-2015/16, surveillance data from England for laboratory-confirmed MenC cases were collated; using the screening method, we updated vaccine effectiveness (VE) estimates. Typing data and genomes were obtained from the Meningitis Research Foundation Meningococcus Genome Library and PubMLST database. Phylogenetic network analysis of MenC cc11 isolates was undertaken. We compared bactericidal antibody assay results using anonymised sera from 2014 to similar data from 1996-1999, 2000-2004 and 2009.ResultsMenC cases fell from 883 in 1998/99 (1.81/100,000 population) to 42 cases (0.08/100,000 population) in 2015/16. Lower VE over time since vaccination was observed after infant immunisation (p = 0.009) and a single dose at 1-4 years (p = 0.03). After vaccination at 5-18 years, high VE was sustained for ≥ 8 years; 95.0% (95% CI: 76.0- 99.5%). Only 25% (75/299) children aged 1-14 years were seroprotected against MenC disease in 2014. Recent case isolates mostly represented two cc11 strains.ConclusionHigh quality surveillance has furthered understanding of MenC vaccines and improved schedules, maximising population benefit. The UK programme provides high direct and indirect protection despite low levels of seroprotection in some age groups. High-resolution characterisation supports ongoing surveillance of distinct MenC cc11 lineages.
1999 年，英国（UK）是第一个引入脑膜炎奈瑟菌 C 群（MenC）结合疫苗的国家。随着进一步的了解、新疫苗的出现和疾病流行病学的变化，该疫苗接种计划也在不断发展。
描述英国 MenC 疾病的特征以及人群对 MenC 疾病的保护情况。
1998/99 年至 2015/16 年期间，收集英格兰实验室确诊的 MenC 病例监测数据；采用筛查方法，更新疫苗有效性（VE）估计值。从脑膜炎研究基金会脑膜炎奈瑟菌基因组文库和 PubMLST 数据库获取分型数据和基因组。对 MenC cc11 分离株进行系统进化网络分析。我们比较了使用 2014 年匿名血清和 1996-1999 年、2000-2004 年和 2009 年类似数据的杀菌抗体检测结果。
MenC 病例数从 1998/99 年的 883 例（每 10 万人 1.81 例）降至 2015/16 年的 42 例（每 10 万人 0.08 例）。自接种疫苗以来，随着时间的推移，婴儿免疫接种（p=0.009）和 1-4 岁时接种一剂疫苗（p=0.03）的 VE 逐渐降低。在 5-18 岁时接种疫苗后，高 VE 可持续 8 年以上；95.0%（95%CI：76.0-99.5%）。2014 年，1-14 岁儿童中仅有 25%（75/299）对 MenC 疾病具有血清保护作用。最近的病例分离株主要代表两种 cc11 菌株。
高质量的监测进一步了解了 MenC 疫苗，并改进了接种计划，使人群受益最大化。尽管在一些年龄组中血清保护率较低，但英国计划提供了高度的直接和间接保护。高分辨率特征支持对不同的 MenC cc11 谱系进行持续监测。
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