Invasive serogroup B meningococci in England following three years of 4CMenB vaccination – First real-world data. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Lucidarme, Jay; Bai, Xilian; Lekshmi, Aiswarya; Clark, Stephen A.; Willerton, Laura; Ribeiro, Sonia; Campbell, Helen; Serino, Laura; De Paola, Rosita; Holland, Ann; Louth, Jennifer; Ramsay, Mary E.; Ladhani, Shamez N.; Borrow, Ray
• Is Part Of: Journal of infection. Volume 84:Issue 2(2022)
• Page Start: 136
• Page End: 144
• Publication Date: 2022-02
• Subjects: Meningococcal disease -- Serogroup B -- 4CMenB -- Meningococcal antigen typing system -- MATS -- Vaccine coverage -- England; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2021.11.015
• Languages: English
• ISSNs: 0163-4453

Abstract

Highlights: 4CMenB reduces disease due to strains with cross-reactive antigen variants. No increase in absolute numbers of cases due to poorly covered strains was observed. Further evidence of the importance of a booster for NadA-mediated protection. Further evidence for waning of pora-mediated immunity pre-booster. Abstract: Objectives: In 2015 the UK became the first country to implement the meningococcal B (MenB) vaccine, 4CMenB, into the national infant program. 4CMenB is expected to cover meningococci expressing sufficient levels of cross-reactive proteins. This study presents clonal complex, 4CMenB antigen genotyping, and 4CMenB coverage data for all English invasive MenB isolates from 2014/15 (1 year pre-vaccine) through 2017/18 and compares data from vaccinated and unvaccinated ≤3 year olds. Methods: Vaccine coverage of all invasive MenB isolates from 2014/15 to 2017/18 ( n = 784) was analysed using the Meningococcal Antigen Typing System. Genotyping utilised the Meningococcus Genome Library. Results: Among ≤3 year olds, proportionally fewer cases in vaccinees (1, 2 or 3 doses) were associated with well-covered strains e.g. cc41/44 (20.5% versus 36.4%; P <0.01) and antigens e.g. PorA P1.4 (7.2% versus 17.3%; P = 0.02) or fHbp variant 1 peptides (44.6% vs 69.1%; P <0.01). Conversely, proportionally more cases in vaccinees were associated with poorly-covered strains e.g. cc213 (22.9% versus 9.6%; P <0.01) and antigens e.g. variant 2 or 3 fHbp peptides (54.2% versus 30.9%; P <0.01). Conclusions: 4CMenB reduces disease due to strains with cross-reactive antigen variants. No increase in absolute numbers of cases due to poorly covered strains was observed in the study period.