Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, UK; Monash University and Monash Children's Hospital, Melbourne, Australia.
Department of Biology, University of Oxford, Oxford, UK.
Clin Microbiol Infect. 2022 Dec;28(12):1649.e1-1649.e8. doi: 10.1016/j.cmi.2022.07.004. Epub 2022 Jul 13.
Serogroup W and Y invasive meningococcal disease increased globally from 2000 onwards. Responding to a rapid increase in serogroup W clonal complex 11 (W:cc11) invasive meningococcal disease, the UK replaced an adolescent booster dose of meningococcal C conjugate vaccine with quadrivalent MenACWY conjugate vaccine in 2015. By 2018, the vaccine coverage in the eligible school cohorts aged 14 to 19 years was 84%. We assessed the impact of the MenACWY vaccination programme on meningococcal carriage.
An observational study of culture-defined oropharyngeal meningococcal carriage prevalence before and after the start of the MenACWY vaccination programme in UK school students, aged 15 to 19 years, using two cross-sectional studies: 2014 to 2015 "UKMenCar4" and 2018 "Be on the TEAM" (ISRCTN75858406).
A total of 10 625 participants preimplementation and 13 438 postimplementation were included. Carriage of genogroups C, W, and Y (combined) decreased from 2.03 to 0.71% (OR 0.34 [95% CI 0.27-0.44], p < 0.001). Carriage of genogroup B meningococci did not change (1.26% vs 1.23% [95% CI 0.77-1.22], p = 0.80) and genogroup C remained rare (n = 7/10 625 vs 17/13 438, p = 0.135). The proportion of serogroup positive isolates (i.e. those expressing capsule) decreased for genogroup W by 53.8% (95% CI -5.0 - 79.8, p = 0.016) and for genogroup Y by 30.1% (95% CI 8.946·3, p = 0.0025).
The UK MenACWY vaccination programme reduced carriage acquisition of genogroup and serogroup Y and W meningococci and sustained low levels of genogroup C carriage. These data support the use of quadrivalent MenACWY conjugate vaccine for indirect (herd) protection.
自 2000 年以来，血清群 W 和 Y 侵袭性脑膜炎球菌病在全球范围内有所增加。针对血清群 W 克隆复合物 11（W:cc11）侵袭性脑膜炎球菌病的迅速增加，英国于 2015 年用四价 MenACWY 结合疫苗替代了青少年脑膜炎球菌 C 结合疫苗加强剂量。到 2018 年，14 至 19 岁符合条件的学校队列的疫苗覆盖率达到 84%。我们评估了 MenACWY 疫苗接种计划对脑膜炎球菌带菌的影响。
使用两项横断面研究（2014 至 2015 年的“UKMenCar4”和 2018 年的“Be on the TEAM”），对英国 15 至 19 岁学生中开始 MenACWY 疫苗接种计划前后通过培养定义的口咽脑膜炎球菌带菌流行率进行了一项观察性研究。
共纳入 10625 名实施前和 13438 名实施后参与者。C、W 和 Y 基因型（组合）的携带率从 2.03%降至 0.71%（OR 0.34 [95%CI 0.27-0.44]，p<0.001）。B 型脑膜炎球菌的携带率没有变化（1.26%与 1.23%[95%CI 0.77-1.22]，p=0.80），C 基因型仍然很少（n=7/10625 与 17/13438，p=0.135）。W 基因型血清阳性分离株（即表达荚膜的分离株）的比例下降了 53.8%（95%CI-5.0-79.8，p=0.016），Y 基因型下降了 30.1%（95%CI 8.946·3，p=0.0025）。
英国 MenACWY 疫苗接种计划减少了 W 基因型和 Y 基因型脑膜炎球菌以及 C 基因型脑膜炎球菌的携带，并维持了低水平的 C 基因型携带。这些数据支持使用四价 MenACWY 结合疫苗进行间接（群体）保护。
