title: Impact of an Immunization Campaign to Control an Increased Incidence of Serogroup B Meningococcal Disease in One Region of Quebec, Canada.
abstract: Invasive meningococcal disease (IMD) incidence increased in Quebec, starting in 2003, and was caused by a serogroup B sequence type 269 clone. The Saguenay-Lac-Saint-Jean (SLSJ) region was particularly affected with a rate of 3.4 per 100000 person-years in 2006-2013. In May 2014, an immunization campaign was launched in SLSJ, using the 4-component protein-based meningococcal vaccine (MenB-4C). We aimed to evaluate the impact of the campaign 2 years after its initiation.
  
  
  
  Immunization registry data and serogroup B invasive meningococcal disease (B-IMD) cases notified to public health authorities and confirmed by culture or polymerase chain reaction from July 1996 to December 2016 were analyzed, including a multivariate Poisson regression model of incidence rates.
  
  
  
  By the end of the campaign, 82% of the 59000 targeted SLSJ residents between 2 months and 20 years of age had been immunized. Following the initiation of the campaign, no B-IMD case occurred among vaccinees, whereas 2 cases were reported among unvaccinated adult SLSJ residents, and a third case in an unvaccinated child who had stayed in the region during the week prior to disease onset, in 2015. B-IMD incidence decreased in all other regions in the years 2015-2016 but sporadic cases continued to occur. A multivariate analysis showed a significant effect of the campaign in the SLSJ region (relative B-IMD risk: 0.22; P = .04).
  
  
  
  Results suggest a high level of protection provided by MenB-4C following mass vaccination at regional level. This, along with reassuring safety data, supports the current recommendations for MenB-4C use for controlling outbreaks caused by clones covered by the vaccine.
authors.affiliation: Department of Social and Preventive Medicine, Laval University, Quebec, Canada.|Division of Biological Risks and Occupational Health, Quebec National Public Health Institute ( Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec ), Quebec, Canada.|Quebec University Hospital Research Centre, Quebec City, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: De Wals
authors.affiliation: Quebec University Hospital Research Centre, Quebec City, Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Deceuninck
authors.affiliation: Quebec Public Health Laboratory, Quebec National Public Health Institute (Laboratoire de santé publique du Québec), Sainte-Anne-de-Bellevue, Quebec, Canada.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Lefebvre
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada.
authors.forename: Raymond
authors.initials: R
authors.lastname: Tsang
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada.
authors.forename: Dennis
authors.initials: D
authors.lastname: Law
authors.affiliation: Division of Biological Risks and Occupational Health, Quebec National Public Health Institute ( Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec ), Quebec, Canada.
authors.forename: Gaston
authors.initials: G
authors.lastname: De Serres
authors.affiliation: Division of Biological Risks and Occupational Health, Quebec National Public Health Institute ( Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec ), Quebec, Canada.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Gilca
authors.affiliation: Division of Biological Risks and Occupational Health, Quebec National Public Health Institute ( Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec ), Quebec, Canada.
authors.forename: Rodica
authors.initials: R
authors.lastname: Gilca
authors.affiliation: Division of Biological Risks and Occupational Health, Quebec National Public Health Institute ( Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec ), Quebec, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Boulianne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017589:Immunization Programs; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000008:administration & dosage*; D008875:Middle Aged; D038541:Neisseria meningitidis, Serogroup B / Q000302:isolation & purification*; D011792:Quebec / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C570015:4CMenB vaccine; D022401:Meningococcal Vaccines
keywords: immunization campaign; outbreak; serogroup B meningococcal disease; meningococcal vaccine