Meningococcal disease in adolescents and young adults: a review of the rationale for prevention through vaccination

Figures & data

Table 1. Meningococcal vaccines currently licensed for use in adolescents and young adults in countries with advanced economies.*

	Vaccine Type	Serogroups Included	Year First Licensed	Countries/Regions of Licensure	Approved Ages
MenACWY-CRM^Citation60,Citation64–Citation67	Conjugate	ACWY	2010	Australia	≥ 2 months
(Menveo®, GlaxoSmithKline)				Canada	2 months–55 years
				Europe	≥ 2 years
				United States	2 months–55 years
MenACWY-D^Citation60,Citation63,Citation68–Citation71	Conjugate	ACWY	2005	Australia	9 months–55 years
(Menactra®, Sanofi Pasteur)				Canada
				New Zealand
				United States
MenACWY-TT^Citation72-Citation74	Conjugate	ACWY	2012	Australia	12 months–55 years
(Nimenrix®, Pfizer)				Canada	6 weeks–55 years
				Europe	≥ 6 weeks
				New Zealand	12 months–55 years
MenB-4C^Citation60,Citation63,Citation75–Citation78	Protein	B	2013	Australia	≥ 2 months
(Bexsero®, GlaxoSmithKline)				Canada	2 months–17 years
				Europe	≥ 2 months
				United States	10–25 years
MenB-FHbp^Citation60,Citation79–Citation82	Protein	B	2014	Australia	≥ 10 years
(Trumenba®, Pfizer)				Canada	10–25 years
				Europe	≥ 10 years
				United States	10–25 years
MenC-CRM^Citation63,Citation83	Conjugate	C	2000	Canada	≥ 2 months
(Menjugate®, GlaxoSmithKline)
MenC-TT^Citation63,Citation84,Citation85	Conjugate	C	2000	Australia	≥ 8 weeks
(NeisVac-C®, Pfizer)				Canada	≥ 2 months
				New Zealand	≥ 8 weeks
MenC-TT/Hi-TT^Citation63,Citation86(Menitorix®, GlaxoSmithKline)	Conjugate	C	2006	Australia	6 weeks–24 months

*Advanced economies were defined by the International Monetary Fund and included Australia, Canada, Europe, New Zealand, and the United States.¹⁸ Data are current as of June 2018.

Table 2. Clinical recommendations for meningococcal vaccination of adolescents and young adults in advanced economies.*

	Age, Years	Recommendations
Australia^Citation92	15–19	MenB^†
Canada^Citation93	12–24	MenC conjugate or MenACWY conjugate^‡
		MenB-4C for those who want to protect against serogroup B infection
Europe^Citation94
Austria	11–13	MenACWY
Cyprus	≥ 2	MenACWY polysaccharide
		(only on specific indications)
Czech Republic	13–17	MenACWY
	≥ 18	MenACWY and MenB
France	2–24	MenC (catch-up)
Germany	2–17	MenC (catch-up)
Greece	11–12	MenACWY
	≥ 13	MenACWY (catch-up)
Ireland	12–13	MenC
Italy	12–14	MenACWY
Liechtenstein	11–20	MenC (catch-up)
Poland	19	MenC
Spain	12	MenC
United Kingdom	13–15, 17–25	MenACWY conjugate^§
New Zealand^Citation95	Adolescents/young adults	MenC or MenACWY vaccination should be considered for those living or planning to live in
		communal accommodation^‖
United States^Citation96,Citation97	11–18	MenACWY (single dose at age 11 or 12 with booster at age 16 years)
	≥ 10	MenB (routine use for individuals aged ≥ 10 years at increased risk for MenB disease; consideration for individuals aged 16–23 years for short-term protection)

Data are current as of June 2018.

*Advanced economies were defined by the International Monetary Fund and included Australia, Canada, Europe, New Zealand, and the United States.¹⁸

^†Particularly recommended for adolescents and young adults living in close quarters.

^‡Dependent on local epidemiology and programmatic considerations.

^§From September 2015, a MenACWY conjugate vaccine replaced the MenC vaccine.¹⁸

^‖MenB vaccines are not currently licensed in New Zealand.

Figure 1. Incidence of meningococcal disease in adolescents by country.^{14,33,34,45,46}

*Data are for invasive meningococcal disease.For the United States, data by age group are for the Active Bacterial Core Surveillance areas (California [3-county San Francisco Bay area], Colorado [5-county Denver area], Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York [15-county Rochester and Albany areas], Tennessee [20 counties]) excluding Oregon. Data for the general population are for national estimates reported to the National Notifiable Disease Surveillance System.

Figure 2. Coverage of meningococcal vaccines in adolescents.^54,119–125

MenC = Meningococcal serogroup C conjugate vaccine; MenACWY = quadrivalent meningococcal conjugate vaccine.

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