What Would be the Best Schedule for Prevention of Meningococcal Disease in All Ages? The UK Experience

Abstract

Meningococcal disease is a major global public health problem, and vaccination is the optimal means of prevention. Meningococcal vaccination programmes have significantly evolved, for example, in the UK, since their introduction in 1999. The UK, the first country to introduce meningococcal serogroup C conjugate (MCC) vaccination, commenced this in 1999 with a primary infant series at 2, 3 and 4 months of age, together with a catch-up campaign of a single dose for children aged 1-18 years. Subsequent changes to the schedule have occurred in response to increasing knowledge about how MCC vaccines work, together with improved knowledge of meningococcal transmission. Firstly, in 2006, the schedule was refined from a three-dose to a two-dose priming schedule with the addition of a booster in the second year of life. This was followed by a further change in 2013, when the number of priming doses was further reduced to a single priming dose along with a booster maintained at 12 months of age and the introduction of an adolescent MCC booster dose. This in 2015 was changed from monovalent serogroup C to quadrivalent A, C, W and Y in response to an outbreak of serogroup W.