Impact of meningococcal serogroup C conjugate vaccines on carriage and herd immunity

被引：354

作者：

Maiden, Martin C. J. ^{[1
]}

Ibarz-Pavon, Ana Belen ^{[1
]}

Urwin, Rachel ^{[1
]}

Gray, Stephen J. ^{[3
]}

Andrews, Nicholas J. ^{[7
]}

Clarke, Stuart C. ^{[8
]}

Walker, A. Mark ^{[9
]}

Evans, Meirion R. ^{[10
]}

Kroll, J. Simon ^{[6
]}

Neal, Keith R. ^{[11
]}

Ala'Aldeen, Dlawer A. A. ^{[12
]}

Crook, Derrick W. ^{[2
]}

Cann, Kathryn ^{[2
]}

Harrison, Sarah ^{[13
]}

Cunningham, Richard ^{[14
]}

Baxter, David ^{[5
]}

Kaczmarski, Edward ^{[4
]}

MacLennan, Jenny ^{[1
]}

Cameron, J. Claire ^{[15
]}

Stuart, James M. ^{[16
]}

机构：

[1] Univ Oxford, Dept Zool, Oxford OX1 3PS, England

[2] Univ Oxford, John Radcliffe Hosp, Nuffield Dept, Clin & Lab Sci, Oxford OX3 9DU, England

[3] Manchester Med Microbiol Partnership, Hlth Protect Agcy, Meningococcal Reference Unit, Manchester, Lancs, England

[4] Manchester Royal Infirm, Manchester, Lancs, England

[5] Univ Manchester, Sch Med, Div Epidemiol & Hlth Sci, Manchester M13 9PL, Lancs, England

[6] Univ London Imperial Coll Sci Technol & Med, Sch Med, London SW7 2AZ, England

[7] Ctr Infect, Hlth Protect Agcy, London, England

[8] Univ Southampton, Sch Med, Mol Microbiol Grp, Southampton SO9 5NH, Hants, England

[9] Univ Wales, Bangor, Gwynedd, Wales

[10] Parc Nantgarw, Natl Publ Hlth Serv Wales, Unit 1, Cardiff, S Glam, Wales

[11] Univ Nottingham, Queens Med Ctr, Nottingham NG7 2RD, England

[12] Univ Nottingham, Inset Infect Immun & Inflammat, Sch Mol Med Sci, Div Microbiol, Nottingham NG7 2RD, England

[13] Lescaze Off, SW Peninsula Hlth Protet Unit, Dartington, Devon, England

[14] Derriford Hosp, Plymouth PL6 8DH, Devon, England

[15] Hlth Protect Scotland Clifton House, Glasgow, Lanark, Scotland

[16] Hlth Prot Agcy SW, Gloucester, England

来源：

JOURNAL OF INFECTIOUS DISEASES | 2008年 / 197卷 / 05期

基金：

英国惠康基金;

关键词：

D O I：

10.1086/527401

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. In 1999, meningococcal serogroup C conjugate (MCC) vaccines were introduced in the United Kingdom for those under 19 years of age. The impact of this intervention on asymptomatic carriage of meningococci was investigated to establish whether serogroup replacement or protection by herd immunity occurred. Methods. Multicenter surveys of carriage were conducted during vaccine introduction and on 2 successive years, resulting in a total of 48,309 samples, from which 8599 meningococci were isolated and characterized by genotyping and phenotyping. Results. A reduction in serogroup C carriage (rate ratio, 0.19) was observed that lasted at least 2 years with no evidence of serogroup replacement. Vaccine efficacy against carriage was 75%, and vaccination had a disproportionate impact on the carriage of sequence type (ST)-11 complex serogroup C meningococci that (rate ratio, 0.06); these meningococci also exhibited high rates of capsule expression. Conclusions. The impact of vaccination with MCC vaccine on the prevalence of carriage of group C meningococci was consistent with herd immunity. The high impact on the carriage of ST-11 complex serogroup C could be attributed to high levels of capsule expression. High vaccine efficacy against disease in young children, who were not protected long-term by the schedule initially used, is attributed to the high vaccine efficacy against carriage in older age groups.

引用

页码：737 / 743

页数：7

共 40 条

[1]

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