Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 4;7(11):e2443551.
doi: 10.1001/jamanetworkopen.2024.43551.

Quadrivalent Conjugate Vaccine and Invasive Meningococcal Disease in US Adolescents and Young Adults

Thomas Shin  1 , Chad R Wells  2 , Affan Shoukat  3 , Lilia Potter-Schwartz  2 , Edith Langevin  4 , Joanne M Langley  5 , Alison P Galvani  2 , Seyed M Moghadas  6
Affiliations

Quadrivalent Conjugate Vaccine and Invasive Meningococcal Disease in US Adolescents and Young Adults

Thomas Shin et al. JAMA Netw Open. .

Abstract

Importance: Beginning in 2005, the US implemented routine immunization of adolescents with a quadrivalent conjugate vaccine (MenACWY) for the prevention of invasive meningococcal disease (IMD).

Objectives: To assess whether MenACWY immunization was associated with a reduced IMD burden among the US adolescent population and how the downward trajectory of IMD that began in the mid-1990s might have evolved in the absence of vaccination efforts.

Design, setting, and participants: In this decision analytical study, a bayesian hierarchical Poisson regression model was developed to investigate the potential trajectory of IMD among US adolescents and young adults without vaccination and evaluate the direct association of vaccination with IMD burden. The model included the entire age-stratified US population and was fitted to national incidence data for serogroups C, W, and Y from January 1, 2001, to December 31, 2021, with stratification by vaccination status for IMD cases.

Intervention: Simulated counterfactual scenario of absent vaccination from 2005 to 2021, while retaining the incidence rate of IMD for unvaccinated individuals estimated during model fitting.

Main outcomes and measures: The main outcomes were the estimated numbers of IMD cases and deaths averted by MenACWY vaccination among US adolescents and young adults aged 11 to 23 years.

Results: Among the entire US population from 2005 to 2021, MenACWY vaccination prevented an estimated 172 (95% credible interval [CrI], 85-345) cases of IMD among US adolescents 11 to 15 years of age and 328 (95% CrI, 164-646) cases of IMD among those aged 16 to 23 years. Absent vaccination, the cumulative incidence of IMD in these age groups would have been at least 59% higher than reported over the same period with vaccination. Using case fatality rates of unvaccinated individuals derived from national data, vaccination averted an estimated 16 (95% CrI, 8-31) deaths among adolescents aged 11 to 15 years and 38 (95% CrI, 19-75) deaths among those aged 16 to 23 years.

Conclusions and relevance: This decision analytical model suggests that the MenACWY vaccination program in the US was associated with a reduced burden of meningococcal disease. Without vaccination, the incidence rates per 100 000 adolescents and young adults would have been substantially higher than those observed during the vaccine era.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Mr Shin reported being a Sanofi employee during the submitted work. Ms Langevin reported being a Sanofi employee and holding Sanofi shares/stock options during the conduct of the study. Dr Langley reported receiving grants from GSK paid to employer for conduct of research, grants from Moderna paid to employer for conduct of vaccine studies, grants from Sanofi paid to employer for conduct of vaccine studies, and grants from Pfizer paid to employer for conduct of vaccine studies outside the submitted work; and serving as senior medical advisor for the Meningitis Foundation of Canada. Dr Galvani reported receiving personal fees from Sanofi Pasteur during the conduct of the study. Dr Moghadas reported receiving personal fees from Sanofi during the conduct of the study. No other disclosures were reported.

Figures

Figure.
Figure.. Model Fit and Simulated Counterfactual Scenario
Model fit (dark blue dashed line) to observed data (light bue dots) with 95% credible intervals (shaded areas) for vaccine-eligible age groups 11 to 15 years (A) and 16 to 23 years (C). The counterfactual scenario without vaccination is shown by the orange line. Annual incidence rates of invasive meningococcal disease (IMD) per 100 000 population of age groups 11 to 15 years (B) and 16 to 23 years (D). Incidence rates were adjusted for the population size over the study period. MenACWY indicates quadrivalent conjugate vaccine for invasive meningococcal disease.
See this image and copyright information in PMC

References

    1. Pace D, Pollard AJ. Meningococcal disease: clinical presentation and sequelae. Vaccine. 2012;30(suppl 2):B3-B9. doi:10.1016/j.vaccine.2011.12.062 - DOI - PubMed
    1. Shen J, Begum N, Ruiz-Garcia Y, Martinon-Torres F, Bekkat-Berkani R, Meszaros K. Range of invasive meningococcal disease sequelae and health economic application—a systematic and clinical review. BMC Public Health. 2022;22(1):1078. doi:10.1186/s12889-022-13342-2 - DOI - PMC - PubMed
    1. Christensen H, May M, Bowen L, Hickman M, Trotter CL. Meningococcal carriage by age: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10(12):853-861. doi:10.1016/S1473-3099(10)70251-6 - DOI - PubMed
    1. Parikh SR, Campbell H, Bettinger JA, et al. . The everchanging epidemiology of meningococcal disease worldwide and the potential for prevention through vaccination. J Infect. 2020;81(4):483-498. doi:10.1016/j.jinf.2020.05.079 - DOI - PubMed
    1. Soeters HM, Diallo AO, Bicaba BW, et al. ; MenAfriNet Consortium . Bacterial meningitis epidemiology in five countries in the meningitis belt of sub-Saharan Africa, 2015-2017. J Infect Dis. 2019;220(220)(suppl 4):S165-S174. doi:10.1093/infdis/jiz358 - DOI - PMC - PubMed

Publication types