Meningococcal vaccination in pregnancy

Abstract

Invasive meningococcal disease causes meningitis and septicemia worldwide with highest rates of disease occurring in children <2 years of age, and in particular young infants. Vaccination during pregnancy has been a successful strategy for prevention of other infections in young infants, most notably tetanus, pertussis and influenza. However, few studies of meningococcal vaccines in pregnancy have been undertaken, and none include the most commonly used current vaccines to prevent disease by capsular groups A, B, C, W and Y. The limited data suggest that the older polysaccharide vaccines are immunogenic, but the impact on prevention of infant disease has not been measured. Further studies of MenB protein vaccines and MenA protein-polysaccharide conjugate vaccines in particular are needed if vaccination in pregnancy is to be utilized as an approach to prevention of meningococcal disease in young infants.

Keywords: Neisseria meningitidis; antenatal; immunization; infant; meningitis; newborn; septicemia; vaccines.

Figure 1.

Incidence of invasive meningococcal disease in infants under 1 year of age. Data from Cohn et al. and MacNeil et al.

Figure 2.

Distribution of cases of invasive meningococcal disease in different age groups in infants under 1 year of age. Data from Ladhani et al., Cohn et al.^, MacNeil et al. and Azzari et al. Data from Italy only include capsular group B cases (MenB). Age groups of the Italy data are slightly different to the other studies: 0–4 months, 5–8 months and 9–12 months.