title: Introducing vaccination against serogroup B meningococcal disease: an economic and mathematical modelling study of potential impact.
abstract: BACKGROUND
  Meningococcal disease remains an important cause of morbidity and mortality worldwide. The first broadly effective vaccine against group B disease (which causes considerable meningococcal disease in Europe, the Americas and Australasia) was licensed in the EU in January 2013; our objective was to estimate the potential impact of introducing such a vaccine in England.
  
  
  METHODS
  We developed two models to estimate the impact of introducing a new 'MenB' vaccine. The cohort model assumes the vaccine protects against disease only; the transmission dynamic model also allows the vaccine to protect against carriage (accounting for herd effects). We used these, and economic models, to estimate the case reduction and cost-effectiveness of a number of different vaccine strategies.
  
  
  RESULTS
  We estimate 27% of meningococcal disease cases could be prevented over the lifetime of an English birth cohort by vaccinating infants at 2,3,4 and 12 months of age with a vaccine that prevents disease only; this strategy could be cost-effective at £9 per vaccine dose. Substantial reductions in disease (71%) can be produced after 10 years by routinely vaccinating infants in combination with a large-scale catch-up campaign, using a vaccine which protects against carriage as well as disease; this could be cost-effective at £17 per vaccine dose.
  
  
  CONCLUSIONS
  New 'MenB' vaccines could substantially reduce disease in England and be cost-effective if competitively priced, particularly if the vaccines can prevent carriage as well as disease. These results are relevant to other countries, with a similar epidemiology to England, considering the introduction of a new 'MenB' vaccine.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK. hannah.christensen@bristol.ac.uk
authors.forename: Hannah
authors.initials: H
authors.lastname: Christensen
authors.forename: Matthew
authors.initials: M
authors.lastname: Hickman
authors.forename: W John
authors.initials: WJ
authors.lastname: Edmunds
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Trotter
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D006801:Humans; D007223:Infant; D008297:Male; D008390:Markov Chains; D008589:Meningococcal Infections / Q000191:economics* / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000008:administration & dosage* / Q000191:economics* / Q000276:immunology; D018803:Models, Economic; D015233:Models, Statistical; D038541:Neisseria meningitidis, Serogroup B / Q000276:immunology*; D014611:Vaccination / Q000191:economics; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000191:economics / Q000276:immunology
chemical_list: D022401:Meningococcal Vaccines; D018074:Vaccines, Conjugate