title: Preventing secondary cases of invasive meningococcal capsular group B (MenB) disease using a recently-licensed, multi-component, protein-based vaccine (Bexsero(®)).
abstract: OBJECTIVE
  To assess the potential use of a protein-based meningococcal group B (MenB) vaccine (Bexsero(®)) in addition to antibiotic chemoprophylaxis for preventing secondary cases.
  
  
  METHODS
  Published studies on the risk of secondary meningococcal infections were used to estimate the numbers needed to vaccinate (NNV) with Bexsero(®) to prevent a secondary case in household and educational settings.
  
  
  RESULTS
  Most secondary cases occur within a few days of diagnosis in the index case. Unlike conjugate vaccines, early protection offered after a single dose of Bexsero(®) is likely to be low, particularly in young children, who are at higher risk of secondary infection. NNV was dependent on predicted meningococcal strain coverage, estimated onset of protection after one Bexsero(®) dose and estimated vaccine efficacy. Even in the most favourable scenario where we assume the vaccine is administered within 4 days of the index case and prevents 90% of cases occurring after 14 days, the NNV for household contacts was >1000. NNV in educational settings was much higher.
  
  
  CONCLUSIONS
  The estimated NNV should be taken into account when deciding policy to recommend Bexsero(®) for close contacts of single cases in household or educational settings. Bexsero(®) may have a protective role in clusters and outbreaks.
authors.affiliation: Immunisation Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom; Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, United Kingdom. Electronic address: shamez.ladhani@phe.gov.uk.
authors.forename: Shamez N
authors.initials: SN
authors.lastname: Ladhani
authors.affiliation: South East London Health Protection Team, Public Health England, 1 Lower Marsh, London SE1 7NT, United Kingdom.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cordery
authors.affiliation: Immunisation Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom.
authors.forename: Sema
authors.initials: S
authors.lastname: Mandal
authors.affiliation: School of Social and Community Medicine, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom.
authors.forename: Hannah
authors.initials: H
authors.lastname: Christensen
authors.affiliation: Immunisation Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Campbell
authors.affiliation: Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester M13 9WZ, United Kingdom.
authors.forename: Ray
authors.initials: R
authors.lastname: Borrow
authors.affiliation: Immunisation Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Ramsay
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D017589:Immunization Programs; D008589:Meningococcal Infections / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D038541:Neisseria meningitidis, Serogroup B / Q000276:immunology*; D061366:Numbers Needed To Treat
chemical_list: C570015:4CMenB vaccine; D022401:Meningococcal Vaccines
keywords: Chemoprophylaxis; Contacts; Meningococcal B vaccine; Outbreaks; Prevention