Prevention of meningococcal disease

Abstract

Neisseria meningitidis is the most common cause of meningitis in children aged 2-18 with a mortality rate ranging from 4-40% and substantial morbidity in 11-19% of survivors. Of the four serogroups ofNeisseria meningitidis, serogroups B and C are the most common causes in the United States, with serogroup C causing most disease among adolescents, a population at risk for invasive meningococcal disease. The meningococcal polysaccharide vaccine was developed in response to increasing rates of bacterial meningitis among military recruits. With widespread use of the vaccine in the military, there was a dramatic decreased incidence in invasive meningococcal disease. However, there may be limitations to the polysaccharide vaccine including lack of durable protection, lack of induction of T-cell-dependent immune response, and lack of immunogenicity in children less than 2 years of age. Based on the success of other conjugate vaccines in pediatrics, a new conjugate polysaccharide vaccine, Menactra, has been approved by the Food and Drug Administration and recommended for routine vaccination in adolescents by the Advisory Committee on Immunization Practices.