A National Advisory Committee on Immunization (NACI) update on invasive meningococcal disease (IMD) epidemiology and program-relevant considerations for preventing IMD in individuals at high risk of exposure

Abstract

Following recent outbreaks of invasive meningococcal disease (IMD) in Canada and updates to provincial vaccination guidelines, the National Advisory Committee on Immunization (NACI) conducted a targeted review of evidence with a focus on immunization of adolescents and young adults. NACI reviewed national and international immunization recommendations for populations at high-risk of IMD, national IMD epidemiology and program-relevant considerations. Given the varied IMD epidemiology, NACI determined that recommending a pan-Canadian targeted program is currently challenging and that regional programs may be better suited to prevent IMD in population groups considered to be at high-risk of exposure. Further data is needed to ascertain contemporary risk factors for IMD (including activities and settings associated with bacterial acquisition, carriage and transmission) and estimate the true cost of meningococcal vaccine-preventable infections in Canada. To support provinces and territories in their decision-making, an outline of program-relevant elements for provincial and territorial consideration is provided.

Keywords: NACI; National Advisory Committee on Immunization; adolescents and young adults; guidance; invasive meningococcal disease; meningococcal vaccine; vaccination policy.

Figure 1

Serogroup distribution of invasive meningococcal disease case isolates^a by province/regions, 2015–2020^b Abbreviations: AB, Alberta; BC, British Columbia; MB, Manitoba; MenB, Neisseria meningitidis serogroup B; MenC, Neisseria meningitidis serogroup C; MenW, Neisseria meningitidis serogroup W; MenY, Neisseria meningitidis serogroup Y; ON, Ontario; QC, Québec; SK, Saskatchewan ^a Total includes other serogroups (e.g. E, Z, non-encapsulated) ^b Atlantic includes New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador Data source: National Microbiology Laboratory

Figure 2

Number of invasive meningococcal disease cases in Canada by month, 2012–2022 (N=979^a) ^a Month of onset was unknown for 199 cases Data sources: National Enhanced Invasive Meningococcal Disease Surveillance System (eIMDSS), data request to provinces and territories not participating in eIMDSS, and National Microbiology Laboratory