Meningococcal disease in adolescents and young adults: a review of the rationale for prevention through vaccination

Abstract

Invasive meningococcal disease (IMD) caused by Neisseria meningitidis is characterized by high mortality and morbidity. While IMD incidence peaks in both infants and adolescents/young adults, carriage rates are often highest in the latter age groups, increasing IMD risk and the likelihood of transmission. Effective vaccines are available for 5 of 6 disease-causing serogroups. Because adolescents/young adults represent a significant proportion of cases, often have the highest carriage rate, and have characteristically low vaccination adherence, efforts should be focused on educating this population regarding long-term consequences of infection and the importance of meningococcal vaccination in prevention. This review describes the role of adolescents/young adults in meningococcal transmission and the clinical consequences and characteristics of IMD in this population. With a focus on countries with advanced economies that have specific meningococcal vaccination recommendations, the epidemiology of meningococcal disease and vaccination recommendations in adolescents/young adults will also be discussed.

Keywords: adolescent; meningococcal disease; meningococcal infections; vaccination; vaccines; young adult.

Figure 1.

Incidence of meningococcal disease in adolescents by country.^{14,33,34,45,46} *Data are for invasive meningococcal disease.For the United States, data by age group are for the Active Bacterial Core Surveillance areas (California [3-county San Francisco Bay area], Colorado [5-county Denver area], Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York [15-county Rochester and Albany areas], Tennessee [20 counties]) excluding Oregon. Data for the general population are for national estimates reported to the National Notifiable Disease Surveillance System.

Figure 2.

Coverage of meningococcal vaccines in adolescents.^54,119–125 MenC = Meningococcal serogroup C conjugate vaccine; MenACWY = quadrivalent meningococcal conjugate vaccine.