A policy review of the introduction of the MenACWY vaccine in toddlers across multiple countries

ABSTRACT

Introduction

Immunization is the best strategy to protect individuals from invasive meningococcal disease (IMD). To support decision-making around immunization, this paper considers what has led four countries and regions of two more to introduce the quadrivalent MenACWY vaccine in toddlers (ages 12–24 months).

Areas covered

A narrative literature review was conducted to identify countries that have introduced a MenACWY vaccination program for toddlers. Information from peer-reviewed publications, reports, and policy documents for each identified country was extracted. Australia, Chile, the Netherlands, Switzerland, and regions of Italy and Spain have introduced the MenACWY vaccine in their toddler programs, driven by the rising incidence of MenW and MenY and the vaccine’s ability to provide protection against other serogroups. Australia and the Netherlands considered the economic impacts of implementing a MenACWY toddler vaccination program. Vaccination uptake and effects are reported for three countries; however, in two, isolating the vaccine’s effect from the collateral effect of COVID-related measures is difficult.

Expert opinion

Increased convergence of vaccination policies and programs is needed internationally, as IMD recognizes no borders.

PL AIN LANGUAGE SUMMARY

Vaccination is the best defense against meningitis, a deadly disease. While someone of any age can contract it, children 0–24 months of age are disproportionately affected. The increasing number of cases of meningitis has led four countries plus regions of two more to introduce into their vaccination schedules for toddlers (ages 12–24 months) a vaccine that protects against four different serogroups rather than one serogroup alone. This paper considers what has driven that shift.

KEYWORDS:

• Immunization programs
• epidemiologic monitoring
• vaccination policy
• meningococcal infections
• meningococcal vaccines
• narrative literature review

Article highlights

• This paper considers what has led four countries plus regions of two more to introduce the quadrivalent MenACWY vaccine in toddlers (ages 12–24 months) and in some cases shift from the monovalent MenC vaccine to the quadrivalent MenACWY.

• The countries/regions discussed have taken the rising incidence of MenW and MenY cases as an opportunity to future-proof their national immunization schedule by increasing protection through a quadrivalent MenACWY vaccine available at 12 months of age.

• This study is based on a narrative literature review of peer-reviewed articles and governmental reports and policy documents.

Acknowledgments

We thank Professor Muhamed-Kheir Taha (Invasive Bacterial Infections Unit and the National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France) for his contribution to the discussion. We also thank Katharina Verleger (Real World Evidence and Systemic Consultant, Berlin, Germany) for her contribution to the collection and analysis of data and Christina DuVernay (OPEN Health, Bethesda, Maryland, US) for editorial support.

Declaration of interest

C Valmas and H Rashid are full-time employees of Sanofi, 410 Thames Valley Park Drive, Reading, Berkshire, RG6 1PT, UK. Emanuele Arcà and Marja Hensen are paid employees of Pharmerit International, an OPEN Health Company, which was contracted by Sanofi to support data collection, analysis, and manuscript writing. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have received an honorarium for their review work. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Author contributions

CV: Conception, analysis of data, revision of manuscript, final approval, acceptance of responsibility for contents of manuscript

EA: Conception, analysis of data, drafting and revising the manuscript, final approval, acceptance of responsibility for contents of the manuscript

MH: Conception, analysis of data, drafting and revising the manuscript, final approval, acceptance of responsibility for contents of the manuscript

HR: Conception, analysis of data, revision of manuscript, final approval, acceptance of responsibility for contents of manuscript

Additional information

Funding

This study was funded by Sanofi.