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. 2025 Mar;43(3):311-329.
doi: 10.1007/s40273-024-01439-y. Epub 2024 Nov 25.

Public Health Impact of Introducing a Pentavalent Vaccine Against Invasive Meningococcal Disease in the United States

Hiral Anil Shah  1   2 , Ginita Jutlla  3 , Oscar Herrera-Restrepo  4 , Jonathan Graham  5 , Katherine A Hicks  5 , Justin Carrico  6 , Mei Grace  5 , Diana E Clements  4 , Cindy Burman  4 , Woo-Yun Sohn  7 , Elise Kuylen  8 , Shahina Begum  3 , Zeki Kocaata  8
Affiliations

Public Health Impact of Introducing a Pentavalent Vaccine Against Invasive Meningococcal Disease in the United States

Hiral Anil Shah et al. Pharmacoeconomics. 2025 Mar.

Abstract

Background: Invasive meningococcal disease (IMD) is primarily associated with five Neisseria meningitidis serogroups: A, B, C, W, or Y. In the United States (US), available vaccines protect against serogroups B (MenB), A, C, W, and Y (MenACWY), and A, B, C, W, and Y (MenABCWY). The Advisory Committee on Immunization Practices is re-evaluating the adolescent meningococcal vaccination schedule with varying recommendation formats. This analysis aimed to predict which schedule could avert the most IMD cases and have the most positive public health impact (PHI).

Methods: An epidemiological model compared the 15-year PHI of vaccination schedules using MenB, MenACWY, and/or MenABCWY vaccines versus current US standard of care (SoC). Varying coverage rates reflected routine, shared clinical decision making, and risk-based recommendations. Sensitivity analyses assessed robustness of the results to different inputs/assumptions.

Results: The most positive PHI compared with SoC was observed with one dose of MenACWY at 11 years of age and two doses of MenABCWY (6 months apart) at 16 years of age, assuming routine recommendation and coverage reflecting real-world uptake of MenACWY. This strategy resulted in 123 IMD cases averted (MenB: 59, MenACWY: 64), 17 deaths prevented, 574 life-years saved, and 757 quality-adjusted life-years gained versus SoC. Eliminating MenACWY vaccination at 11 years was found to result in an additional IMD burden.

Conclusion: A routinely recommended two-dose pentavalent vaccine, with doses administered 6 months apart at 16 years of age, alongside the routinely recommended MenACWY vaccine at 11 years of age, would improve the PHI and benefits of IMD vaccination to society.

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Conflict of interest statement

Declarations. Funding: This study was sponsored by GSK. Support for third-party writing assistance for this article was funded by GSK in accordance with Good Publication Practice (GPP 2022) guidelines ( https://www.ismpp.org/gpp-2022 ). Conflict of Interest: HAS, OH-R, JC, DC, W-YS, EK, ZK: employee and shareholder of GSK; GJ: employee of and received consulting fees from GSK; JG, KAH, MG: employee of RTI Health Solutions, which received payment for this study from GSK; CB: employee and shareholder of GSK, shareholder of Pfizer; SB: employee of GSK. Data Availability Statement: The data generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Previous Presentations: Data obtained utilizing this model were presented at the European Society for Paediatric Infectious Diseases (ESPID) 2024 annual meeting. Authors’ Contributions: Substantial contributions to study conception and design: HAS, GJ, OH-R, ZK; substantial contributions to analysis or interpretation of the data: HAS, GJ, OH-R, JG, KAH, JC, MG, DC, CB, W-YS, EK, SB, ZK; drafting the article or revising it critically for important intellectual content: HAS, GJ, OH-R, JG, KAH, JC, MG, DC, CB, W-YS, EK, SB, ZK; final approval of the version of the article to be published: HAS, GJ, OH-R, JG, KAH, JC, MG, DC, CB, W-YS, EK, SB, ZK.

Figures

Fig. 1
Fig. 1
Simplified schematic of the dynamic transmission model. Simplified version of the full set of compartments used in the epidemiological component of the model, which has separate compartments for people who are protected against IMD due to receipt of MenB and/or MenACWY and people who are protected against IMD due to receipt of MenABCWY. In total, there are 36 compartments to reflect four carrier states for each of the following nine statuses in terms of protection against IMD: not protected against IMD due to serogroups A, B, C, W, or Y; protected against IMD due to serogroup B only from MenB; protected against IMD due to serogroup B only from MenABCWY; protected against IMD due to serogroups A, C, W, and Y only from MenACWY; protected against IMD due to serogroups A, C, W, and Y only from MenABCWY; protected against IMD due to serogroups A, B, C, W, and Y with serogroup B protection from MenB and serogroups A, C, W, and Y protection from MenACWY; protected against IMD due to serogroups A, B, C, W, and Y with serogroup B protection from MenB and serogroups A, C, W, and Y protection from MenABCWY; protected against IMD due to serogroups A, B, C, W, and Y with serogroup B protection from MenABCWY and serogroups A, C, W, and Y protection from MenACWY; protected against IMD due to serogroups A, B, C, W, and Y from MenABCWY. The likelihood of carriage is the same between all susceptible compartments. Transmission of meningococcal carriage is modeled dynamically; however, vaccination is assumed not to affect carriage. Therefore, carriage stays essentially constant and the model functions like a static model. IMD invasive meningococcal disease, MenABCWY meningococcal serogroups A, B, C, W, and Y, MenACWY meningococcal serogroups A, C, W, and Y, MenB meningococcal serogroup B
Fig. 2
Fig. 2
Estimated number of IMD cases averted over 15 years in the US by intervention strategy versus the SoC (QQBB; base-case analysis). Summary diagram of all intervention strategies and corresponding numbers of additional IMD cases incurred or IMD cases averted. aExact timings of vaccination per intervention strategy are presented in Supplementary Table 1 (see ESM). B meningococcal serogroup B vaccine, IMD invasive meningococcal disease, MenACWY meningococcal serogroups A, C, W, and Y, MenB meningococcal serogroup B, N no vaccination, P meningococcal serogroups A, B, C, W, and Y vaccine, PHI public health impact, Q meningococcal serogroups A, C, W, and Y vaccine, SoC standard of care (QQBB)
See this image and copyright information in PMC

References

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