Lessons from mass vaccination response to meningococcal B outbreaks at US universities

ABSTRACT

College students in the United States are at an increased risk for meningococcal serogroup B disease or MenB, which causes the majority of invasive meningococcal disease in the country among adolescents and young adults (62%) and also across all age groups (36%) as of 2018. Approximately one-third of MenB cases among college students occur during campus outbreaks, which trigger substantial public health concern and costs associated with conducting rapid mass vaccination campaigns in an emergency setting. Eleven US college outbreaks of MenB disease have occurred since the initial licensure and recommendation of two MenB vaccines in 2014/2015; both vaccines have been used as part of outbreak responses on campuses, but vaccine coverage and multidose series completion among the general adolescent population are very low (approximately 17% of 17-year-olds in the United States received ≥1 dose in 2018). This review recounts shifts in US meningococcal outbreak epidemiology, lessons from immunogenicity evaluations of MenB vaccines with outbreak strains, and recent college outbreak experiences and mass vaccination responses. The challenges of reactive MenB outbreak containment and potential benefits of preventive immunization of US adolescents are also considered.

KEYWORDS:

• Meningitis
• meningococcal
• Neisseria meningitidis
• meningococcal
• serogroup B
• disease outbreak
• infectious
• vaccination
• meningococcal vaccines
• immunogenicity
• serum bactericidal antibody assay

Acknowledgments

This review was sponsored by Pfizer Inc. Editorial/medical writing support was provided by Tricia Newell, PhD, and Emily Stackpole, PhD, of ICON plc (North Wales, PA) and was funded by Pfizer Inc.

Declaration of interest

All authors are employees of Pfizer Inc and may hold stock and/or stock options.

Reviewers disclosure

A reviewer on this manuscript has disclosed that they work for the Immunization and Countermeasures Division who provide vaccine manufacturers with post-marketing surveillance reports on pneumococcal and meningococcal infection. These reports are required from companies by the UK Licensing authority in compliance with their Risk Management Strategy. A cost recovery charge is made for these reports. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by Pfizer Inc.