title: Impact of vaccination during an epidemic of serogroup C meningococcal disease in Salvador, Brazil.
abstract: To combat rising incidence of serogroup C meningococcal disease in the city of Salvador, Brazil, the Bahia state immunization program initiated routine childhood immunization with meningococcal C conjugate vaccine (MenC) in February 2010, followed by mass MenC vaccination of city residents 10-24 years of age from May through August 2010. We analyzed trends in incidence of reported cases of meningococcal disease and serogroup distribution among meningococcal isolates identified in hospital-based surveillance in Salvador from January 2000 to December 2011 and estimated vaccine effectiveness using the screening method. Annual incidence of serogroup C meningococcal disease increased from 0.1 cases per 100,000 population during 2000-2006 to 2.3 in 2009 and 4.1 in 2010, before falling to 2.0 per 100,000 in 2011. Estimated coverage of mass vaccination reached 80%, 67% and 41% among 10-14, 15-19 and 20-24 year olds, respectively. Incidence in 2011 was significantly lower than average rates in 2008-2009 among children <5 years, but reductions among 10-24 year olds were not significant. Among 10-24 year olds, a single dose of MenC vaccine was 100% effective (95% confidence interval, 79-100%) against serogroup C meningococcal disease. Low coverage in the population targeted for mass vaccination may have limited impact on ongoing transmission of serogroup C meningococcal disease despite high vaccine effectiveness.
authors: Gonçalo Moniz Research Center, Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador, Brazil.
authors: Cristiane W
authors: CW
authors: Cardoso
authors: Lorene Louise Silva
authors: LL
authors: Pinto
authors: Mitermayer G
authors: MG
authors: Reis
authors: Brendan
authors: B
authors: Flannery
authors: Joice N
authors: JN
authors: Reis
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D032541:Mass Vaccination; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000008:administration & dosage*; D009345:Neisseria meningitidis / Q000472:pathogenicity; D015397:Program Evaluation; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine