Real-world impact and effectiveness of MenACWY-TT

Figures & data

Table 1. Data elements collected for the reporting of MenACWY incidence rate reduction and vaccine effectiveness in the Netherlands, and England and the data analysis of incidence rate reduction in Australia, and Chile.

Country	Evaluation time periods		Age groups considered as vaccine-eligible for analysis	MenACWY vaccine program	Data sources and references	Vaccine coverage
	Baseline	Post-NIP introduction
The Netherlands	July-2017 to March-2018	July-2019 to March-2020	15–36 months and 14–18 years of age	May 2018: MenACWY-TT introduced into NIP at 14 months of age, replacing MCCV. October 2018 to June 2019: MenACWY-TT mass campaign for those 14–18 years old. January 2020: MenACWY-TT introduced into NIP at 14 years of age.	Ohm et al.^Citation7 The vaccine effectiveness and impact estimates were directly identified in Ohm et al.^Citation7 Incidence of IMD cases was calculated based on the reported numbers of IMD cases to the national surveillance system. The vaccine effectiveness was estimated with the screening method in the study.	Vaccination schedule and uptake: 14 months of age, 93% in 2019; 14–18 years of age, 86% in 2019^Citation7
England	Academic year 2015/16*	Academic year 2018/19*	14–18 years of age (routine cohorts)	August 2015: MenACWY introduced into NIP at 13–14 years of age, replacing MCCV which had been used since September 2013. August 2015 to December 2017: MenACWY** catch-up campaign for those aged 14–18 years old. August 2015: MenACWY** introduced for first time university entrants <25 years of age not previously vaccinated with a MenACWY vaccine. This was later extended so that any individual <25 years of age could receive MenACWY** vaccination. Vaccination schedule and uptake: all students in school years 9 or 10 (at around 14 years of age) and any individual <25 years of age not previously vaccinated with a MenACWY vaccine; the school-based program achieved uptake of 71–86% by August 2019. Reference:^Citation20,Citation21	The vaccine effectiveness and impact estimates were directly identified in Campbell et al.^Citation20 Meningococcal septicemia is a. Incidence of IMD cases was calculated based on the number of IMD cases reported to the meningococcal disease surveillance in England. Vaccine effectiveness was estimated with the indirect screening method in the study.	An 83% vaccine uptake of MenACWY** was achieved over the first four years of the program. The school-based program achieved uptake of 71–86% by August 2019^Citation20,Citation21
Australia	2017	2019	1–4 years and 15–19 years of age	July 2018: MenACWY-TT implemented into NIP at 12 months of age replacing MCCV, which had been used in NIP since 2003. This also replaced some state MenACWY*** programs which had been introduced from 2017. April 2019: MenACWY-TT implemented into NIP at 14–16 years of age replacing a number of state MenACWY*** programs which had been introduced from 2017. April 2019 onwards: MenACWY-TT catch up campaign for those 15–19 years of age^Citation22–24	The incidence of IMD was estimated by using the reported number of IMD cases extracted from the National Meningococcal Surveillance Program annual report, 2017 and 2019^Citation22,Citation25 and the Australian Bureau of Statistics.	Vaccination schedule and uptake: 12 months of age, 95.0% in 2020; 15–19 years of age, 74.3% in adolescents by 17 years of age in 2020^Citation22–24
Chile	2012	2019	1–4 years of age	January 2014: MenACWY-TT introduced into NIP at 12 months of age. This replaced a prior MenACWY^# program undertaken between October 2012 and December 2013 where vaccine was offered to those between 9 months and 4 years of age.:^Citation19,Citation26	The age specific incidence of IMD was estimated by using the reported number of IMD cases extracted from Villena et al.^Citation19,Citation26	Vaccination uptake at 12 months of age was 94.3% between 2013 and 2019.^Citation19,Citation26

*Academic years run from September to August the following year.

**Both MenACWY-TT and MenACWY-CRM were initially used in the program but from December 2016 MenACWY-TT was exclusively supplied.

***State programs incorporated the use of multiple MenACWY vaccines. Vaccines available at this time included MenACWY-DT, MenACWY-CRM and MenACWY-TT.

^#MenACWY-DT and MenACWY-CRM were used.

Figure 1. Incidence rate reductions (95% CI) against MenW and MenCWY disease following the introduction of MenACWY vaccination programs among vaccine-eligible age groups.

Figure 2. Incidence rate reductions (95% CI) against MenW and MenCWY disease following the introduction of MenACWY vaccination programs among non-vaccine-eligible age groups and the entire population.

Table 2. Reported vaccine effectiveness (95% confidence interval) of MenACWY from the Netherlands and England.

	The Netherlands (toddlers)^Citation7	England (adolescents and young adults)^Citation20
MenW	92% (−20%; 99.5%)*	94% (76 ; 99)**
MenY	NA	82% (16 ; 98)**
MenCWY	NA	94% (80 ; 99)**

*Children born on or after March 1, 2017 and diagnosed at the age of 14 months and older between May 1, 2018 and December 31, 2020.

**Vaccine-eligible cohorts as detailed in Table 1.

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