Impact of meningococcal ACWY conjugate vaccines on pharyngeal carriage in adolescents: evidence for herd protection from the UK MenACWY programme

Carr, J. P. et al. (2022) Impact of meningococcal ACWY conjugate vaccines on pharyngeal carriage in adolescents: evidence for herd protection from the UK MenACWY programme. Clinical Microbiology and Infection, 28(12), 1649.e1-1649.e8. (doi: 10.1016/j.cmi.2022.07.004) (PMID:35840033)

Abstract

Objectives: Serogroup W and Y invasive meningococcal disease (IMD) increased globally from 2000 onwards. Responding to a rapid increase in serogroup W clonal complex 11 (W:cc11) IMD, the UK replaced an adolescent booster dose of meningococcal C conjugate vaccine with quadrivalent MenACWY conjugate vaccine in 2015. By 2018, vaccine coverage in the eligible school cohorts aged 14-19 years-old was 84%. We assessed the impact of the MenACWY vaccination programme on meningococcal carriage. Methods: An observational study of culture-defined oropharyngeal meningococcal carriage prevalence before and after the start of the MenACWY vaccination programme in UK school students, aged 15–19 years, using two cross-sectional studies: 2014–15 “UKMenCar4” and 2018 “Be on the TEAM” (ISRCTN75858406). Results: A total of 10625 participants pre-implementation and 13434 post-implementation were included. Carriage of genogroups C, W, and Y (combined) decreased from 2·03% to 0·71% (OR 0·34 [95% CI 0·27–0·44] p<0·001). Carriage of genogroup B meningococci did not change (1·26% vs 1·23% [95% CI 0.77–1.22] p=0·80) and genogroup C remained rare (n = 7/10625 vs 17/13488, p=0·135). The proportion of serogroup positive isolates, i.e., those expressing capsule, decreased for genogroup W by 53.8% (95% CI -5.0%–79.8%, p=0·016) and for genogroup Y by 30·1% (95% CI 8·9%–46·3%, p=0·0025). Conclusions: The UK MenACWY vaccination programme reduced carriage acquisition of genogroup and serogroup Y and W meningococci and sustained low levels of genogroup C carriage. These data support the use of quadrivalent MenACWY conjugate vaccine for indirect (herd) protection.

• Item Type: Articles
• Additional Information: This study was funded by the Wellcome Trust and the National Institute for Health Research (NIHR) Policy Research Programme (PR-ST-0915-10015 and PR-R18-0117-21001).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Smith, Professor Andrew
• Authors: Carr, J. P., MacLennan, J. M., Plested, E., Bratcher, H. B., Harrison, O. B., Aley, P. K., Bray, J. E., Camara, S., Rodrigues, C. M.C., Davis, K., Bartolf, A., Baxter, D., Cameron, J. C., Cunningham, R., Faust, S. N., Fidler, K., Gowda, R., Heath, P. T., Hughes, S., Khajuria, S., Orr, D., Raman, M., Smith, A., Turner, D. P., Whittaker, E., Williams, C. J., Zipitis, C. S., Pollard, A. J., Oliver, J., Morales-Aza, B., Lekshmi, A., Clark, S. A., Borrow, R., Christensen, H., Trotter, C., Finn, A., Maiden, M. C.J., and Snape, M. D.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: Clinical Microbiology and Infection
• Publisher: Elsevier
• ISSN: 1198-743X
• ISSN (Online): 1469-0691
• Published Online: 13 July 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Clinical Microbiology and Infection 28(12): 1649.e1-1649.e8
• Publisher Policy: Reproduced under a Creative Commons License