Exploiting real-time genomic surveillance data to assess 4CMenB meningococcal vaccine performance in Scotland, 2015 to 2022

Rodrigues, C.M.C., MacDonald, L., Ure, R., Smith, A. , Cameron, J.C. and Maiden, M.C.J. (2023) Exploiting real-time genomic surveillance data to assess 4CMenB meningococcal vaccine performance in Scotland, 2015 to 2022. mBio, 14(2), e00499-23. (doi: 10.1128/mbio.00499-23) (PMID:37036356) (PMCID:PMC10127610)

Abstract

The United Kingdom implemented the first national infant immunization schedule for the meningococcal vaccine 4CMenB (Bexsero) in September 2015, targeting serogroup B invasive meningococcal disease (IMD). Bexsero contains four variable subcapsular proteins, and postimplementation IMD surveillance was necessary, as nonhomologous protein variants can evade Bexsero-elicited protection. We investigated postimplementation IMD cases reported in Scotland from 1 September 2015 to 30 June 2022. Patient demographics and vaccination status were combined with genotypic data from the causative meningococci, which were used to assess vaccine coverage with the meningococcal deduced vaccine antigen reactivity (MenDeVAR) index. Eighty-two serogroup B IMD cases occurred in children >5 years of age, 48 (58.5%) of which were in unvaccinated children and 34 (41%) of which were in children who had received ≥1 Bexsero dose. Fifteen of the 34 vaccinated children had received one dose, 17 had received two doses, and two had received three doses. For 39 cases, meningococcal sequence data were available, enabling MenDeVAR index deductions of vaccine-preventable (M-VP) and non-vaccine-preventable (M-NVP) meningococci. Notably, none of the 19 of the children immunized ≥2 times had IMD caused by M-VP meningococci, with 2 cases of NVP meningococci, and no deduction possible for 17. Among the 15 children partially vaccinated according to schedule (1 dose), 7 were infected by M-VP meningococci and 2 with M-NVP meningococci, with 6 for which deductions were not possible. Of the unvaccinated children with IMD, 40/48 were ineligible for vaccination and 20/48 had IMD caused by M-VP meningococci, with deductions not being possible for 14 meningococci.

• Item Type: Articles
• Additional Information: This work was part of the NHS clinical care pathways for meningococcal disease in Scotland, UK, Wellcome Trust grant 218205/Z/19/Z to M.C.J.M., and Thrasher Research Fund grant 15512 to C.M.C.R.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Smith, Professor Andrew
• Authors: Rodrigues, C.M.C., MacDonald, L., Ure, R., Smith, A., Cameron, J.C., and Maiden, M.C.J.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: mBio
• Publisher: American Society for Microbiology
• ISSN: 2161-2129
• ISSN (Online): 2150-7511
• Published Online: 10 April 2023
• Copyright Holders: Copyright © 2023 Rodrigues et al.
• First Published: First published in mBio 14(2):e00499-23
• Publisher Policy: Reproduced under a Creative Commons License