Medical Development, Scientific & Clinical Affairs, Pfizer, 23-25 Avenue Docteur Lannelongue, Paris, 75014, France.
P95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
BMC Public Health. 2020 Dec 9;20(1):1890. doi: 10.1186/s12889-020-09946-1.
Monovalent meningococcal C conjugate vaccine (MCCV) was introduced into the routine immunization program in many countries in Europe and worldwide following the emergence of meningococcal serogroup C (MenC) in the late 1990s. This systematic literature review summarizes the immediate and long-term impact and effectiveness of the different MCCV vaccination schedules and strategies employed.
We conducted a systematic literature search for peer-reviewed, scientific publications in the databases of MEDLINE (via PubMed), LILACS, and SCIELO. We included studies from countries where MCCV have been introduced in routine vaccination programs and studies providing the impact and effectiveness of MCCV published between 1st January 2001 and 31st October 2017.
Forty studies were included in the review; 30 studies reporting impact and 17 reporting effectiveness covering 9 countries (UK, Spain, Italy, Canada, Brazil, Australia, Belgium, Germany and the Netherlands). Following MCCV introduction, significant and immediate reduction of MenC incidence was consistently observed in vaccine eligible ages in all countries with high vaccine uptake. The reduction in non-vaccine eligible ages (especially population > 65 years) through herd protection was generally observed 3-4 years following introduction. Vaccine effectiveness (VE) was mostly assessed through screening methods and ranged from 38 to 100%. The VE was generally highest during the first year after vaccination and waned over time. The VE was better maintained in countries employing catch-up campaigns in older children and adolescents, compared to routine infant only schedules.
MCCV were highly effective, showing a substantial and sustained decrease in MenC invasive meningococcal disease. The epidemiology of meningococcal disease is in constant transition, and some vaccination programs now include adolescents and higher valent vaccines due to the recent increase in cases caused by serogroups not covered by MCCV. Continuous monitoring of meningococcal disease is essential to understand disease evolution in the setting of different vaccination programs.
单 价流脑 C 结合疫苗（MCCV）在 20 世纪 90 年代末 C 群流脑（MenC）出现后，在欧洲和世界范围内的许多国家被纳入常规免疫计划。本系统文献综述总结了不同 MCCV 免疫接种计划和策略的即时和长期影响及效果。
我们在 MEDLINE（通过 PubMed）、LILACS 和 SCIELO 数据库中进行了系统的文献检索，查找同行评审的科学出版物。我们纳入了 MCCV 已纳入常规疫苗接种计划的国家的研究，以及在 2001 年 1 月 1 日至 2017 年 10 月 31 日期间发表的关于 MCCV 影响和效果的研究。
综述共纳入 40 项研究；30 项报告了影响，17 项报告了效果，涵盖了 9 个国家（英国、西班牙、意大利、加拿大、巴西、澳大利亚、比利时、德国和荷兰）。在 MCCV 引入后，所有高疫苗接种率国家的疫苗可及年龄组中 MenC 发病率均显著且即时下降。通过群体免疫效应，非疫苗可及年龄组（尤其是年龄大于 65 岁的人群）的发病率下降通常在引入疫苗后 3-4 年观察到。疫苗有效性（VE）主要通过筛查方法评估，范围为 38%至 100%。疫苗接种后第一年的 VE 通常最高，随着时间的推移而逐渐下降。在为年龄较大的儿童和青少年实施补种运动的国家中，VE 维持得更好，而不是仅对婴儿进行常规免疫接种的国家。
MCCV 非常有效，可显著且持续降低 MenC 侵袭性脑膜炎球菌病的发病率。脑膜炎球菌病的流行病学在不断变化，由于最近由 MCCV 未覆盖的血清群引起的病例增加，一些疫苗接种计划现在包括青少年和更高价疫苗。持续监测脑膜炎球菌病对于了解不同疫苗接种计划下疾病的演变至关重要。
