Gruhn Sebastian, Batram Manuel, Wick Moritz, Langevin Edith, Scholz Stefan, Greiner Wolfgang, Damm Oliver
Department for Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
Vandage GmbH, Detmolder Straße 30, 33604, Bielefeld, Germany.
Infect Dis Ther. 2024 Apr;13(4):907-920. doi: 10.1007/s40121-024-00958-7. Epub 2024 Apr 4.
Invasive meningococcal disease (IMD) causes significant mortality and long-term sequelae. This study assesses the potential public health impact of adolescent vaccination strategies employing MenACWY and MenC vaccines in Germany, where the existing meningococcal immunisation programme predominantly involves MenC administration in toddlers.
A dynamic transmission model was developed to simulate the carriage of five meningococcal serogroup compartments (AY/B/C/W/Other) from 2019 until 2060 within 1-year age groups from 0 to 99 years of age. IMD cases were estimated based on case-carrier ratios. The model considered vaccine effectiveness against carriage acquisition and IMD.
The model predicts that introducing MenACWY adolescent vaccination could lead to a considerable reduction in IMD incidence, with the potential to prevent up to 65 cases per year and a cumulative total of 1467 cases by 2060. This decrease, mainly driven by herd effects, would result in a reduction of IMD incidence across all age groups, regardless of vaccination age. Furthermore, implementing MenACWY vaccination in adolescents is projected to decrease annual MenACWY-related IMD mortality by up to 64%, equating to an overall prevention of 156 IMD deaths by 2060. These protective outcomes are expected to culminate in approximately 2250 life years gained (LYG) throughout the model's projected time horizon. In contrast, the adoption of MenC vaccination in adolescents is predicted to have minimal influence on both IMD incidence and mortality, as well as on LYG.
The results of this study demonstrate that implementing MenACWY vaccination for adolescents in Germany is likely to notably reduce IMD incidence and mortality across age groups. However, the introduction of MenC adolescent vaccination shows only limited impact. Considering the extensive healthcare resources typically required for IMD management, these findings suggest the potential for economic benefits associated with the adoption of MenACWY adolescent vaccination, warranting further cost-effectiveness analysis.
侵袭性脑膜炎球菌病（IMD）会导致严重的死亡率和长期后遗症。本研究评估了在德国采用A、C、W、Y群脑膜炎球菌结合疫苗（MenACWY）和C群脑膜炎球菌多糖疫苗（MenC）的青少年疫苗接种策略对公共卫生的潜在影响，在德国现有的脑膜炎球菌免疫规划主要是对幼儿接种MenC疫苗。
建立了一个动态传播模型，以模拟2019年至2060年期间0至99岁1岁年龄组内五个脑膜炎球菌血清群分区（A/Y/B/C/W/其他）的带菌情况。根据病例与带菌者比例估算IMD病例数。该模型考虑了疫苗对获得带菌状态和IMD的有效性。
该模型预测，引入MenACWY青少年疫苗接种可导致IMD发病率大幅降低，到2060年每年有可能预防多达65例病例，累计预防1467例病例。这种下降主要由群体效应驱动，将导致所有年龄组的IMD发病率降低，无论接种疫苗的年龄如何。此外，预计在青少年中实施MenACWY疫苗接种将使每年与MenACWY相关的IMD死亡率降低多达64%，到2060年总体上可预防156例IMD死亡。在整个模型预测期内，这些保护结果预计将最终带来约2250个生命年的获得（LYG）。相比之下，预计在青少年中接种MenC疫苗对IMD发病率、死亡率以及LYG的影响极小。
本研究结果表明，在德国对青少年实施MenACWY疫苗接种可能会显著降低各年龄组的IMD发病率和死亡率。然而，引入MenC青少年疫苗接种的影响有限。考虑到管理IMD通常需要大量医疗资源，这些发现表明采用MenACWY青少年疫苗接种可能带来经济效益，值得进一步进行成本效益分析。
