Medical Development, Scientific & Clinical Affairs, Pfizer Vaccines, Pfizer Inc , Collegeville, PA, USA.
Postgrad Med. 2020 Sep;132(7):614-623. doi: 10.1080/00325481.2020.1766265. Epub 2020 Jun 1.
College students in the United States are at an increased risk for meningococcal serogroup B disease or MenB, which causes the majority of invasive meningococcal disease in the country among adolescents and young adults (62%) and also across all age groups (36%) as of 2018. Approximately one-third of MenB cases among college students occur during campus outbreaks, which trigger substantial public health concern and costs associated with conducting rapid mass vaccination campaigns in an emergency setting. Eleven US college outbreaks of MenB disease have occurred since the initial licensure and recommendation of two MenB vaccines in 2014/2015; both vaccines have been used as part of outbreak responses on campuses, but vaccine coverage and multidose series completion among the general adolescent population are very low (approximately 17% of 17-year-olds in the United States received ≥1 dose in 2018). This review recounts shifts in US meningococcal outbreak epidemiology, lessons from immunogenicity evaluations of MenB vaccines with outbreak strains, and recent college outbreak experiences and mass vaccination responses. The challenges of reactive MenB outbreak containment and potential benefits of preventive immunization of US adolescents are also considered.
美国大学生感染 B 群脑膜炎奈瑟球菌（MenB）疾病的风险增加，该疾病是导致该国青少年和年轻人（62%）以及所有年龄段（36%）侵袭性脑膜炎奈瑟球菌病的主要原因。截至 2018 年，大学生中约三分之一的 MenB 病例发生在校园爆发期间，这引发了人们的极大关注，并导致在紧急情况下开展大规模疫苗接种活动的相关公共卫生成本增加。自 2014/2015 年两种 MenB 疫苗首次获得许可和推荐以来，美国已经发生了 11 起大学生 MenB 疾病爆发事件；这两种疫苗都曾用于校园爆发的应对，但在普通青少年人群中，疫苗接种率和多剂系列完成率非常低（2018 年，约 17%的 17 岁青少年接种了至少 1 剂）。本文回顾了美国脑膜炎球菌爆发流行病学的变化、针对爆发菌株的 MenB 疫苗免疫原性评估的经验教训，以及最近的大学爆发事件和大规模疫苗接种应对措施。还考虑了 MenB 爆发的反应性控制的挑战以及对美国青少年进行预防性免疫接种的潜在好处。
