Institut Pasteur, Invasive Bacterial Infections Unit, National Reference Centre for Meningococci and Haemophilus Influenza, Paris, France.
GSK, Rockville, MD, USA.
Hum Vaccin Immunother. 2023 Dec 31;19(1):2186111. doi: 10.1080/21645515.2023.2186111. Epub 2023 Apr 5.
Invasive meningococcal disease (IMD) is a life-threatening disease caused by and has high mortality rates. Survivors often exhibit long-term sequelae and reduced life expectancy. Disease incidence is highest in infants and toddlers, with a resurgence of cases in adolescents and older adults (>50 years of age). Substantial heterogeneity exists in the recommendations of meningococcal vaccines included in National Immunization Programs (NIPs) across countries. Recommendations are usually based on infant/toddler immunization, with some countries recommending immunization only for toddlers. While existing recommendations have led to a reduced incidence of IMD in children <5 years of age, there has been an increase in cases among adolescents and older adults. Currently, older adults are not included in the recommendations. The higher healthcare burden and the economic costs associated with IMD in these age groups suggest that it is time to consider including adolescents and older adults in NIPs to protect against IMD caused by the five most prevalent serogroups. Currently, the lack of equity of access to vaccines in the immunization programs is a glaring gap in the betterment of public health, and a broader meningococcal strategy is recommended to provide optimal protection for all age groups.
侵袭性脑膜炎球菌病 (IMD) 是一种由 引起的危及生命的疾病，死亡率很高。幸存者常出现长期后遗症，预期寿命缩短。该病发病率在婴儿和幼儿中最高，青少年和老年人（>50 岁）的病例再次增多。各国国家免疫规划（NIP）中包含的脑膜炎球菌疫苗的建议存在很大差异。建议通常基于婴儿/幼儿免疫接种，一些国家仅建议对幼儿进行免疫接种。虽然现有建议已导致 5 岁以下儿童 IMD 发病率降低，但青少年和老年人的病例有所增加。目前，老年人不在建议范围内。这些年龄组中 IMD 导致的更高医疗保健负担和经济成本表明，是时候考虑将青少年和老年人纳入 NIP 以预防最常见的 5 个血清群引起的 IMD 了。目前，免疫规划中疫苗获取的公平性不足是改善公共卫生的明显差距，建议采取更广泛的脑膜炎球菌策略，为所有年龄段提供最佳保护。
