Predicted coverage by 4CMenB vaccine against invasive meningococcal disease cases in the Netherlands. Issue 49 (17th November 2020)

• Record Type: Journal Article
• Authors: Freudenburg-de Graaf, W.; Knol, M.J.; van der Ende, A.
• Is Part Of: Vaccine. Volume 38:Issue 49(2020)
• Page Start: 7850
• Page End: 7857
• Publication Date: 2020-11-17
• Subjects: Neisseria meningitidis -- 4CMenB vaccine -- Whole-genome sequencing -- gMATS; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2020.10.008
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: 4CMenB vaccine coverage of invasive meningococcal isolates was estimated by gMATS. 73% of all serogroup B isolates were estimated to be covered by 4CMenB vaccine. The degree of vaccine coverage varied by clonal complex and age. Surveillance of circulating strains is essential for predicting vaccine coverage. Abstract: Neisseria meningitidis serogroup B is a major cause of invasive meningococcal disease in Europe. In the absence of a conjugate serogroup B vaccine, a subcapsular 4CMenB vaccine was developed. Data on 4CMenB vaccine efficacy is still limited. Recently, genomic MATS (Meningococcal Antigen Typing System) was developed as a tool to predict strain coverage, using vaccine antigens sequence data. We characterized all invasive meningococcal isolates received by the Netherlands Reference Laboratory for Bacterial Meningitis (NRLBM) in two epidemiological years 2017–2019 using whole-genome sequencing and determined serogroup, clonal complex (cc) and estimated 4CMenB vaccine coverage by gMATS. Of 396 cases of invasive meningococcal disease, corresponding to an incidence of 1.22 cases/10 5 inhabitants, 180 (45%) were serogroup W, 155 (39%) serogroup B, 46 (12%) serogroup Y, 10 (3%) serogroup C, 2 non-groupable (0.5%) and 3 (0.7%) unknown. The incidence was the highest among 0–4 years olds (4 cases/10 5 inhabitants), and 57/72 (79%) of these cases were serogroup B. Serogroup W predominated among persons 45 years of age or older with 110/187 (59%) cases. Serogroup B isolates comprised 11 different clonal complexes, with 103/122 (84%) isolates belonging to 4 clonal complexes: cc32, cc41/44, cc269 and cc213. In contrast, serogroup W isolates were genetically similar with 95% belonging to cc11. Of 122 serogroup B isolates, 89 (73%; 95% CI: 64–80%) were estimated to be covered by 4CMenB and the degree of coverage varied largely by clonal complex and age. Among the 0–4 year olds, 25 of 43 (58%; 95% CI: 43–72%) MenB isolates were estimated to be covered. Since the coverage of the 4CMenB vaccine is dependent on circulating clonal complexes, our findings emphasize the need for surveillance of circulating meningococcal strains. In addition, estimation of age specific coverage is relevant to determine the right target age group for vaccination.