Optimizing strategies for meningococcal C disease vaccination in Valencia (Spain)

BACKGROUND: Meningococcal C (MenC) conjugate vaccines have controlled invasive diseases associated with this serogroup in countries where they are included in National Immunization Programs and also in an extensive catch-up program involving subjects up to 20 years of age. Catch-up was important, no...

Descripción completa

Detalles Bibliográficos
Autores: Pérez-Breva, Lina, Villanueva, Rafael J, Villanueva-Oller, Javier, Acedo, Luis, Santonja, Francisco, Moraño, José A, Abad, Raquel, Vazquez-Moreno, Julio Alberto, Díez-Domingo, Javier
Tipo de recurso: artículo
Fecha de publicación:2014
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/7135
Acceso en línea:http://hdl.handle.net/20.500.12105/7135
Access Level:acceso abierto
Palabra clave:Adolescent
Adult
Child
Child, Preschool
Female
Humans
Male
Meningococcal Infections
Meningococcal Vaccines
Middle Aged
Spain
Vaccination
Young Adult
Immunization Programs
Descripción
Sumario:BACKGROUND: Meningococcal C (MenC) conjugate vaccines have controlled invasive diseases associated with this serogroup in countries where they are included in National Immunization Programs and also in an extensive catch-up program involving subjects up to 20 years of age. Catch-up was important, not only because it prevented disease in adolescents and young adults at risk, but also because it decreased transmission of the bacteria, since it was in this age group where the organism was circulating. Our objective is to develop a new vaccination schedule to achieve maximum seroprotection in these groups. METHODS: A recent study has provided detailed age-structured information on the seroprotection levels against MenC in Valencia (Spain), where vaccination is routinely scheduled at 2 months and 6 months, with a booster dose at 18 months of age. A complementary catch-up campaign was also carried out in n for children from 12 months to 19 years of age. Statistical analyses of these data have provided an accurate picture on the evolution of seroprotection in the last few years. RESULTS: An agent-based model has been developed to study the future evolution of the seroprotection histogram. We have shown that the optimum strategy for achieving high protection levels in all infants, toddlers and adolescents is a change to a 2 months, 12 months and 12 years of age vaccination pattern. If the new schedule were implemented in January 2014, high-risk subjects between 15-19 years of age would have very low seroprotection for the next 6 years, thereby threatening the program. CONCLUSIONS: High protection levels and a low incidence of meningococcal C disease can be achieved in the future by means of a cost-free change in vaccination program. However, we recommend a new catch-up program simultaneous to the change in regular vaccination program.