Impact of meningococcal ACWY conjugate vaccines on pharyngeal carriage in adolescents: evidence for herd protection from the UK MenACWY programme. (December 2022)

• Record Type: Journal Article
• Authors: Carr, Jeremy P.; MacLennan, Jenny M.; Plested, Emma; Bratcher, Holly B.; Harrison, Odile B.; Aley, Parvinder K.; Bray, James E.; Camara, Susana; Rodrigues, Charlene M.C.; Davis, Kimberly; Bartolf, Angela; Baxter, David; Cameron, J. Claire; Cunningham, Richard; Faust, Saul N.; Fidler, Katy; Gowda, Rohit; Heath, Paul T.; Hughes, Stephen; Khajuria, Sujata; Orr, David; Raman, Mala; Smith, Andrew; Turner, David P.J.; Whittaker, Elizabeth; Williams, Christopher J.; Zipitis, Christos S.; Pollard, Andrew J.; Oliver, Jennifer; Morales-Aza, Begonia; Lekshmi, Aiswarya; Clark, Stephen A.; Borrow, Ray; Christensen, Hannah; Trotter, Caroline; Finn, Adam; Maiden, Martin C.; Snape, Matthew D.; Jolley, Keith A.; Ford, Karen; Roberts, Hannah; Palmer, Karen; Suggitt, Debbie; Pemberton, Nicola; Ray, Samantha; Wootton, Mandy; Ladhani, Shamez N.; Owens, Daniel; Cathie, Katrina; Royal, Simon; Oldfield, Neil; Ure, Roisin; Richards, Jennifer; Ramsay, Rebecca; Hill, Samantha Thomson; Duale, Kaltun;
• Is Part Of: Clinical microbiology and infection. Volume 28:Number 12(2022)
• Page Start: 1649.e1
• Page End: 1649.e8
• Publication Date: 2022-12
• Subjects: Meningococcal Disease -- ACWY -- Conjugate vaccines -- Pharyngeal carriage -- Adolescents -- Neisseria meningitidis -- Herd immunity; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2022.07.004
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: Objective: Serogroup W and Y invasive meningococcal disease increased globally from 2000 onwards. Responding to a rapid increase in serogroup W clonal complex 11 (W:cc11) invasive meningococcal disease, the UK replaced an adolescent booster dose of meningococcal C conjugate vaccine with quadrivalent MenACWY conjugate vaccine in 2015. By 2018, the vaccine coverage in the eligible school cohorts aged 14 to 19 years was 84%. We assessed the impact of the MenACWY vaccination programme on meningococcal carriage. Methods: An observational study of culture-defined oropharyngeal meningococcal carriage prevalence before and after the start of the MenACWY vaccination programme in UK school students, aged 15 to 19 years, using two cross-sectional studies: 2014 to 2015 "UKMenCar4" and 2018 "Be on the TEAM" (ISRCTN75858406). Results: A total of 10 625 participants preimplementation and 13 438 postimplementation were included. Carriage of genogroups C, W, and Y (combined) decreased from 2.03 to 0.71% (OR 0.34 [95% CI 0.27–0.44], p < 0.001). Carriage of genogroup B meningococci did not change (1.26% vs 1.23% [95% CI 0.77–1.22], p = 0.80) and genogroup C remained rare (n = 7/10 625 vs 17/13 438, p = 0.135). The proportion of serogroup positive isolates (i.e . those expressing capsule) decreased for genogroup W by 53.8% (95% CI -5.0 – 79.8, p = 0.016) and for genogroup Y by 30.1% (95% CI 8.946·3, p = 0.0025). Discussion: The UK MenACWY vaccination programme reduced carriage acquisition of genogroup and serogroup Y and W meningococci and sustained low levels of genogroup C carriage. These data support the use of quadrivalent MenACWY conjugate vaccine for indirect (herd) protection. Graphical abstract: Image 1