Estimation of the Impact of Meningococcal Serogroup C Universal Vaccination in Italy and Suggestions for the Multicomponent Serogroup B Vaccine Introduction.
In Italy, the meningococcal C conjugate vaccine (MenC) has been offered in most regions since 2009-2010. The incidence of Invasive Meningococcal Disease (IMD) was 0.25 confirmed cases per 100,000 in 2011, but this may be considerably underestimated due to underdetection and underreporting. This study estimates the impact of the MenC universal vaccination (URV) in the Puglia region by assessing the completeness of three registration sources (notifications, hospitalizations, and laboratory surveillance). Capture-recapture analysis was performed on meningococcal meningitis collected within 2001-2013. The impact of URV among ≤ 18-year-olds was assessed by attributable benefit, preventable fraction, and prevented fraction. Missed opportunities for vaccination were evaluated from surveillance of IMD. The proportion of detected serogroups was applied to the number of IMD in the postvaccination period to compute the cases still preventable. The sensitivity of the three sources was 36.7% (95% CI: 17.5%-57.9%) and registrations lost nearly 28 cases/year in the period. Attributable benefit of URV was -0.5 cases per 100,000, preventable fraction 19.6%, and prevented fraction 31.3%. Three adolescent cases missed the opportunity to be vaccinated. The multicomponent serogroup B meningococcal vaccine has the potential to further prevent at least three other cases/year. Vaccination strategy against serogroup B together with existing programmes makes IMD a 100% vaccine-preventable disease.
Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 20, 71122 Foggia, Italy.
Domenico
D
Martinelli
Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 20, 71122 Foggia, Italy.
Francesca
F
Fortunato
Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 20, 71122 Foggia, Italy.
Maria Giovanna
MG
Cappelli
Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 20, 71122 Foggia, Italy.
Vanessa
V
Cozza
Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 24, 70124 Bari, Italy.
Maria
M
Chironna
Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 20, 71122 Foggia, Italy.
Rosa
R
Prato
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000276:immunology*; D038541:Neisseria meningitidis, Serogroup B / Q000276:immunology*; D038542:Neisseria meningitidis, Serogroup C / Q000276:immunology*; D011159:Population Surveillance; D012044:Regression Analysis; D014611:Vaccination
D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine