National and regional differences in meningococcal vaccine recommendations for individuals at an increased risk of meningococcal disease

ABSTRACT

Introduction

Invasive meningococcal disease (IMD) is a severe, life-threatening condition caused by infection with Neisseria meningitidis. Currently available vaccines offer protection against the five most common meningococcal disease-causing serogroups and include monovalent and quadrivalent conjugate vaccines (MenA, MenC, MenACWY vaccines) and outer membrane vesicle- and/or recombinant protein-based vaccines (MenB vaccines).

Areas covered

Country and regional immunization programs target populations susceptible to IMD and typically emphasize the highest-risk age groups (i.e., infants, adolescents/young adults, and the elderly); however, additional groups are also considered at an elevated risk and are the focus of the current review. Specific increased-risk groups include individuals with underlying immunocompromising medical conditions, university/college students, Indigenous people, laboratory workers, military personnel, men who have sex with men, and travelers to areas with hyperendemic IMD. This review compares established meningococcal vaccination recommendations for these vulnerable groups in Europe, the United States, Australia, New Zealand, Israel, Brazil, and Turkey.

Expert opinion

Recommendations should be standardized to cover all groups at increased risk of IMD.

KEYWORDS:

• increased risk
• MenACWY
• MenB
• vaccine
• vaccine recommendations

Article highlights

• Meningococcal vaccination recommendations for groups at an increased risk of invasive meningococcal disease vary considerably worldwide.

• Notable disparities exist between MenB and MenACWY or MenC vaccine recommendations, and country-specific recommendations do not always correspond with the predominant serogroups responsible for disease.

• Updating and standardizing existing recommendations for vaccination against the five major disease-causing serogroups among individuals at increased risk is critical to improve protection of vulnerable populations from meningococcal disease.

Declaration of Interest

Cynthia Burman was an employee of Pfizer at the time of manuscript development and may hold stock or stock options. Jamie Findlow is an employee of Pfizer Ltd and may hold stock or stock options. Helen Marshall is an investigator on vaccine trials sponsored by industry. Her institution has received funding for investigator led research from GSK, Pfizer, and Sanofi Pasteur. She does not receive any personal payments from Industry. Marco Safadi has received grants to support research projects and consultancy fees from GSK, Pfizer Inc, and Sanofi Pasteur.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contribution statement

All authors have substantially contributed to the conception and design of the review article and interpreting the relevant literature; and all authors have been involved in writing the review article or revising it for intellectual content.

Acknowledgments

Editorial/medical writing support was provided by Srividya Ramachandran, PhD, and Kate Russin, PhD (ICON, Blue Bell, PA, USA) and was funded by Pfizer Inc. Helen Marshall acknowledges NHMRC support - Practitioner Fellowship APP1155066.7References

Additional information

Funding

This manuscript was funded by Pfizer Inc.