McMillan Mark, Koehler Ann P, Lawrence Andrew, Sullivan Thomas R, Bednarz Jana, MacLennan Jenny M, Maiden Martin C J, Ladhani Shamez N, Ramsay Mary E, Trotter Caroline, Borrow Ray, Finn Adam, Kahler Charlene M, Whelan Jane, Vadivelu Kumaran, Richmond Peter C, Marshall Helen S
Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.
Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
J Infect Dis. 2022 Feb 15;225(4):637-649. doi: 10.1093/infdis/jiab444.
Recombinant protein-based vaccines targeting serogroup B meningococci protect against invasive disease but impacts on carriage are uncertain. This study assessed carriage prevalence of disease-associated meningococci in 2018-2020 as the proportion of vaccinated adolescents increased following introduction of a school-based 4CMenB immunization program.
Eligible participants who completed high school (aged 17-25) in South Australia in the previous year had an oropharyngeal swab taken and completed a risk factor questionnaire. Disease-associated meningococci (genogroups A, B, C, W, X, Y) were detected by meningococcal and genogroup-specific polymerase chain reaction.
The analysis included 4104 participants in 2018, 2690 in 2019, and 1338 in 2020. The proportion vaccinated with 4CMenB increased from 43% in 2018, to 78% in 2019, and 76% in 2020. Carriage prevalence of disease-associated meningococci in 2018 was 225/4104 (5.5%). There was little difference between carriage prevalence in 2019 (134/2690, 5.0%; adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], .64-1.05) and 2020 (68/1338, 5.1%; aOR, 0.82; 95% CI, .57-1.17) compared to 2018.
Increased 4CMenB uptake in adolescents was not associated with decline in carriage of disease-associated meningococci. 4CMenB immunization programs should focus on direct (individual) protection for groups at greatest risk of disease.
NCT03419533.
针对B群脑膜炎球菌的基于重组蛋白的疫苗可预防侵袭性疾病，但对带菌情况的影响尚不确定。本研究评估了2018 - 2020年疾病相关脑膜炎球菌的带菌率，随着基于学校的4CMenB免疫计划的实施，接种疫苗的青少年比例有所增加。
前一年在南澳大利亚完成高中学业（年龄在17 - 25岁）的符合条件的参与者接受了口咽拭子采集并完成了危险因素问卷调查。通过脑膜炎球菌和基因群特异性聚合酶链反应检测疾病相关脑膜炎球菌（基因群A、B、C、W、X、Y）。
分析包括2018年的4104名参与者、2019年的2690名参与者和2020年的1338名参与者。接种4CMenB的比例从2018年的43%增加到2019年的78%和2020年的76%。2018年疾病相关脑膜炎球菌的带菌率为225/4104（5.5%）。与2018年相比，2019年（134/2690，5.0%；调整优势比[aOR]，0.82；95%置信区间[CI]，0.64 - 1.05）和2020年（68/1338，5.1%；aOR，0.82；95%CI，0.57 - 1.17）的带菌率几乎没有差异。
青少年中4CMenB接种率的增加与疾病相关脑膜炎球菌带菌率的下降无关。4CMenB免疫计划应侧重于对疾病风险最高的人群进行直接（个体）保护。
NCT03419533。
